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Research & Practice for Persons with Severe Disabihties
2004, Vol. 29, No. 3, 161-168
copyright 2004 by
T A S H
CLASSIC TASH ARTICLE III
Reprinted from The Joumai of The Association for the Severely
Handicapped
Volume
9(3),
F all, 1984
The Importance of Choice Making Skills
For Students with Severe Disabilities
Mayer Shevin and Nancy K. Klein.
Author Information
Mayer Sh evin, Ph .D ., Assistant Professor, Specialized
Instructional Programs, Cleveland State University.
Nancy K. Klein, Ph .D ., Professor, Specialized Instruc-
tional Programs, Cleveland State University.
Article Descriptors
autonomy; behavior management; choice-making; curriculum
design; independence; self-management; severely retarded
Making choices is an essential part of functioning
independently as an adult in society. Activities
specifically directed toward helping students leam to
make choices, however, are typically neglected in
educational programs for students with severe
disabilities. This paper presents a rationale for the in-
clusion of choice-making as an imp ortant skill area for
persons with severe disabilities. Behavioral approaches
that present useful means of conceptualizing choice-
making in the school life of severely disabled students
are identified. Pro cedures are suggested for teaching
choice-making skills, for integrating opportunities for
exercising those skills throughou t the course of the stu-
dent s school life, and or fostering choice-making skills
through the use of logical consequences.
During the past decade, implementation of the nor-
malization principle has resulted in a restructuring of
educational and residential services for persons with
severe handicaps. T his system change h as been accom -
panied by a reexamination of curricular content for
these students. Whereas severely handicapped persons
in institutions and in schools traditionally have been
taught compliance, more recent training programs
reflect new expectations and views of people with
severe disabilities. Professionals are now focusing on
strategies to enable these citizens to avail themselves
of the opportunities inherent in community facilities
by transferring the focus from compliance to foster-
ing independence and self-reliance (Wehman &
McLaughlin, 1981).
One aspect of teaching independence that has been
neglected is teaching severely handicapped persons to
make choices. T his paper presents a rationale for the
need to structure teaching activities to enable these
students with severe handicaps to exercise their own
choice in school, at home, and in community settings.
Some possible areas for classroom activities are sug-
gested, including (a) the design and im plementation of
age-appropriate experiences; and (b) the creation of
opportunities, both in and out of school, for exercis-
ing choice.
For non-handicapped children, little or no formal at-
tention is paid in school to the establishment of skills
related to autonomy and to choice-making; however,
most children will nevertheless acquire such skills dur-
ing their childhood. In contrast, we cannot predict
with any confidence that these autonomous skills will
develop in this informal fashion for students who are
retarded. Retarded students are likely to have very
limited opportunity for learning through interaction
with, and observation of, normal agemates and older
children (Porter, Ramsey, Tremblay, laccobo, &
Crawley, 1978). Such self-reliance is important to the
quality of life of individuals who are retarded if they
are to reap the benefits of norm alized services. Schools
must take responsibility for teaching such skills directly
and explicitly. Concurren tly, analysis of current pro-
grams must be undertaken to determine which aspects
of programm ing serve to deter the development of self-
reliance and independence related to making choices.
Students who are severely retarded may require ex-
tensive assistance in developing the skills necessary for
exercising choice, rather tJian merely following
teachers' or parents' leads. Learning to make choices
can extend to areas of major life concerns such as voca-
tion, residence, and consent to medical treatment, as
well as to relatively minor, but cumulatively signifi-
cant day-to-day decisions such as choice of recreational
activities, partners for social activities, food, clo thing,
music, seating, and scheduling.
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Shevin and Klein
Defining and Assessing Choice-Making
Deflning choice making
Most studies which look at choice-making in peo-
ple who are severely retarded (Holvoet, Brewer.
Mulligan, Guess, Helmstetter, & Riggs, 1981; Mithaug
& Hanawalt, 1978; Mithaug & Mar, 1980; Wehman,
1979;
and Wuerch & Voeltz, 1982) do not include
definitions of cho ice-m akin g
per se.
