This study examined the utility of a paired-choice preference assessment in predicting reinforcer efficacy for a 13-month old with a history of prenatal drug exposure. First, two paired-choice assessments were conducted one week apart, using the same items. A high level of correspondence between the two assessments was observed. Next, a reinforcer assessment was conducted indicating that the high-preference items identified by the pairedchoice assessments served as reinforcers for the participant. The results suggest that the paired choice assessment was effective in predicting reinforcers for this infant. Limitations of the current study and suggestions for future early intervention research are discussed.