Despite increased recognition of the importance of providing routine choice opportunities for persons with severe handicaps, this population continues to experience a typical lack of such opportunities. We evaluated a program for increasing the amount of choices made during routine mealtimes by persons with profound mental retardation and minimal communication skills. The choice provision program, involving systematic presentation of alternative food and drink items in a step-wise fashion during the course of the meal, was implemented with three persons in a residential facility. Results indicated that after implementation of the choice program, all three participants made consistently more choices concerning the foods and beverages they consumed relative to baseline. The choice provision program was conducted without extending the amount of time typically allotted to mealtime within the residential setting. Results are discussed in regard to additional research needed to continue developing means of assisting persons with profound mental retardation to exert control over meaningful events in their lives.
An area of recent and pervasive concern in service provision for persons who have severe handicaps is choice making. The need to provide choice-making opportunities for this population has been discussed repeatedly in the professional literature (Guess, Benson, & Siegel-Causey, 1985; Houghton, Bronicki, & Guess, 1987; Shevin & Klein, 1984). Major professional organizations also have incorporated the importance of providing choices for persons with severe disabilities into their policy statements (e.g., AAMR, 1990). Relatedly, the provision of choice-making opportunities has become a required part of new governmental regulatory standards, including the Title XIX Medicaid Program that regulates habilitative service delivery for some 140,000 people with mental retardation (Holburn, 1990).
The recent increase in attention given to client choice making has been due in large part to heightened awareness of the importance of having choice opportunities on the overall quality of life of persons with severe handicaps (Parsons, Reid, Reynolds, & Bumgarner, 1990