There does not
appear to be a common definition of choice-making
in this field that addresses the student's desires as in-
tegral to the process. In other words, helping the child
to understand what she actually wants is not usually
considered as part of th act of' 'choosing something.' '
The absence of such a feature in a working definition
of ch o ic e prevents professionals in the field from
focusing on issues related to the disabled individual's
role in setting her own objectives, and in exercising
autonomous control as a consumer of habilitative and
educational services. W ithout a view of choice-making
that includes teaching children to identify personal
preferences, professionals and advocates are at risk of
mistaking lack of protest for informed consent, habitual
behavior for active choice, and resignation to one's lot
for contentment with that lot. There is a need to be
able to determine, in a given situation, whether or not
a student or client is exercising real autonomy.
This determination is most difficult for those with
seriously limited behavioral repertoires. Two examples
will illustrate the complexity of this issue:
1.
A teacher wishes to teach a student to operate a
soft-drink machine, so that she may purchase a drink
during breaktime. The student, in her current opera-
tion of the machine, puts the coins in the coin slot, and
then, without directing her eyes at the machine, slaps
her hand against the machine's face until she hits one
of the panels. W hen a can of soda falls into the recep-
tacle, she picks it up, Of)ens it and drinks the soda. Can
that student be said to have chosen that particular
brand?
2. A w orkshop supervisor asks a worker who is sit-
ting at a table containing the materials for an assembly
task to begin screwing the nut-and-bolt sets together.
Two minutes later, the supervisor sees that no sets have
been assembled by that worker. Is the supervisor to
consider the worker as having been non-compliant, as
having misunderstood the task, or as having chosen
not to participate?
For the purposes of this paper, ch oo sin g is de-
fined as the act ofan individual's selection of a pre-
ferred alternative from amo ng several familiar options.
The use of the word pr ef er re d in this definition
highlights the assumption that people with severe
disabilities have personal preferences, likes and
dislikes, which they can learn to identify for themselves
through ongoing educational experiences. It is assumed
that persons with severe handicaps can learn to express
their preferences, and that parents, teachers and
managers in their environment can learn to be respon-
sive to both typical and atypical expression s of choice.
The emphasis on selection among familiar options
highlights the longitudinal nature of education and pro-
gramming for meaningful choice-making.
Research in choice making
For the special educator engaged in fostering choice-
making activities in students who are severely retarded,
two areas of the research literature are of particular
interest: (1) research that documents the effects of
choice-making activities on learning, classroom
behavior, skill generalization, and independent func-
tioning in regular and special education settings; and
(2) studies that address the specific problems related
to assessing and developing choice-making skills in
students who are severely retarded.
Holvoet, Brewer, Mulligan, Guess, Helmstetter and
Riggs (1981 ), in a survey of the experimental literature
related to the effect of choices on learning rate and stu-
dent motivation, found few studies in which the effects
of choice-making on school behavior had been studied
in students who are retarded. However, they identified
several studies from the regular education literature
(Berk, 1976; Felixbrod & O'L eary , 1973; Hock stra,
1978; Wh ite, 1977) which docum ented the positive ef-
fects of choice-making on learning rate. Researchers
who have looked at choice-making by individuals who
are severely retarded (Holvoet et al., 1981; Mithaug
& Hanawalt, 1978; Mithaug & Mar, 1980) have found
that one cannot assume that a student has made a choice
simply because that student has acted in a situation in
which choice is permitted. Mithaug and Hanawalt
(1978) have described the ambiguities which arise
when individuals who are severely retarded are
presented with opportunities for choice-making, since
these individuals may lack precise verbal responses,
facial exp ressions, task avoidance behav iors, and other
means by whi ch pre fe rences a re t yp i ca l l y
communicated.
