Using a visual support package to facilitate independent leisure engagement and choice-making for individuals with moderate to severe autism in Taiwan

LAY ABSTRACT

Self-determination encompasses various components, including decision-making and independence, making it a complex process. While the importance of self-determination for individuals with autism spectrum disorder has been explored in previous studies, there is limited research focusing on individuals with moderate to severe autism spectrum disorder. Evidence-based practices such as visual activity schedules and video modeling have shown effectiveness in promoting independence among individuals with autism spectrum disorder. To address the need for independence and choice-making among individuals with moderate to severe autism spectrum disorder, this study developed a visual support package incorporating visual activity schedules, video modeling, preference assessments, and prompt procedures. By investigating the intervention's effectiveness in three participants, this study contributes to the existing literature on the use of a visual activity schedule and video modeling in enhancing choice-making and independent leisure engagement. Following the intervention, all participants were able to select three leisure activities, develop their own visual schedules, and complete them. Notably, this study conducted preference assessments to determine participants' preferred leisure activities and did not provide additional reinforcement. Practical implications of this research include incorporating video prompting as needed and adjusting activity engagement time. Future research should explore the long-term effectiveness of the visual support package and its application in developing novel skills or vocational activities for individuals with moderate to severe autism spectrum disorder. This study fills a critical gap in the literature, providing important insights for practices and research in the field of autism spectrum disorder interventions.

A practitioner's guide to emphasizing choice-making opportunities in behavioral services provided to individuals with intellectual and developmental disabilities

Promoting choice is a defining value guiding Positive Behavior Support (PBS) models for serving individuals with intellectual and/or developmental disabilities (IDD). The ability to make independent choices is of paramount importance to self-advocacy and self-determination. Promoting choice is also an essential commitment of trauma-informed care (TIC) in the provision of services to vulnerable individuals, as trauma often involves experiences in which an individual has no control over aversive events that occur, and choice-making opportunities can empower traumatized individuals to regain control over the environments they routinely encounter. However, incorporating meaningful choice making into behavioral programming is often more difficult than it seems. We synthesize the relevant, contemporary literature to provide professionals with actionable suggestions for incorporating choice making into everyday behavioral services. After summarizing the importance of promoting choice into behavioral services based on the values that define both PBS and TIC frameworks, we (a) offer a behavior-analytic interpretation of the skill of making choices, (b) synthesize key literature on how to teach choice making skills, (c) provide recommendations for the situations within one's care in which choice-making opportunities may be most beneficial, and (d) discuss some of the barriers and potential solutions to incorporating choice-making opportunities for individuals with IDD.

Preparing staff to enhance active participation of adults with severe disabilities by offering choice and prompting performance during a community purchasing activity

The purpose of this study was to evaluate the effects of a multicomponent staff training package on the number of choice responses and performance responses made by adults with disabilities in a community purchasing activity. The multicomponent training package included an inservice (written manuals, a verbal explanation of the information, role play activities, and video examples) performance feedback sessions in the community context, and self-monitoring instruction. Primary data were collected on how each staff offered choices and prompted performance with an individual with severe disabilities in three different fast food restaurants per week. Secondary data were collected on the number of choices individuals with disabilities made and the level of their performance during a purchase in a fast food restaurant. The findings showed that all four of the staff did not give opportunities for choices and used intrusive prompting or performed the skill for the person in baseline, but mastered these skills the first probe after the training sessions. In addition, the staff generalized offering choices and prompting performance across settings and adults with disabilities and maintained the skills. Also, the adults with disabilities increased the number of choice responses they made as well as their level of performance (compared to baseline) after the staff received the intervention.