Choice and preference assessment research with people with severe to profound developmental disabilities: a review of the literature.

The authors read 30 studies about choice and preference for people with severe to profound developmental disabilities. They grouped the papers into two piles: choice interventions and preference assessments.

They wrote a plain-language summary of each pile. The review does not report new data; it stitches together what was already known in 2005.

Giving clients real choices cut problem behavior and increased adaptive behavior. Structured preference tests (single-item, paired-stimulus, MSW) reliably found reinforcers.

Staff guesses were often wrong. Systematic tests beat opinion every time.

Kang et al. (2013) superseded this review. Their stricter systematic review of 14 studies pinpoints which assessment formats give the most accurate reinforcer picks, updating the looser 2005 narrative.

Lord et al. (1997) seems to contradict the review. They found that letting learners pick between two already-liked items did not boost task responding. The clash fades when you see they used only high-preference items; the review mixed in meaningful choices across daily routines, not just reinforcer selection.

Mueller et al. (2000) adds another wrinkle. Choice helped only when items were truly preferred; with low-preference junk it did nothing. Value and population differences explain the apparent contradiction.

Villafaña et al. (2023) extends the idea. They showed pictorial food assessments work for kids with food refusal, proving the 2005 methods still evolve for new clinical problems.

Stop guessing reinforcers. Run a brief paired-stimulus or MSW test before every new program. If problem behavior pops up, build in real choices—what to do first, which seat to take, which song to play. The 2005 evidence says those small choices cut problem behavior and build cooperation. For the toughest cases who can only press one switch, borrow the 2011 two-choice setup—brief familiarization then quick reversals. Update your procedures with the 2013 systematic-review picks for even better accuracy.