In studies with students who are severely retarded,
as in studies with no nhandicapped students, choice ap-
pears to be seen as an y student behav ior, deemed ap-
propriate by the experimenter, in a setting in which
more than one behavior is deemed appro pria te, pro-
vided only that the experimenter has demonstrated that
the student's behavior relative to the various possible
tasks is somewhat consistent over time. In other w ords,
our profession has focused on choice-making as a per-
missible activity, rather than as a teaching target. For
many students who are severely retarded, this may
mean that they remain dependent on others for direc-
tion, even though the theoretical possibility of choice
does exist. In contrast, this paper suggests that choice-
making is a viable teaching target, to be subjected to
task analysis, planning, implementation and evaluation
similar to those which are characteristic of more tradi-
tional content areas.
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Assessing choice making
Some of the information needed to determine
whether choosing is taking place on any given occa-
sion can be identified through the use of the A B C
analytic model of applied behavior analysis (e.g.
Sulzer-Azaroff & Mayer, 1977). The use of this model
is enhanced when observers incorporate additional
behavioral data that are not typically collected or valued
within the applied behavior analytic model. This in-
cludes information related to the student's previous
history, which m ay not be easily available to the clini-
cian or teacher. Also of importance are descriptions
of behaviors that are not previously specified in
research designs or IEPs as target behav iors . Due
to the precision of descriptive observation required,
and the inability of professionals to predict in advance
the sponta neou s beh avi ors being looked for, such
behaviors do not easily lend themselves to quantitative
recording or reductionist coding procedures.
Rather than viewing cho ice-making as a single target
behavior, an array of related behaviors that comprise
the target must be considered. For example, in describ-
ing choice-making related to workshop tasks, such an
array might include quantitative data on latency, rate
and intensity of on-task behavior, descriptive informa-
tion on socialization, facial expression and body
language during the task, and responses to interview
questions related to the workshop tasks among which
choices are to be made.
In order to arrive at a meaningful characterization
of choice-making, educators need to go beyond the
typical scope of applied behavior analysis. Fortunate-
ly, there are alternative behavioral approaches, each
with a substantial theoretical and research base, upon
which professionals can draw:
1. Studies of verbal interaction: Although most of
their work has centered on issues of affective and social
development. Bell and Ainsworth (1972) have iden-
tified in operational terms the concept of the
respon-
sive parent,
and have documen ted the role of that adult
in infant development. In their study, the important
variables in parental behavior that were related to the
social and affective development of their children were
related to the degree to which the parents were respon-
sive, that is, the degree to which they came under the
control of the expressive behavior (i.e ., the crying) of
their children. (For a review of this literature in rela-
tion to crying, see Shevin, 1979.) Recent work by
Rogers-Warren (1981) has documented the effects of
such parent-child interaction on more advanced levels
of language development, and has provided a basis for
characterizing such interactions behaviorally. Work by
Sapon and Kaczmarek (1975) and Kaczmarek (1977)
in the descriptive analysis of verbal behavior provides
us with an analytic framework for looking at behavioral
development as an ongoing expansion of correspond-
ing productive and receptive verbal repertoires between
children and those around them. These models are ap-
plicable in the study of choice-making, in that they pro-
vide the basis for a global characterization of adult-
child relationships in terms of the degree to which the
adult's behavior is guided by that of the child, as well
as providing a means of studying the shifts which take
place in those adult-child relationships over time.
2. Environmentat psychoiogy and ecological
behaviorism:
In their analysis of the practice of body-
rocking in residential institutions for retarded persons,
Klaber and Butterfield (1968) studied body-rock ing not
as an indication of the deviance or deficits of the in-
dividuals displaying the behavior, but rather as a
diagnostic indicator of the level of care and the ap-
propriateness of program ming received by the residents
in various institutions. Rogers-Warren and Warren
(1977), in a collection entitled
Ecological Perspec-
tives in Behavior Ana lysis,
ha ve assembled the works
of authors who provide models for looking at behavior
not as a series of isolated target behaviors, but as net-
works of interactive behaviors existing in a material
and social context, in which students and teachers are
both interactive participants.
