Participants

Three male individuals enrolled in a university-based adult day program participated in the study. All participants were diagnosed with ASD and moderate to severe intellectual disability. The Vineland Adaptive Behavior Scales—Third Edition (Vineland-3; Sparrow et al., 2016) was administered to the parent(s) of each of the participants to assess their adaptive behavior.

Andrew was a 41-year-old man diagnosed with ASD and Fragile X syndrome. Standardized scores for his Vineland-3 placed him in the low (20–70) range for all three domains, Communication (20), Daily Living Skills (30), and Socialization (20), and the overall Adaptive Behavior Composite (24). His parents reported that he spoke using single words and short phrases and followed three-step instructions for familiar tasks. Though Andrew communicated vocally without interrupting, he did not start conversations with others by discussing their interests.

Jameson was a 36-year-old man diagnosed with ASD. Standardized scores for his Vineland-3 placed him in the low (20–70) range for all three domains, Communication (20), Daily Living Skills (20), and Socialization (20), and the overall Adaptive Behavior Composite (20). His parents reported that he spoke primarily using single words and followed instructions involving one action and one object. While Jameson could recognize emotions in others, he did not initiate conversations or typically try to make friends with peers.

Liam was a 39-year-old man diagnosed with ASD. Standardized scores for his Vineland-3 placed him in the low (20–70) range for all three domains, Communication (20), Daily Living Skills (24), and Socialization (20), and the overall Adaptive Behavior Composite (22). His parent reported that he spoke in complete sentences and followed two-step instructions. Liam did not typically engage in spontaneous or reciprocal conversation.

Setting and Materials

Sessions occurred in a large conference room (approximately 5 m by 7 m). Masking tape divided the room in half. Identical tables (approximately 0.75 m by 2.75 m) were positioned along the wall on both sides of the room, and a chair was positioned in front of each table when appropriate. During the interaction condition, an experimenter sat in a second chair next to the table on one side of the room. Activities and materials were placed on the tables or the floor next to the tables, when appropriate, during relevant test conditions. Other materials included data sheets, pens/pencils, video cameras, and timers. Table 1 lists the leisure activities in Phase 1, and Table 2 lists leisure activities used in Phases 2 and 3. Activities in Phase 1 (Table 1) were selected from ones the clients had recently participated in at the day program, as observed by the experimenters and staff. For Phases 2 and 3 (Table 2), activities were selected on the basis of those experimenters and staff observed being engaged by other clients at the day program but not the clients themselves.

Table 1 Leisure activities used in Phase 1Table 2 Matched and unmatched leisure activities used in Phases 2 and 3ProcedurePhase 1: Leisure Component Preference Assessment

In the first phase of the investigation, a concurrent-operant assessment was used to determine the components of the leisure activities participants preferred. During the initial trial of each component, participants were provided 15-s of presession exposure to each option (e.g., interaction and no-interaction). The choice was provided while the participant stood at the center of the room on the tape line. If participants did not choose within 10-s, the participant was repositioned in the center of the room, presession access to choices was repeated, and the choice was presented again. Although rare, if participants continued to have difficulty choosing, then presession exposure was reintroduced in subsequent trials. The 2-min condition began when the participant moved to one side of the room. Participants could move freely from one side of the room to the other during the session. Trained observers monitored the time allocated to each side of the room. The side of the room on which each leisure activity was placed and the order of presession exposure was balanced across sessions. Each test was conducted at least four times for each participant or until a definitive pattern of preference, defined as one choice selected at least two-thirds (66.7%) of the time emerged.

All participants were given choices related to critical aspects of leisure activities. LaRue et al. (2020) identified interaction vs. no-interaction and stationary vs. movement. The third component, electronic vs. nonelectronic, was new to this analysis. In adding this component, we aimed to expand leisure activity options and reflect modern preferences, as electronic activities play a significant role in leisure.

Interaction vs. No-interaction

For this test, participants could choose between interacting with a staff member or sitting at a table alone for this test. Staff members ranged from novel individuals to those who frequently worked with the clients. The staff member selected for each session was based on convenience (i.e., the person already working with them). The experimenter began each session with verbal directions, “You can sit at this table by yourself, or you can sit at this table with [person’s name]. Pick one.” If the participant chose interaction, then the staff member would lead the participant in casual conversation. Conversations were not constrained in their content, and interactions ranged from generic comments (e.g., comments about clothing or the weather) to specific interests (e.g., the music of Tina Turner and Shania Twain). If the participant initiated a topic of conversation, the staff was instructed to follow their conversational lead. If the participants chose no interaction, then they would sit alone at the table without receiving attention.

Stationary vs. Movement

 For this test, participants could choose between an activity that required them to stand and frequently change positions (e.g., dribbling a basketball while standing) or to remain seated in a chair at the table (e.g., playing with a tennis ball while seated). The experimenter began each session with verbal directions, “You can sit and play [activity], or you can stand and play [activity]. Pick one.”

Electronic vs. Nonelectronic

 For this test, participants could choose between an activity displayed on an electronic device (e.g., a puzzle on the iPad) or a nonelectronic analog (e.g., a cardboard puzzle). Activities were equated in terms of task and difficulty. For example, if the nonelectronic condition used a 16-piece puzzle, the electronic condition used a 16-piece puzzle on the iPad. The experimenter began each session with verbal directions, “You can sit at this table and play with [activity] on the iPad, or you can sit at this table and play with the [activity]. Pick one.”

Phase 1 results were used to develop a leisure activity preference profile for each participant we applied to Phase 2. The profile was based on the time allocated across the different assessment conditions. For example, if the participant allocated most of their time to noninteractive, stationary, non-electronic activities, activities fitting that description matched the preference profile, and activities fitting the description of interactive, movement, and electronic were considered unmatched.

