Assessing preferences of individuals with acquired brain injury using alternative stimulus modalities

To extend previous research on alternative stimulus preference assessment (SPA) modalities to individuals with severe ABI by evaluating the effects of pictorial, verbal and tangible item presentation.

Paired-stimulus procedure used for SPA sessions with the order of modalities counterbalanced across participants. Reinforcer assessments (RAs) were experimentally evaluated using an alternating treatments design. A progressive-ratio procedure was used for reinforcer assessment (RA) sessions.

Six adults with severe ABI. The Assessment of Basic Learning Abilities was conducted to assess discrimination skills; the Reinforcer Assessment for Individuals with Severe Disabilities structured interview was administered to identify items for subsequent evaluations. Three SPA sessions-one of each stimulus modality-were conducted with each participant. Subsequent RAs were conducted using the stimuli ranked as the most highly preferred for each participant.

Each modality identified a different food item with the highest selection percentage for three participants, while three participants had highly consistent SPA results. Subsequent RAs demonstrated that all modalities made valid predictions of foods that would function as reinforcers for programming.

Use of the different direct-observation methods to identify reinforcers for reductive and skill acquisition programming would likely be a useful addition to rehabilitation settings.