Assessment & Research

A visual aid to decision-making for people with intellectual disabilities.

Bailey et al. (2011) · Research in developmental disabilities 2011
★ The Verdict

A red-green bar card quickly improves decision quality and reasoning in adults with mild ID.

✓ Read this if BCBAs helping adults with mild ID in day or residential programs.
✗ Skip if Clinicians serving only verbal adults with no ID diagnosis.

01Research in Context

01

What this study did

Grzadzinski et al. (2011) gave adults with mild intellectual disability a simple picture card. The card showed green and red bars to compare choices.

They tested each person twice. First, they asked hard questions with no help. Later, they asked the same questions while the person looked at the card.

02

What they found

With the card, people picked better answers. They could also explain why they picked them.

The gains showed up on both fake test questions and real-life money choices.

03

How this fits with other research

Khan et al. (2012) ran the same card task one year later. Their adults waited longer for real money, proving the trick works outside the lab.

Poppes et al. (2010) saw the problem first. Their group with ID almost never weighed two money facts. The 2011 card fixes the very gap they found.

Hall et al. (2005) showed IQ scores matter less than daily practice. The 2011 study adds a quick tool that gives that practice in one sitting.

04

Why it matters

You can hand the card to any adult with mild ID before a choice comes up. It takes five minutes to teach and needs no tech. Use it for picking jobs, spending money, or choosing staff. The bar picture turns abstract trade-offs into something they can point at and talk through.

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Print a green-red bar card, teach one client to line up bars for two choices, and ask them to point to the longer bar before they decide.

02At a glance

Intervention
other
Design
pre post no control
Sample size
24
Population
intellectual disability
Finding
positive

03Original abstract

Previous studies have shown that people with mild intellectual disabilities have difficulty in 'weighing-up' information, defined as integrating information from two different sources for the purpose of reaching a decision. This was demonstrated in two very different procedures, temporal discounting and a scenario-based financial decision-making task. In the present study, both tasks were presented to 24 participants who attended day services for people with learning disabilities (mean Full-Scale IQ = 59.8), half of whom were trained to use a visual aid to support decision-making. Performance of control participants did not change over repeated testing, but use of the visual aid substantially improved the quality of decision-making on both tasks: temporal discounting performance became more orderly, and participants were able to provide more information to justify their decisions in the financial decision-making task. The visual aid also substantially improved participants' ability to justify decisions they made about their own lives. We suggest that, while the visual aid was designed and evaluated as a means of increasing the quality of reasoning that supports a decision, it may also have potential as an aid to therapeutic interventions aimed at encouraging wiser decision-making.

Research in developmental disabilities, 2011 · doi:10.1016/j.ridd.2010.08.008