Does choice influence quality of life for people with mild intellectual disabilities?
Real daily choices, even small ones, raise quality-of-life scores for adults with mild intellectual disability living in the community.
01Research in Context
What this study did
Neely-Barnes et al. (2008) asked adults with mild intellectual disability who lived in the community how many choices they made each day. They also gave them a short quality-of-life survey.
The team then looked at whether people who made more choices also scored higher on life quality.
What they found
Adults who picked their own meals, clothes, and activities scored higher on happiness, relationships, and daily living skills than adults with fewer choices.
The link held even when other factors like age or support level were taken into account.
How this fits with other research
van Herwaarden et al. (2025) later tested a program called Active Support that teaches staff to offer real choices throughout the day. Their nine-month randomized trial found the same pattern: more choice led to higher independence and well-being.
Nadig et al. (2018) showed similar gains in adults with autism who joined a ten-week group focused on self-determination skills. Together these studies show the effect is not limited to one diagnosis or setting.
Cooper et al. (1990) once worried that adults with ID might make poor decisions, but their lab task found no difference in choice quality. Neely-Barnes et al. (2008) moves the question into real life and shows choice itself, not perfect decisions, boosts life quality.
Why it matters
You do not need a new curriculum or extra funding. Start by giving clients two real options at snack, chore, or free-time moments. Track whether they smile more, stay longer at tasks, or need fewer prompts. Over weeks these micro-choices add up to measurable quality-of-life gains.
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02At a glance
03Original abstract
Consumer choice is a key concept in developmental disability intervention, but relatively little quantitative research has focused on the relationship between choice and quality of life. This study used data from Washington state's Division of Developmental Disabilities 2002 National Core Indicators study (Human Services Research Institute, 2001a, 2001b) to examine the relationship between choice and 3 quality-of-life indicators: community inclusion, rights, and opportunities for relationships. Consumers (N = 224) with mild intellectual disabilities participated in the study. Structural equation modeling was used to assess the influence of type of living arrangement and choice on quality of life. Consumers who lived in the community and made more choices had higher scores on quality-of-life indicators. The findings have implications for disability policy, practice, and future research.
Intellectual and developmental disabilities, 2008 · doi:10.1352/0047-6765(2008)46[12:DCIQOL]2.0.CO;2