Response Measurement and Interobserver Agreement

Graduate students and trained staff members collected data on the time allocated to each choice, defined as the number of seconds spent on either side of the divided room. A second independent observer collected data during 66.7% of sessions during Phase 1 of the investigation. Interobserver agreement (IOA) was calculated for the percentage of time allocated in each condition. The agreement for the time allocated was calculated by taking the total number of seconds from one observer and dividing it by the total number of seconds recorded by the second observer. IOA averaged 99.8% across all participants (range, 97.5–100%). IOA was high, in part, because participants did not often switch sides of the room after making their initial choice.

Phase 2: Analysis of Leisure Profile

In this phase, participants were exposed to two distinct types of leisure activities based on the results of Phase 1. First, we designed leisure activities that matched the client profile of the leisure preference assessment. We then designed unmatched activities using the opposite of the profile produced by the assessment. For example, if a participant’s leisure activities profile suggested that they preferred activities that involved low levels of social interaction, little movement, and an electronic interface, an activity that matched this profile (e.g., playing a basketball game alone on the iPad) would be compared to an activity with the opposite profile of high level of social interaction, required movement, and a nonelectronic interface (e.g., shooting basketball while conversing with a peer or staff member). Two matched and two unmatched activities were compared for each participant for Phase 2 (Table 2).

Design, Response Measurement, and Interobserver Agreement

A multielement design was used to evaluate the differences in activity engagement across matched and unmatched activities. Sessions lasted 2 min. Matched and unmatched activities were evaluated at least three times each, and the specific activities used in each session were randomly selected from the list in Table 2.

Graduate students and trained staff members collected data on client engagement and frequency of problem behavior with each activity. Activity engagement was defined as the percentage of 10-s whole intervals oriented to the designated activity while using the materials how they were generally designed to be used. This definition was consistent across all three participants. Frequency data on the occurrence of problem behavior was collected and converted to responses per minute for each client. Operational definitions for each participant’s target behaviors are summarized next.

Andrew

Swearing was defined as any instance of profanity. Spitting was defined as the forceful expulsion of saliva from the mouth directed at another person, excluding instances where Andrew spat on the ground outdoors, in a trash can, or into a sink. Property disruption was defined as any instance or attempt to forcefully displace an object at least 6 in/15.24 cm from its original position without appropriate functional purpose or permission. Aggression was defined as an instance or attempt of forceful contact between any part of Andrew’s body and another individual, which included strikes with an open or closed hand, head butting, kicking, pushing, pinching, or biting. A previous functional analysis (FA) indicated that most topographies of Andrew’s behavior were maintained by automatic reinforcement. He had a behavior support plan (BSP) in place at the time of assessment and engaged infrequently in problem behavior during the day.

Jameson

Property disruption was defined as any instance or attempt of forceful displacement of an object 6 in/15.24 cm or greater from its original position without appropriate functional purpose or permission. Self-injury was defined as any instance or attempt of forceful contact between head and hand(s) or leg and hand(s) from a distance of at least 6 in/15.24 cm. Aggression was defined as any instance or attempt of forceful contact between any part of Jameson’s body and another individual, including strikes with an open or closed hand, head butting, scratching, or biting other individuals. Previous ABC data indicated that most topographies of Jameson’s behavior were maintained by automatic reinforcement. He had a BSP in place at the time of assessment and engaged infrequently in problem behavior during the day.

Liam

Shirt biting was defined as any instance in which Liam placed the fabric of his shirt or jacket into his mouth and bit down on it with his teeth. Self-injury was defined as any instance of forceful contact between a part of Liam’s body and another part of his body or object (e.g., hitting the table or hitting his leg). Aggression was defined as any attempt or forceful contact between any part of Liam’s body and another individual from 4 in/10.16 cm or greater, which included striking another with an open or closed fist, grabbing, and squeezing. Recent FA data indicated that Liam’s behavior was maintained by access to routines. He had no BSP in place at the time of assessment and engaged in moderate rates of problem behavior during the day.

A second independent observer collected data during 50% of sessions across all participants. Interval-by-interval IOA for activity engagement was calculated first by scoring observer data as agreements or disagreements for each 10-s interval. The number of intervals with agreements was divided by the total number of intervals and then converted to a percentage. IOA averaged 97.0% across all participants (91.7–100%). IOA for combined inappropriate behavior was calculated using exact agreement by dividing the number of agreements (a 10-s interval in which both observers scored the same frequency of problem behavior) by the number of agreements plus disagreements and converting the ratio to a percentage. IOA averaged 98.3% across all participants (range, 91.7–100%).

Phase 3: Preference for Matched and Unmatched Activities

A concurrent-operant assessment was implemented to determine participant preference for matched and unmatched leisure activities. Activities were placed on opposite sides of the room (with a staff member on the appropriate side for the interaction component) and were available concurrently. The side of the room on which each leisure activity was placed, and the order of presession exposure was balanced across trials. The same matched and unmatched activities from Phase 2 were used in Phase 3 (Table 2). Participants were asked to choose between the matched activity and the unmatched activity. If participants did not choose within 10-s, the participant was repositioned in the center of the room, and the choice was presented again. Trained observers monitored the choices made by the participants. The preference assessment consisted of at least four-choice trials.

Response Measurement and Interobserver Agreement

Graduate students and trained staff members collected data on client activity selection. A second independent observer collected data during 41.7% of sessions. IOA was calculated by taking the total number of agreements (the same activity selected), dividing by the total number of agreements and disagreements, and converting the ratio to a percentage. IOA was 100% across all participants.