Innovation of a reinforcer preference assessment with the difficult to test.

In this study, we continued evaluation of a two-choice preference assessment aimed at identifying a hierarchy of reinforcers for individuals with only one voluntary motor sequence-closing and releasing an adaptive switch. We assessed preferences among types of sensory stimulation in 6 adults with multiple profound impairments using concurrent synchronous reinforcement contingencies. Pre-experimental assessments with various types of stimulation led to the selection of music (A), vibration (B), and either olfactory or visual stimulation (C) as the 3 modalities for continued testing. Each participant received opportunities for familiarization with each type of stimulation in blocks of six 20-min sessions in which the closure of an adaptive switch produced the stimulation for as long as the switch remained closed. Next, participants could choose between pairs of types of stimulation in blocks of 12 sessions. In the first 6 of the 12 sessions, switch closure activated one type (e.g., A) and switch release activated the contrasted type (e.g., B). In the second 6 sessions, the contingencies were reversed. Two additional 12-session blocks completed all possible contrasts (AB, BC and AC). Four of the 6 participants showed distinct preferences in these two-choice tests with indications of preference hierarchies. The results demonstrate a method for obtaining indications of relative preference for potentially reinforcing stimuli from individuals without communication and without the abilities to act on more than one switch.