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Page 1: Ripley 2011 Evaluation of Pref Formats

Amanda Ripley, MS BCBAImagine! Behavioral Health Services

Paula K. Davis, Ph.D.Southern Illinois University

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2008: 38.7 million adults 65 and older

By 2050: 88.5 million adults 65 and older

By 2030: 1 in 5 Americans will be 80 and older

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AD: cognitive disturbance and decline of memory

Current: 71 seconds

By 2050: 33 seconds

Make up 47% of residents of nursing home

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ActivitiesChoice and Variety (Logsdon, 2000)Purposeful Activities (Basler, 2005)Ethical Obligations (Skinner, 1969)

Preference AssessmentsType (MSWO, paired-choice)Format (tangible, pictorial)Physical (reach, vision)

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Compared Tangible and Pictorial Formats

Results: 5/7 did not show consistent preferences across the two formats

Conclusion: preference assessments are affected by presentation format

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Compared choice formats to engagementPictorial, Tangible, Verbal, Textual

Results: tangible and verbal were predictive of engagement

Conclusion: implications for clinicians who need assessment that are quick and yield predictive results

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Evaluate the consistency of preferences across presentation formatsEvaluate preferences between productive and leisure activities

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3 Females76 to 88 years oldMMSE:11 to 20ADL dependentAll participants made a choice between pairs

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12 activities were chosen from a list provided (Burket, 2008)

6 Leisure Activities6 Productive Activities

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4 Preference Assessments were conducted:Informal (Questionnaire)

Tangible Paired-Choice

Verbal Paired-Choice

Single Stimulus Engagement

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Each activity was asked 1 timeResponse Measurement:

Preferred: confirming statement (yes, sure)Not Preferred: declining statement (no, nope)

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Verbal: Question onlyTangible: Question and Item Presented

1 minute contingent access to activityResponse Measurement:

Verbal: Participant said name of itemTangible: Participant said name of, approached, or touched item

Scheduled Breaks (every 20 minutes)

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[activity] for up to 30 minutes while I do some

30 minute accessResponse Measurement:

Engaged: actively manipulating the item and/or looking at the materials without sleeping (i.e., shutting eyes for more than one second)

10s Whole Interval Recording

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Taken 33% of SessionsTreatment Integrity: 100% for all sessionsInterobserver Agreement

Informal: 100%Verbal: 98% - 100% Tangible: 97% - 100%SSE: 98%-99%

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Informal and systematic assessment not comparableSignificant correlation / similar hierarchies between tangible and verbal

No significant correlation for SSE and other assessments

Highest Engagement: first 10 minute blockPreferred both Leisure and Productive Activities

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Choice and Variety are important

Length of Activities

Stimulus Control issues

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Activities based upon previous life rolesEvaluate individualized activities vs. generic activities?

Attrition RatesWill other different types / formats avoid attrition rates?