Helping People with Developmental Disabilities Express Personal Preferences
Categories: ASD and DD, Adult-focused
How can I help someone with a developmental disability better communicate and express themselves?
By Teka J. Harris, M.A., BCBA
Do you prefer coffee or tea? Ham and cheese, or tuna salad? What is your favorite television program? No doubt you can easily answer these questions and just as easily make your preferences known to others.
For some individuals with developmental disabilities, however, communicating personal preferences can be a frustrating challenge. Many of these individuals know exactly what they like and do not like, but lack the communication skills necessary to make their wants, needs, and preferences known. Oftentimes, others make choices for them.
Creating opportunities for individuals with developmental disabilities to make their own choices is important. Obtaining input directly from these individuals is the best and most accurate way to determine their likes and dislikes.
As a clinician who works with adults who have communications challenges, I often rely on nonverbal communication such as facial expressions, body language, and behavior to help me determine their preferences.
There are several methods that can be used to determine an individual’s preferences. One is to offer a “forced choice,” a choice between one item and another. For example, you might place a bottle of soda and a container of orange juice in front of a person and ask him to choose which he would like to drink. He may indicate his preference with a smile, eye contact, or by pointing to the item he wants. He may indicate dislike by pushing one of the items away. He may also look away or fail to respond, which might be an indication of indifference toward both items.
Forced choices can be helpful if you’re trying to determine what an individual wants to eat or drink, where he wants to go, and which activities he would like to engage in. They can also be used to determine which items a person would like to earn as a reward in a skill-training program, or upon completion of a work activity.
Another method used to determine what a person prefers is preference assessment. Preference assessments are similar to forced choices, but they go one step further. Let’s say the individual reaches for the container of orange juice. You could assume that the orange juice is the preferred item, but it could simply be the better of the two choices. What if the individual preferred orange juice to soda, but would actually rather have a glass of milk?
To conduct a preference assessment, you would leave the soda (the chosen item) in front of the individual, but replace the orange juice (the item not chosen) with something new. If the individual chooses the soda again, then it might be safe to assume that the soda is actually what he wants. If the individual chooses the new item, then you know that this item is more highly preferred than both the orange juice and the soda. You could stop there, or you could continue by switching out the item that was not chosen, with another new item. Keep in mind that an individual’s preferences may change. He or she may prefer milk after eating a cookie, but not after eating a bowl of spaghetti.
Individuals with developmental disabilities have the right to make choices, and it is up to the caregivers and treatment providers to ensure that they have every opportunity to do so. Preference assessments enable people with special needs to make choices. They also provide these individuals with more control over their environments, thereby increasing their independence, self-confidence, and self-esteem.
Teka J. Harris, M.A., BCBA, is the Clinical Director for the Western Massachusetts division of the May Center for Adult Services. She can be contacted in West Springfield at 413.734.0300 (x261) or at firstname.lastname@example.org.