Evaluating and Increasing Meal-Related Choices Throughout a Service Setting for People with Severe Disabilities

An area of concern regarding quality of life among people with severe disabilities is the amount of choice individuals make during their daily routine. This investigation examined a means of evaluating and increasing meal-related choices in an adult education service setting. A choice provision program was implemented in each of four classrooms in which there was a lack of student choices during break periods relative to other classrooms. The program included stepwise procedures for quantitatively evaluating choice making and systematically presenting choice opportunities along with a supervision component for assisting staff in providing such opportunities. The program was accompanied by increased choices in each classroom. Additionally, a social validity comparison indicated: (a) in four other settings serving people with severe disabilities there were minimal choices, especially when compared with choices reported by adults without disabilities; and (b) the increased choice making accompanying the program in this study was well above the level in the four comparison settings and was comparable to the level reported by people without disabilities. Results are discussed in regard to extending advances in choice making reflected in the literature into routine service settings and using quantifiable assessments of choice making as part of agency best-practices evaluation.