These broader perspect ives and contextual
frameworks provide richer descriptions of those
behaviors which, when viewed narrowly, are often
characterized as off-ta sk, non-co mp liant or de -
via nt behavio rs. For the student with limited social
and communicative repertoires, it may be precisely
those off-task behaviors which represent the most ef-
fective current m eans of exercising some control ov er
the environment, and are thus the best available ex-
pression of personal choice.
A number of common features are found in the ap-
proaches described above, which are pertinent to the
area of choice-making. They provide special contexts
for considering students' behavior:
1. professional attention is focused on the similarities
which exist among all people, rather than on deficits
and differences;
2.
descriptions of behavior take into account the
transactional nature of human interactions, consider-
ing the activities of all of the participants in an interac -
tion, not only the actions of the deviant one; and
3. an attempt to describe students' behavior, to the
greatest extent possible, from the students' perspec-
tive, rather than from those of the teacher or the in-
stitution, undergirds this process.
Notes Toward a
Choice-Fostering Curriculum
Professionals concerned with fostering choice-
making in students with severe disabilities are travel-
ing in relatively uncharted terrritory, without the com-
forts of traditional behavioral definitions and research
methodologies. However, the lack of a precise,
familiar terminology should not deter professionals
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Shevin and Klein
from taking steps toward fostering those skills in
whatever settings they are working. A multiplicity of
approaches by professionals and advocates sharing a
common commitment to individual rights and in-
dividual development will provide the experiential basis
out of which comparative research methodologies and
new evaluation designs can grow.
As instructional procedures and behavioral targets
related to choice-making are developed, two reference
points can guide these efforts: identification of ways
in which most citizens typically indicate and exercise
choice in our society, and identification of mechanisms,
however atypical, by which students with severe
disabilities currently make their wishes known. The
goal, of course, is to teach students culturally nor-
mative ways of exercising choice, as alternatives to
biting, flinging or screaming. However, teachers must
avoid being trapped into the absurdity of spending
many years prodding a non-compliant child through
a choice-making readiness pro gra m, while label-
ing the behaviors by which the child may be currently
demonstrating preferences as stubborn or ma nipulative.
Successful fostering of choice-making will require
both systematic teaching of new skills, and provision
of opportunities to practice those skills in the classroom
and in natural settings at home and in the community.
There are at least three essential components to a
choice-fostering curriculum: (a) cognitive/discrimina-
tion skill clusters; (b) affective skill clusters; and (c)
generalization of skills in real-life experiences.
Included in the
cognitive/discrimination skill clusters
are those skills which enable the learner to understand
and discriminate from among alternatives as a prere-
quisite to acting. Among the skills in this component
are visual, auditory, tactile and gustatory discrimina-
tion skills, and the understanding of such concepts as
c h o o s e , f i n i sh , n o w , l a t e r , m o r e , a nd
so forth.
The
affective skill cluster
includes concepts such as
I l ike/don't l ik e, I prefe r, I want to/don' t want
to d o , and so forth. These affective terms are in-
troduced in a choice-making episode at the time that
the choice is actually made.
The
real-life experiences
are the activities, both in-
side and outside of the classroom, which form the con-
tent of choices to be made. These include choices of:
food, clothing, toys, activities, activity partners, etc.
Classroom choices may also include choices available
within behavior contracting systems, such as choices
of reinforcers, target behaviors, working conditions,
etc.
The age and co mpetenc e of the child are critical fac-
tors to consider when selecting real-life experiences
for the classroom. Therefore, the teacher must assess
the significance and/or risk of the choices presented
in relation to the age and ability of the child. For ex-
ample, a four-year-old child might have the opportunity
to choose among various snacks and drinks at snack-
time, but would not be allowed to choose between
wearing a lightweight jacket or a snowsuit when the
outside temperature is below freezing. As the child
becomes older and, with increasing practice, more
adept at choice-making, the significance, that is the
consequences of that child's choices, must grow ac-
cordingly. For example, a twenty-year-old who has
learned to m ake choices might be given the opportunity
to choose an apartment. This real-life choice, while
beyond the capability of a four-year-old child, is also
beyond the capability of the student labeled retarded
who has had no previous experience with choice-
making. As retarded children move toward adulthood,
they will also benefit from choice-making which ex-
pands from choices in a small number of areas to
choices across a broad number of domains.
