Systematic Review of Procedures and Outcomes of Choice-Based Interventions with Children
Letting kids make small choices during ABA sessions can increase cooperation without hurting clinical outcomes.
01Research in Context
What this study did
Kestner et al. (2023) read every paper they could find on giving kids choices during ABA.
They looked at studies with children, both with and without disabilities.
The team sorted the papers by how choice was added: picking reinforcers, picking tasks, or picking the order of activities.
What they found
Most studies used simple choice formats like "pick your toy" or "work first or play first".
Few studies let kids pick between whole treatment packages.
The review shows you can embed choice without losing control of the clinical goal.
How this fits with other research
Cryan et al. (1996) did a smaller review 27 years earlier. They only looked at people with severe disabilities. Kestner et al. (2023) widened the lens to all children and found the same core idea: choice helps.
Auten et al. (2024) came next. They zoomed in on one fancy method called concurrent-chains. Kestner et al. (2023) shows that simple choice works too—you don’t need the fancy setup.
Green et al. (1999) and Wanchisen et al. (1989) are single-case studies inside Kestner’s big picture. These old papers prove that one child picking a toy can cut problem behavior. Kestner shows this scales across hundreds of kids.
Why it matters
You can give choice today without redesigning your whole program. Start small: let the child pick the reinforcer before each trial, or pick the order of two tasks. The review says this tiny step can boost cooperation and still hit your target skills.
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02At a glance
03Original abstract
AbstractIn behavior-analytic clinical work and research, opportunities for choice can be arranged as an independent variable, and response allocation among choice options can be measured as a dependent variable (i.e., engaging in one response given two or more concurrently available options). Choice-based interventions provide behavior analysts with tools to promote their clients’ rights to autonomy and self-determination by incorporating client preference. The purpose of the current article is to systematically review the literature published from 2003 to 2020 on choice-based interventions with children. We reviewed 32 articles (38 experiments) identified through ERIC, PsycINFO, and MEDLINE/PubMed, and we summarized the participant and study characteristics arranged into two categories by procedure: (1) differential reinforcement with asymmetrical-choice options; and (2) building choice opportunities into daily contexts. We provide suggestions for clinical applications of choice to intervention procedures and future research. The reviewed literature demonstrates how practitioners working with children can use choice-based interventions to incorporate consumer choice into clinical practice while effectively addressing versatile clinical goals across populations and settings.
Education and Treatment of Children, 2023 · doi:10.1007/s43494-023-00088-8