Preference and Person-Centered Services

Preference, or choice, is the allocation of responding to one among many alternative responses (Fisher & Mazur, 1997). Changing preferences may yield access to a larger variety of reinforcing items, which may be beneficial, for example, to individuals who have developmental disabilities, and who generally have a narrow array of preferred stimuli or activities that can be used as reinforcers in the learning process (Hanley, Iwata, Roscoe, Thompson & Lindberg, 2003). Changing preferences may also lead to better quality of work life (Green, Reid, Passante & Canipe, 2008), and increase access to work-related “natural reinforcement” (Daniels & Daniels, 2006).

While there is evidence that several procedures effectively change preference, in applied settings it is important to use interventions that will require the least amount of complexity. For example, Hanley et al. (2003a) showed that response-restriction—limiting access to a preferred item below baseline levels—could be used to temporarily affect the preference of three adults with developmental disabilities for vocational and leisure tasks. The activities selected were ones reported to be preferred, available in the home or workshop area, could be placed on a table, and with which the participants could interact independently. Interaction with the activities was measured using 5-s partial interval recording, within a 5-min session. Preference for an activity was measured following four rules that aimed at determining which activity was the one in which a participant would engage for the largest percentage of intervals. Restricting access to the preferred activities led to an increase in engagement with the less preferred ones.

Changes in the way billing is currently done for services provided for adults with intellectual or developmental disabilities (IDD) now recommend a person-centered approach and services provided in the Home and Community-Based Settings (HCBS), which means more integration of the person with IDD into mainstream society. Understanding preferences and ways in which one can assess, and increase preference for one task or decrease it for another can be valuable tools in providing person-centered care that widens the possibility of inclusion and adaptability in novel settings.  Behavior analysts are well equipped to help in developing interventions and program that can lead to more successful job placements, where an individual can have his skills set paired with preferred activities. With a little creativity, a lot can be done.

How do you prepare the people you serve for integration and independence? What roles do preference assessment and programmed preference change take in your practice? Comment below and share your experience with us.

References

Daniels, A., & Daniels, J. (2006). Performance Management: Changing Behavior that Drives Organizational Effectiveness. Atlanta, GA: Performance Management Publications.

Fisher, W. W., & Mazur, J. E. (1997). Basic and applied research on choice responding. Journal of Applied Behavior Analysis, 30, 387-410.

Green, C. W., Reid, D. H., Passante, S., Canipe, V. (2008). Changing less-preferred duties to more-preferred: a potential strategy for improving supervisor work enjoyment. Journal of Organizational Behavior Management, 28, 90-109.

Hanley, G. P., Iwata, B. A., Lindberg, J. S., & Conners, J. (2003). Response-restriction analysis: assessment of activity preferences. Journal of Applied Behavior Analysis, 36, 47-58.

Hanley, G., Iwata, B., Roscoe, E. M., Thompson, R. H., & Lindberg, J. S. (2003). Response- restriction analysis: II. alteration of activity preferences. Journal of Applied Behavior Analysis, 36,  59-76.

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