etadd_46(4) - Division on Autism and Developmental Disabilities

2008), and increasing adaptive behavior (e.g.,
Cannella-Malone et al., 2009; Harding et al.).
Third, a functional relation is demonstrated
between the treatment and resulting change
in the target behavior. Thirteen studies on the
effects of choice interventions on behavior are
present across the current review (Cannella et
al., 2005; Lancioni et al., 1996) with positive
results. Positive in all three reviews indicated
that the provision of choice led to a change in
behavior indicating a functional relation. In
the current review, 12 out of 13 studies implemented
a single subject experimental design
that demonstrated a functional relation.
Three studies implemented a multiple baseline
design (Cannella-Malone et al., 2009;
Carlson et al., 2008; Sigafoos et al., 2005)
where experimental control is demonstrated
when and only when the intervention is implemented.
Four studies implemented a reversal
design (Harding et al., 2005; Harding et
al., 2009; Humenik et al., 2008; Tasky et al.,
2008) in which experimental control is demonstrated
when a behavior change is observed
when and only when the intervention is implemented,
and when the intervention is withdrawn,
the target behavior returns to previously
observed levels without treatment. Two
studies implemented an alternating treatments
design (Son et al., 2006; Spevack et al.,
2005) and one implemented a multielement
design (Reed et al., 2009). In these designs,
experimental control is demonstrated when
one data path increases or decreases to a
greater degree than the other independent
variables tested. Finally, two used multiple experimental
designs (Hoch et al., 2002; Sigafoos
et al., 2009) to demonstrate experimental
control.
Fourth, experimental control was demonstrated
across a sufficient range of studies,
researchers, and participants. In the current
review, nine of the thirteen studies focusing
on choice interventions did not have overlapping
first authors. That is, the first author of a
study did not appear again in the literature
search as first author on another study. Of
these nine studies, results were positive for
eight and negative for one. The eight studies
with positive results included a total of 16
individuals with various severe to profound
disabilities, including traumatic brain injury
(Tasky et al., 2008), autism (Carlson et al.,
2008), and developmental disabilities (Sigafoos
et al., 2009).
Lastly, practices were not implemented with
documented fidelity. Studies included in the
current review did not include data on treatment
integrity, limiting support for choice interventions
to be considered an evidencebased
practice. Although a functional relation
was demonstrated in the majority of studies—
indicating the treatment was responsible for
the behavior change—the extent to which the
treatment was implemented as it was outlined
should be viewed with some caution.
Horner et al. (2005) suggested a criterion
of five single-subject studies with acceptable
experimental control, across at least three different
researchers, and at least 20 participants
across the five studies. Although treatment
integrity data is lacking, the four other criteria
have clearly been met, suggesting that choice
interventions can be considered an evidencebased
practice for individuals with severe to
profound disabilities as defined by Horner et
al.
In addition to the support for choice interventions
to be considered an evidence-based
practice, the findings on preference assessments
also have practical implications for the
assessment of preferred stimuli and the guidance
of interventions to encourage more independence
and involve the individual in
treatment implementation. For example,
Hanley et al. (2005) assessed preference for
treatment components in a functional communication
training (FCT) package using a
concurrent chains procedure. Participants
demonstrated a clear preference for the treatment
package that included FCT and punishment
over the package that consisted of FCT
and extinction. These data indicated that
treatment selection may be guided empirically
while still taking the individual’s treatment
preference into account.
One of the most significant areas where
preference assessments and choice interventions
may be useful is in implementing quality
services for individuals with severe to profound
disabilities. Cannella et al. (2005) suggested
the use of preference assessments and
choice interventions as an aid to guide the IEP
process and enhance person-centered planning.
Current research, though still applicable
to a younger student population, may also
588 / Education and Training in Autism and Developmental Disabilities-December 2011