etadd_46(4) - Division on Autism and Developmental Disabilities

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mined person. The dissonance created by the goal-state/actual-state discrepancy will hopefully cause the person to engage in reducing the discrepancy. The effort to reduce this discrepancy results in a means-ends chain that allows a person to seek solutions using a selfregulated, problem-solving strategy that allow him or her to reach a goal. Consequently, the “solution searching and solution testing lead to consequences that feed back and alter subsequent discrepancies, expectations, searches, and selections” (p. 12). It is a loop of choosing, acting, evaluating, and adjusting. Consequently, although choice making and problem solving are typically not associated, it is clear that the latter operation (problem solving) can be achieved only after the former operation (choice making) has been fully experienced by consumers. Agran and Hughes (1997) described problem solving as a process of “determining the most appropriate and efficient response to a given problem” (p. 172). People experience a discrepancy (the problem), consider and implement their solution, evaluate, and adjust as much as necessary to reach the goal state. Unfortunately, as consumers have historically received little exposure to making meaningful choices, and consequently little practice at solving problems, they are not able to regulate their lives as independently as they could. One cannot select an efficient response to a problem (or achieve a goal) unless one has familiarity with the various consequences that may be experienced (e.g., greater productivity leads to more financial compensation, which provides more goods and services). The first step in problem solving is identifying the problem or stating a goal (achieving an outcome). This is similar to choice making—what choice should be made. The next step that follows is determining the relative weight or consequences of choices—if I opt for Choice A, this will happen; if I opt for Choice B, this will happen. With this understanding individuals can determine which actions are in their best interests—in effect, problem solve. It is strongly recommended that consumers are not only taught to choose one stimulus over another but to also learn to evaluate the relative benefits and disadvantages of their choices. For example, if an employee asks to work at a fast-food restaurant, he or she may find him- or herself in a work environment, which has characteristics he or she doesn’t prefer (e.g., many people, work standing up). By understanding the need for consumers to practice choice making and problem solving, support staff can provide opportunities to improve consumers’ capacity to successfully perform self-regulated problem solving and begin to take more ownership and control over their lives. Self-determined individuals are aware of their needs and make decisions to meet those needs by setting goals, taking action, and adjusting through ongoing self-evaluation in order to meet those goals. Without opportunities to make meaningful choices and practice the problem-solving process, consumers will continue to be dependent on others, living in an other-determined state. Barriers to Choice Making Although well acknowledged as both a best practice and service requirement, choice making represents a potentially disquieting event to service delivery and traditional practice, and may be difficult to provide to consumers in a meaningful way. As discussed previously, the impetus for choice making is to drive and plan vocational and habilitation programs based on consumer input, but there are several barriers that challenge both its purpose and impact on an individual’s lifestyle. No choice making. Agran et al. (2010) investigated the extent to which consumers with intellectual and severe intellectual disabilities were provided choice-making opportunities and the types of choices they were asked to make. For the participants at one agency that provided sheltered employment, they were asked once a year at their Individual Program Plan meetings if they wanted to work elsewhere such as a supported employment placement. However, this agency did not offer supported employment, so, although the consumers were asked to make a choice, in effect there was no “real” choice involved. Also, as Storey (2005) suggested, even though an adult service agency is committed to providing a full continuum of work placements, it is unlikely that consumers will be able to choose any placement option since there may be limitations in the resources available; the agency may not have the capacity (i.e., staff, Choice Making / 571
transportation, commitment) to provide this full range of services; and consumers may be directed to certain job placements to keep the continuum viable (keep all placement options available). As Storey noted, such a situation provides an “illusion of choice” in which a menu of services is theoretically possible, but might not be achievable due to budgetary or other constraints. In both of these cases choices might have been provided but no real choice making occurred since consumers’ preferences and choices were not supported--in short, the action of choice making occurred but no meaningful change occurred due to it. As Agran et al. (2010) noted, this practice is disingenuous and may suggest that choice making is an activity that must be provided to consumers but one that has little or no influence on the nature or quality of their work experiences. As Brown, Bayer, and Brown (1992) indicated, individuals with intellectual disabilities need to believe that change is possible before they engage in selfdirected actions to promote such change. Additionally, Ward (2005) suggested that service providers must be committed to provide a variety of choice options consistent with an individual’s interests and preference. Consequently, when given a choice that involves either engaging in an activity or not—“Do you want to go bowling or not?,” this really isn’t choice making, since no other options are available. Far too enough such dichotomous choice-making opportunities are provided. As Bambara (2004) recommended, individuals should be exposed to option-rich environments in which they will have ample opportunities to identify, evaluate, and experience the consequences of their expressed preferences and choices. Having the choice of taking what is offered or nothing at all has little instructive value and does little to enhance the quality of an individual’s lifestyle. This type of choice making is referred to as a “Hobson’s Choice” (Brown, 2005) and, regrettably, may represent many of the choice-making situations provided to persons with disabilities. Ward suggested that choice making at a minimum should involve deciding which of two or more options the individual wishes to engage in. Further, the magnitude or scope of the life choices consumers make warrant further study. The available research suggests that choices involving minor or routine changes (e.g., time for a coffee break) are offered far more frequently than choices that may have a major impact on an individual’s life (e.g., change of job) (Burton Smith, Morgan, & Davidson, 2005; Stancliffe & Wehmeyer, 1995). For example, Agran et al. (2010) reported that more consumers in their sample were asked what they wanted for lunch or what they wanted to do after work