Brown et al. (1980) have identified a process for the
establishment of appropriate educational plans for
students with severe disabilities. These procedures in-
clude strategies for inventories involving students, their
parents and guardians, and the community en-
vironments within which the students currently or
potentially function. Such individualized and
ecologically based strategies for identification of cur-
ricular content and instructional design are directly ap-
plicable to the determination of the highest priority
areas for the targeting of choice-making activities. The
single departure from the model described by Brown
et al. (1980) is that, in their list of 16 dim ension s to
be considered in prioritizing curricular content, stu-
dent preference is listed as one item, without assum-
ing any special importance. For obvious reasons, in
the curricular area of choice-fostering skills, student
preference will, by definition, assume a position of
highest consideration in prioritizing goals.
Thre e contexts for fostering choice-m aking skills in
severely retarded students will be described below.
These include:
1. classroom activities designed to teach specific
choice-making skills;
2. integration of choice-making opportunities
throughout the student's day, across curricular
domains; and
3. provision of opportun ities, both inside and out-
side of school, for students to experience the
benefits and consequences of choices they have
made.
Fostering Choices Through Specific Curricular
Units
The following procedures are suggested as an ex-
ample of the activities that a hypothetical teacher of
four- to six-year-old children with severe disabilities
might follow. They will serve to illustrate the inclu-
sion of specific choice-fostering content in a school's
curriculum.
1. Content selection — the ages and abilities of the
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children in the class are considered prior to selecting
a real-life experien ce on w hich to focus. LFsing the pro -
cedures described by Brown et al. (1980) for the
establishment of functional, age-appropriate objectives,
a teacher of young children may select food as an ap-
propriate category for teaching choice-making skills.
2 . Cognitive/discrimination skill cluster
— iden-
tification of the discrimination skills used when a child
makes food choices . These skills include some m ethod
of indicating choice (e.g., pointing), and the ability to
discriminate between foods of similar appearance ( e.g .,
oranges and lemons). Following the visual discrimina-
tion activities, the child is given the opportunity to ex-
perience the differences in taste of these objects. Such
visual and gustatory discrimination skills will form the
foundation for subsequent affectively based decision-
making.
3. Affective skill cluster — once the child has
discriminated among different foods, and has indicated
through either typical or atypical communication modes
which of these foods he prefers, the teacher models
words or gestures that can be used to label the child's
responses to the foods. As the child tastes, and subse-
quently reaches for, the orange, the teacher may use
words such as tastes go od , I like it , or tastes
sw ee t. As the child tastes the lemon , and subsequently
grimaces, refiises it or pushes it away, the teacher may
use words such as tastes so ur, that 's not go od ,
or I do n't like tha t. Initially, the teacher might use
one food which is likely to be selected, and another
which is likely to be rejected (e.g., apple and onion).
Subsequently, the child can be presented with two
desirable foods, and be taught to indicate a favorite.
Consultation with parents is important at this stage. It
is important for the teacher to be sensitive to expres-
sions of student preference, to model the affective ter-
minology, to point out to the child that a choice has
been made, and to elicit feedback from the child about
whether she likes the choice.
Once these initial discriminations are mastered, and
the child can systematically label preferences, the
child's choice-making skills may be refined in the
following ways:
1.
by decreasing the gradations of the discrimina-
tions made within a domain (e.g., gross to
fine);
2 .
by increasing the number of objects among
which discriminations are made; and
3. by adding new dom ains within which
discriminations are made.
