Amanda Ripley, MS BCBAImagine! Behavioral Health Services

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

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

AD: cognitive disturbance and decline of memory

Current: 71 seconds

By 2050: 33 seconds

Make up 47% of residents of nursing home

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

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

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

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

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

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

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

6 Leisure Activities6 Productive Activities

4 Preference Assessments were conducted:Informal (Questionnaire)

Tangible Paired-Choice

Verbal Paired-Choice

Single Stimulus Engagement

Each activity was asked 1 timeResponse Measurement:

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

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)

[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

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

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

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

Choice and Variety are important

Length of Activities

Stimulus Control issues

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

Attrition RatesWill other different types / formats avoid attrition rates?

Thank you!

Email: aripley@imaginecolorado.org