than if they wanted another job, who they wanted as a support person, or who they wanted to work with it. It would appear that major life decisions continue to be made others and consumers may be restricted to a small set of choice options that will have little or no impact on their quality of life. In this respect personal choice and autonomy are curtailed, and choice making is restricted to a relatively small pool of opportunities. Major work and life decisions continue to be externally controlled and consumers have a seemingly minor role in the direction their lives take. Consequently, the purpose of choice making— providing a means to express and control one’s life decisions—is greatly compromised. To correct this situation, it is critical that we not only provide consumers with ample choice-making opportunities but that we endeavor to provide choices that are personally meaningful and important. Interpreting Choices Choice making (and other forms of self-determination) is contingent on the assumption that a consumer’s expression of a choice or wish is understood by service providers or support personnel. Accordingly, communication competence is synonymous with self-determination (Brown, Gothelf, Guess, & Lehr, 1998). However, as Brown et al. noted, consumers who have severe communication challenges may employ nonsymbolic, idiosyncratic, inconsistent, or self-selected modes of communication to express their choices. Consequently, choice making for these individuals presumes that the communication receivers (e.g., caregivers, support people) can interpret such communication. In this respect, selfdetermination may be wholly dependent on others and is meaningful only to the extent that the choice is correctly interpreted. Most 572 / Education and Training in Autism and Developmental Disabilities-December 2011
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Education and Training in Autism an
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March 2012 Manuscripts Accepted for
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new line of research, the review ho
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TABLE 1—(Continued) Overview of H
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TABLE 1—(Continued) Overview of H
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Figure 1. MP3 Player (Model: SM-320
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Figure 3. Sony-Ericsson K800. Retri
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computer with three middle school s
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Figure 6. Video iPod. Apple, Inc. h
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example, in contrast to previous st
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using public transportation. Device
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accessible software to increase ind
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(14.3%), a unique curriculum (13.8%
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TABLE 1 Student Characteristics Stu
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eos” was highlighted. Students th
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ment was 100% for baseline and main
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Figure 3. Percentage of independent
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how to program and operate the equi
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Individuals with Disabilities Educa
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Education and Training in Autism an
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TABLE 1 Video Prompting Studies Con
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TABLE 1—(Continued) Video Prompti
Page 45 and 46: Length of video clips. Researchers
Page 47 and 48: to learn three cooking tasks. Resul
Page 49 and 50: Van Laarhoven and Van Laarhoven-Mye
Page 51 and 52: Dogoe, M., & Banda, D. R. (2009). R
Page 53 and 54: Education and Training in Autism an
Page 55 and 56: TABLE 1 Summary of Demographic and
Page 57 and 58: TABLE 2 Summary of Outcome Variable
Page 59 and 60: with students in preschool (Akmanog
Page 61 and 62: with MoID acquiring some of their p
Page 63 and 64: Vocational task. To date one study
Page 65 and 66: ed; thereby adding to the amount of
Page 67 and 68: Retardation and Developmental Disab
Page 71 and 72: TABLE 1 Student Demographic Informa
Page 73 and 74: Figure 1. Example of the mini-poste
Page 75 and 76: Experimental Design This study empl
Page 77 and 78: intervention sessions was 75.55% de
Page 79 and 80: help continue maximum skill profici
Page 83 and 84: at the same time, or did not respon
Page 85 and 86: Figure 1. Correct responses for Joe
Page 87 and 88: sponses for each skill. No trends w
Page 89 and 90: then be used as a template for quic
Page 91 and 92: 2007). Choice making initiates the
Page 93 and 94: making choices is clearly not in th
Page 95: epeated until stable choice pattern
Page 99 and 100: can be made. Last, because consumer
Page 103 and 104: TABLE 1 Studies Listed According to
Page 105 and 106: TABLE 1—(Continued) Studies Liste
Page 111 and 112: (i.e., MSW) and duration-based (i.e
Page 113 and 114: 2008), and increasing adaptive beha
Page 115 and 116: port difficulty implementing the in
Page 117 and 118: of a preferred item while continuin
Page 119 and 120: Kreiner, J., & Flexer, R. (2009). A
Page 123 and 124: autism on the CARS. Regarding socia
Page 125 and 126: other effect size measures and with
Page 127 and 128: quests during baseline sessions. Du
Page 129 and 130: ulation was generally clear and he
Page 131 and 132: communication training as a treatme
Page 133 and 134: encing allergy symptoms (one partic
Page 135 and 136: Assessments Preference assessment.
Page 137 and 138: Interobserver agreement. A second o
Page 139 and 140: challenging behavior in the presess
Page 141 and 142: tion of the preferred item signaled
Page 143 and 144: ior: An analysis of the literature.
Page 145 and 146: moderate intellectual disabilities
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Effects of the STAR intervention pr
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Copeland, S. R. (2002). See citatio
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126. Ezell, D., & Klein, C. (2003).
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computer-based instruction program.
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sight words to students with mental
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Mastropieri, M. A. (2009). See cita
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262. Noyes, D. A., & Sax, C. L. (20
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Rispoli, M. (2009). See citation #1
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Sparks, S. (2010). See citation #87
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Vlaskamp, C. (2008). See citation #
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INDEX—VOLUME 46,
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Runes, Sandra. See Hausmann-Stabile
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Review of video prompting studies w
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Look! I'm in College! DVD Look, I
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13th International Conference on Au
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