Association for Behavior Analysis International

1. Activity engagement is imperative to promoting independence, reducing the number of opportunities to engage in problem behavior (e.g., wandering), and has been associated with increasing quality of life among older adults. Given the benefits of activity engagement, it is imperative to examine how we can effectively increase engagement with preferred activities. With some activities, social attention may be a significant component and may help facilitate engagement. This symposium will include two talks: 1) Assessing Preferences for Care of People with Dementia: A Simultaneous Treatments Design and 2) Promoting Activity Engagement in Older Adults.

This presentation is tailored to practitioners and researchers in the field of behavioral gerontology; however, practitioners and researchers outside the field of behavioral gerontology are encouraged to attend. Given the importance of activity engagement, practitioners, both in and outside the field of behavioral gerontology, prioritize increasing engagement.

Older adults with intellectual disabilities are likely to have lower levels of engagement. In efforts to increase activity engagement, researchers have implemented various strategies to increase engagement (Engelman, Atlus, & Mathews, 1999; Engstrom, Mudford, & Brand, 2015). Current literature, however, has not directly compared those approaches to one another. The purpose of this study was to use an alternating treatments design to compare the following four strategies: 1) provided access to preferred items with no attention, 2) provided attention every 10 minutes for 60 seconds, 3) provided attention every 10 minutes for 10 minutes, and 4) provided 30 minutes of attention followed by 30 minutes of no attention. The participant was a 63-year old male diagnosed with moderate intellectual disability and attended an adult day program. Prior to implementing those approaches, a paired stimulus preference assessment was conducted to determine the participant’s top preferred activities. Results suggest that providing social attention for 30 minutes followed by no attention produced the greatest level of activity engagement. Implications and suggestions for future research will be discussed.

Stimulus preference assessments have previously been used with people with dementia to determine their preferences for tangible items such as edibles and leisure items. However, to date there is no literature exploring preferences for the type of social interaction that may accompany engagement with preferred activities. We used a rarely-used simultaneous treatments design to measure the preferences of people with dementia who were unable to state vocally their preferences for different contingencies of care. For example, for a participant for whom completing jigsaws was a preferred activity, we investigated whether she preferred to be provided with prompts to complete the activity jigsaw, to be left to complete the jigsaw alone, or to receive non-contingent attention during the activity. We compared simultaneous presentations of the available contingencies to sequential presentations in order to determine whether either presentation format was more effective than the other for measuring preference. Additionally, we took continuous data on engagement and indices of happiness as corollary measures of preference during the delivery of each chosen contingency. We will discuss our findings in relation to supporting people with communication difficulties and dementia, and with regard to issues of faulty stimulus control in the behavior of people with dementia.