These examples assume that the students display
relatively well developed receptive and expressive
verbal repertoires. Additional concerns must be ad-
dressed by teachers who work with students who have
extremely limited communicative skills. For students
who display non-standard or inconsistent communica-
tive behavior, the teacher must frequently take pains
to ascertain that the student's message has been ac-
curately received. Duncan, Sbardellati, Maheady and
Sainato (1981) have suggested a continuum of response
modes to be used in testng and assessment situations,
which lend themselves to the determination of student
choices. They recommend that, in decreasing order of
desirability, the following communication modes be
used: (a) use of expressive language responses (vocal);
(b) use of pointing respo nses; (c) use of existing m otor
responses; (d) training of existing inconsistent
responses; and (e) teaching of a nonexistent response
(p . 18).
One potential difficulty to which teachers must be
attuned is that gestures and facial expressions, which
have a commonly interpreted meaning in society at
large, may be used inadvertently in non-standard ways
by students. For example, a cJiild with limited com-
munication skills or with cerebral palsy may smile
when asked if she wants something to drink; the smile
may no t necessarily indicate a y e s answer to the
question.
A second difficulty is that, for a student w hose
limited commu nication includes a consistent y es /n o
response, the student's preference in a given case may
not be able to be expressed by a simple yes or no. For
examp le: a teacher says to Albert, H er e's the
xylophone, the trumpet, and the ocarina. Would you
like to play with the tru m pe t? Albert nods his head
y e s .
The teacher hands Albert the trumpet. H e tums
it over in his hands, looks into the mouthpiece, puts
it down on the table, points to the ocarina, and wh ines.
The teacher says, N o , Albert, you already chose the
t rumpet .
In this situation, Albert's preference may have been
Let me look at the trumpet for a moment, and then
I'll decide which instrument I'd like . How ever, when
limited in his productive verbal behavior to a yes/no
response, the closest he is able to come is to indicate
y e s . The teacher, however, may erroneously con-
clude only that Albert do esn't know what he wan ts.
Such conflicts and misunderstandings are less likely
to arise in situations in which the choices available to
students are more open-ended, less limited ones, and
in situations in which the student has many oppor-
tunities to experience directly the various alternatives
prior to making a choice. Fu rthermo re, ongoing com-
munication amon g pare nts, teachers and other profes-
sionals and caretakers in the student's environment,
using formal systems such as the Communication
Record (Kollinzas, 1983) or less formal anecdotal com-
munications, will allow those directly involved with
an individual to become aware of the student's
preferences.
Integrating Choice Making Throughout the School
Day
As important as the establishment of discrete choice-
making skills might be , it will be of little avail if choice-
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this child have been permitted to order the food that
he probably dislikes, or should the teacher have in-
terceded to prevent his having to face a distasteful
lunch?
In such a situation, it is important that the child be
permitted to exercise his own initiative. To facilitate
this,
structured activities which involve tasting a variety
of foods might be arranged to precede the child's ex-
ercising choice in this situation. By allowing the child
to live with his choice, the teacher provides the stu-
dent with an excellent opportunity to understand the
consequences of personal decision-making. Students
who have been labeled as retarded must learn that for
them, as for everyone else, som e consequences of their
choices will be negative ones.
Some teachers or parents seem to believe that we
must not allow retarded individuals to fail. It seems
unkind to withhold intervention when a retarded per-
son is going to err. Ho wev er, persons who are retarded
must not be denied the opportunity to learn from their
own mistak es. Veach (1977) has forcefully described
the importance of this type of experience for young
children in general; Perske (1972) has made an ex-
cellent case for th e dignity of ri sk as a critical ele-
ment of normalization for those persons identified as
retarded.
Conclusion
For y ears, special education p ractitioners h ave taken
pride in their skill in identifying curricular areas of im-
portance to students, defining these areas in ways
which lend themselves to meaningful assessment and
task analysis, and developing effective p rocedures for
establishing skills by assisting students through small,
incremental steps toward mastery. Within that process,
we have sometimes lost track of a primary objective
of special education — that is, the preparation of
students wh o can function effectively without our ongo-
ing expert assistance. Ultimately, our success in
meeting that objective must serve as the basis for
evaluating how successful we have been in all the other
objectives which we set for ourselves as teachers of,
and advocates for, people with severe disabilities.
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