Evaluation of Preference and Subsequent Stimulus Engagement Among Older Adults with Dementia

Older adults often engage in few activities, for short periods of time, and typically engage with one item without switching to other items. The purposes of this study were (a) to further evaluate the MSWO preference assessment as well as the utility of the brief free-operant presentation method with older adults with dementia to identify preferred activities, (b) to determine if non-variable selection during a free operant preference assessment was due to repetitive behavior through concurrent engagement analyses, and (c) to determine the reinforcing effectiveness of stimuli identified via the single-array MSWO and free operant preference assessments through a reinforcer assessment. The results suggest that for 6 of the 7 participants the free operant was a better predictor for time allocation and engagement with a preferred activity. The results suggest that the single array MSWO was not as predictive of time allocation or engagement as the free operant, resulting in false positives. The results also suggest that individuals not switching items may be a result of the environment rather than a symptom of dementia (repetitive behavior), showing that it was not that the participants could not switch, but rather that they chose not to switch