Reinforcement Inventory

/ Instructions: The items in this questionnaire refer to things and experiences that may give a child joy, satisfaction, and/or pleasurable feelings. For each item, activity, and event, check one option in the columns below that indicates how much this individual “enjoys” the described item, activity, or event. Some of them will not apply.
Child: / Date:
Person Completing Form:
Description of Potentially Reinforcing Items, Activities, and/or Events / Not at All / A Little / A Fair Amount / Much / Very Much

A. Food Items

  1. Candy (What kind?)

  1. Raisins

  1. Cereals

  1. Nuts

  1. Chips

  1. Cake

  1. Cookies

  1. Beverage (What kind?)

  1. Ice Cream (What kind?)

a.
b.
  1. Other Food Items

a.
b.
c.
d.
e.

Reinforcement Inventory

/ Instructions: The items in this questionnaire refer to things and experiences that may give a child joy, satisfaction, and/or pleasurable feelings. For each item, activity, and event, check one option in the columns below that indicates how much this individual “enjoys” the described item, activity, or event. Some of them will not apply.
Description of Potentially Reinforcing Items, Activities, and/or Events / Not at All / A Little / A Fair Amount / Much / Very Much

B. Entertainment

  1. Watching Television (What shows?)

a.
b.
c.
  1. Movies

  1. Music

  1. Going to Events (Which events?)

a.
b.
  1. Bike Riding

  1. Skating

  1. Table Games

  1. Coloring/Painting

  1. Video Games

  1. Other

a.
b.
c.
d.
e.
f.
g.
h.

Reinforcement Inventory

/ Instructions: The items in this questionnaire refer to things and experiences that may give a child joy, satisfaction, and/or pleasurable feelings. For each item, activity, and event, check one option in the columns below that indicates how much this individual “enjoys” the described item, activity, or event. Some of them will not apply.
Description of Potentially Reinforcing Items, Activities, and/or Events / Not at All / A Little / A Fair Amount / Much / Very Much

C. Arts/Crafts

  1. Playing an Instrument

  1. Singing

  1. Dancing

  1. Drawing

  1. Building Models

  1. Others

a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
l.

Reinforcement Inventory

/ Instructions: The items in this questionnaire refer to things and experiences that may give a child joy, satisfaction, and/or pleasurable feelings. For each item, activity, and event, check one option in the columns below that indicates how much this individual “enjoys” the described item, activity, or event. Some of them will not apply.
Description of Potentially Reinforcing Items, Activities, and/or Events / Not at All / A Little / A Fair Amount / Much / Very Much

D. Excursions

  1. Ride in Car

  1. Visit Relatives/Friends

  1. Picnic

  1. Lunch/Dinner Outing

  1. Go to Store

  1. Go for a Walk

  1. Amusement Park

  1. Go to a Mall

  1. Others

a.
b.
c.
d.
e.
f.
g.
h.
i.
j.

Reinforcement Inventory

/ Instructions: The items in this questionnaire refer to things and experiences that may give a child joy, satisfaction, and/or pleasurable feelings. For each item, activity, and event, check one option in the columns below that indicates how much this individual “enjoys” the described item, activity, or event. Some of them will not apply.
Description of Potentially Reinforcing Items, Activities, and/or Events / Not at All / A Little / A Fair Amount / Much / Very Much

E. Social/Interactions

  1. Social Praise (By whom?)

a.
b.
c.
  1. Being Hugged

  1. Being Touched

  1. Group Activities

  1. Talking with Others

  1. Time Alone

  1. Others

a.
b.
c.
d.
e.
f.
g.

Reinforcement Inventory

/ Instructions: The items in this questionnaire refer to things and experiences that may give a child joy, satisfaction, and/or pleasurable feelings. For each item, activity, and event, check one option in the columns below that indicates how much this individual “enjoys” the described item, activity, or event. Some of them will not apply.
Description of Potentially Reinforcing Items, Activities, and/or Events / Not at All / A Little / A Fair Amount / Much / Very Much

F. Domestic Activities

  1. Setting Table

  1. Making Bed

  1. Sweeping

  1. Dusting

  1. Outside work

  1. Cooking

  1. Shopping

  1. Menu Planning

  1. Running Errands

  1. Exemptions from Chores

  1. Others

a.
b.
c.
d.
e.
f.
g.

Reinforcement Inventory

/ Instructions: The items in this questionnaire refer to things and experiences that may give a child joy, satisfaction, and/or pleasurable feelings. For each item, activity, and event, check one option in the columns below that indicates how much this individual “enjoys” the described item, activity, or event. Some of them will not apply.
Description of Potentially Reinforcing Items, Activities, and/or Events / Not at All / A Little / A Fair Amount / Much / Very Much

G. Personal Appearance

  1. New Clothes

  1. Costumes

  1. Getting Haircut

  1. Having Picture Taken

  1. Others

a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.

Reinforcement Inventory

/ Instructions: The items in this questionnaire refer to things and experiences that may give a child joy, satisfaction, and/or pleasurable feelings. For each item, activity, and event, check one option in the columns below that indicates how much this individual “enjoys” the described item, activity, or event. Some of them will not apply.
Description of Potentially Reinforcing Items, Activities, and/or Events / Not at All / A Little / A Fair Amount / Much / Very Much

H. Sensory Stimulation

  1. Smells

  1. Colors

  1. Noise Makers

  1. Cold

  1. Warm

  1. Wet

  1. Vibration

  1. Rocking

  1. Others

a.
b.
c.
d.
e.
f.
g.
h.

Reinforcement Inventory

/ Instructions: The items in this questionnaire refer to things and experiences that may give a child joy, satisfaction, and/or pleasurable feelings. For each item, activity, and event, check one option in the columns below that indicates how much this individual “enjoys” the described item, activity, or event. Some of them will not apply.
Description of Potentially Reinforcing Items, Activities, and/or Events / Not at All / A Little / A Fair Amount / Much / Very Much

I. Other Events/Activities

  1. Reading

  1. Being Read to

  1. Books/Magazines

  1. Money

  1. Having Free Time

  1. Others

a.
b.
c.
d.
e.
f.
g.
h.
i.
j.

Reinforcement Inventory

/ Instructions: The items in this questionnaire refer to things and experiences that may give a child joy, satisfaction, and/or pleasurable feelings. For each item, activity, and event, check one option in the columns below that indicates how much this individual “enjoys” the described item, activity, or event. Some of them will not apply.
Description of Potentially Reinforcing Items, Activities, and/or Events / Not at All / A Little / A Fair Amount / Much / Very Much

J. Tokens

  1. Star Chart

  1. “Happy Faces”

  1. Badges

  1. Certificates

  1. Token Accumulation

  1. Points

  1. Money

  1. Gift Certificates

  1. Others

a.
b.
c.
d.
e.
f.
Integrated Behavioral Solutions, Inc. / Page 1 of 10
© 2000