Assessing Preference and Stability of Preference for Individuals with Neurocognitive Disorder

Poor engagement can lead to a reduced quality of life for individuals with neurocognitive disorder (NCD). Research on determining preference and increasing engagement with this population is limited. The purpose of this study was to compare the accuracy of four preference assessment formats in identifying preferred activities and predicting engagement for six females with NCD and to measure the stability of preference and engagement over time. We compared the predictability of single-stimulus(SS) verbal and multimedia assessments, caregiver ranking (CR) assessments, and multiple-stimulus without-replacement (MSWO) assessments. Participants responded consistently on SS assessments, but we noted inconsistencies between the CR and MSWO assessments. SS assessments predicted engagement during engagement analyses, but rank-order assessments did not predict engagement for moderately ranked activities. The rank-order assessments predicted engagement for highly ranked activities for most participants and for low-ranked activities for two participants. We also evaluated the stability of preferences and engagement over time. Participants responded consistently on SS assessments and inconsistently on MSWO assessments across time. SS assessments consistently predicted engagement during engagement analyses for five participants, but when activity rank is considered, the MSWO was inconsistent in predicting engagement across time for most participants. These results suggest that SS assessments may be useful for identifying preferred activities and engagement, and preferences may remain stable for some individuals with NCD.