Balancing the Right to Habilitation With the Right to Personal Liberties: The Rights of People With Developmental Disabilities to Eat Too Many Doughnuts and Take a Nap

Abstract

In the pursuit of efficient habilitation, many service providers exercise a great deal of control over the lives of clients with developmental disabilities. For example, service providers often choose the client's habilitative goals, determine the daily schedule, and regulate access to preferred activities. This paper examines the advantages and disadvantages of allowing clients to exercise personal liberties, such as the right to choose and refuse daily activities. On one hand, poor choices on the part of the client could hinder habilitation. On the other hand, moral and legal issues arise when the client's right to choice is abridged. Recommendations are offered to protect both the right to habilitation and the freedom to choose.

Assessing Food Preferences Among Persons With Profound Mental Retardation: Providing Opportunities to Make Choices

“…Given the importance of providing choices (Bannerman et al, 1990;Guess et al, 1985;Houghton et al, 1987;Shevin & Klein, 1984), future research should evaluate how to assist nonverbal persons with profound mental retardation in making other types of choices, such as specific preparation offoods (e.g., scrambled eggs versus fried eggs) and use or nonuse of condiments. Also, evaluating the context in which respective choices are provided warrants investigation in regard to whether preferences change over time or as a function of specific conditions (e.g., use of con- Given the outcome of this investigation, as well as similar results in the leisure and vocational areas referred to previously, a basic technology currently exists for reliably identifying preferences and reinforcers for persons with severe handicaps.…”

Toward Effective and Preferred Programming: A Case for the Objective Measurement of Social Validity with Recipients of Behavior-Change Programs

“…Routine use of this procedure allows for self-determination (Bannerman et al, 1990) and for the person to be at the center of the planning Incorporate at least three options in your assessment: two should be target behavior-change procedures (those of interest); a third option should be a control context devoid of reinforcement and therefore unlikely to be preferred. Inclusion of this third context will allow you to distinguish between ambivalence (fairly equal responding to the two target options) from indiscriminate performance in the assessment (fairly equal responding to all options).…”

“…It is not because professionals do not agree that recipients of the behavior-change procedures should have influence over their selection. There is an abundance of shared advocacy for involving recipients in decisions regarding behavior-change procedures; such inclusion has been advocated by many different people in many different ways and for quite some time (self-determination movement: Bannerman, Sheldon, Sherman, & Harchik, 1990; positive behavioral support systems: Carr et al, 2002;person-centered planning: Holburn, 1997; a children's rights-based approach: Lundy & McEvoy, 2009; right to effective treatment: Van Houten et al, 1988). Another main finding of the social validity review ) seems pertinent here: 90% of social validity assessments involve indirect measures (e.g., verbal responses to questions about the appropriateness of procedures).…”

Effects of Reinforcement Choice on Task Responding in Individuals With Developmental Disabilities

“…Thus, permitting individuals with developmental disabilities to select their own tasks, activities, and reinforcers is valuable not only because it enhances personal dignity and self-determination, as suggested by numerous authors (e.g., Bannerman, Sheldon, Sherman, & Harchik, 1990;Guess, Benson, & Siegel-Causey, 1985;Shevin & Klein, 1984), but also because such opportunities can function as a useful clinical tool.…”