Teaching choice making during social interactions to students with profound multiple disabilities

We taught 4 students with profound multiple disabilities to use a microswitch communication system to request a change in recreational stimuli during social interactions with nondisabled peers. In Study 1, we conducted a preference assessment across a range of stimuli for each student. The most and least preferred stimuli were incorporated into microswitch communication system training in Study 2. During the second study, 3 of the 4 students (a) learned to use the microswitch communication system to control stimulus presentation, (b) more clearly differentiated their time among stimuli, and (c) increased their level of general alertness. Study 3 extended the use of the microswitch communication system to social interactions with nondisabled peers. Two students were more engaged in interactions when they chose when to change stimuli; 1 student was more alert when a peer chose when to change activities; a 4th student showed an undifferentiated pattern. The outcomes of the investigation are discussed in terms of the effects of controlling stimulus presentation on the behavior of students with profound multiple disabilities and the stability of preference hierarchies over time.