Assessing choice making among children with multiple disabilities

Some learners with multiple disabilities display idiosyncratic gestures that are interpreted as a means of making choices. In the present study, we assessed the validity of idiosyncratic choice-making behaviors of 3 children with multiple disabilities. Opportunities for each child to choose between food and drink were provided under two conditions. In one condition, the children were given the food or drink item corresponding to their prior choice. In the other condition, the teacher delivered the item opposite to that chosen. It was reasoned that valid choice-making behaviors would be reflected in a greater tendency to accept the chosen item and refuse the unchosen item. Direct observations revealed all children consistently indicated choices during both conditions. Choices of both the food and drink items were made by all 3 children. A reversal design demonstrated that acts of refusal were more frequent when choices were followed by delivery of the item opposite to that chosen. Similar assessment procedures may be effective in determining the function of idiosyncratic gestures exhibited by persons with multiple disabilities. For children lacking such skills, intervention to teach valid choice-making behaviors may be needed to complement assessment procedures.