Concepts and Issues Related to Choice Making and Autonomy among Persons with Severe Disabilities

Guess, Doug; Benson, Holly Anne; Siegel-Causey, Ellin; Agran, Martin

doi:10.2511/rpsd.33.1-2.75

Cited by 26 publications

(14 citation statements)

References 13 publications

(12 reference statements)

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“…In the past it was common for people with learning disabilities to have little or no choice generally, not merely in regard to food issues (Guess et al 1985). Following the adoption of the tenets of 'normalization' and 'social role valorization' (Nirje 1972;Tyne 1981;Wolfensberger 1972Wolfensberger , 1983 large-scale institutions closed and gradually people with learning disabilities came to live in smaller groups and in individual tenancies, and for support to be more personcentred.…”

Section: Choice For People With Learning Disabilitiesmentioning

confidence: 99%

From biscuits to boyfriends: the ramifications of choice for people with learning disabilities

Smyth¹,

Bell²

2006

Br J Learning Disab

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Accessible summary• Choosing can be easy, such as when deciding what biscuit to eat.• Sometimes it is hard to choose, such as deciding on who to have as a boyfriend or girlfriend.• Sometimes even choosing a biscuit can be hard if your doctor says it is not healthy for you.• There are lots of reasons why we choose to do things.• Everyone needs to think about these reasons to help people with learning disabilities make good choices. SummaryChoice plays an important role in a person's quality of life. This paper looks at the issue of choice for people with learning disabilities. It considers the extent to which people with learning disabilities are able to choose and are provided with real choices. It also covers the extent to which true choice may or may not be advantageous for some people with learning disabilities. By concentrating particularly on the issue of choice about food and diet, this paper indicates how seemingly simplistic choices, such as decisions over food consumed, can cause major health problems for the decision-maker and hence be a more complex and vital decision than at times it is perceived to be. Additionally, this paper focuses on important factors surrounding choice for people with learning disabilities that previous research may have overlooked. One such factor is how past experience affects the decision-making process. Another, is the issue of the range of choice that is possible, relative to a person's cognitive ability to be fully aware of this range. In particular, this paper emphasizes the important role of the carer. It addresses the impact which the carer's own, perhaps unconscious personal choices, beliefs and ideologies may have on the 'choices' made by people with learning disabilities, and more worryingly, on the 'choices' offered to them. This paper highlights problems with current research into the area of choice for people with learning disabilities and provides suggestions for future study.

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Section: Choice For People With Learning Disabilitiesmentioning

confidence: 99%

From biscuits to boyfriends: the ramifications of choice for people with learning disabilities

Smyth¹,

Bell²

2006

Br J Learning Disab

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“…This conflict is recognized in the recent Green Paper on social care, Independence, Well-Being and Choice, which acknowledges the need for a debate about managing issues of choice against the protection of vulnerable adults such that choice is not invariably sacrificed to the goal of protecting individuals from risk (DH, 2005;see Beamer &Brooks, 2001 andGuess et al, 1985 for discussions of this issue). But risk is not the only agenda that might conflict with goals of choice and empowerment, and the Green Paper recognizes that staff can be under pressure from several different directions.…”

Section: ) Conflicting Agendas and Inspection Regimesmentioning

confidence: 99%

“…Suggestions for overcoming these sorts of problems do appear in the literature in the form of carefully controlled behavioural experiments in which people learn to use symbols, objects or microswitches to express preferences (eg Cooper & Browder, 1998;Guess et al, 1985;Lancioni et al, 1998;Nozaki & Mochizuki, 1995), or in recommendations to supporters to gather evidence to support interpretations (Edge, 2001;Grove et al, 2000;Puddicombe, 1995), and to treat behaviours as having meaning using developmental models (eg Grove et al, 1999). However, these strategies require either a degree of specialist knowledge or a culture of consistency, debate and evaluation which may be lacking in many services for people with severe communication difficulties.…”

Section: ) Communication Difficultiesmentioning

confidence: 99%

Promoting choice and control in residential services for people with learning disabilities

Finlay

Walton

Antaki

2008

Disability & Society

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This paper discusses the gap between policy goals and practice in residential services for people with learning disabilities. Drawing on a nine-month ethnographic study of three residential services, it outlines a range of obstacles to the promotion of choice and control that were routinely observed in the culture and working practices of the services. Issues discussed include conflicting service values and agendas, inspection regimes, an attention to the bigger decisions in a person's life when empowerment could more quickly and effectively be promoted at the level of everyday practice, problems of communication and interpretation, and the pervasiveness of teaching. We offer a range of suggestions as to how these obstacles might be tackled.Promoting choice and control..

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“…Many researchers share the opinion that independence, understood as a combination of self-determination and self-care, is a key competence which can even improve one's state of health (Guess, Benson & Siegel-Causey, 2008). Research in this field (e.g.…”

Section: Introductionmentioning

confidence: 99%

Identity, self-sufficiency and disability in the context of educational and vocational activity

Piotrowski¹,

Brzezińska²

2011

Polish Psychological Bulletin

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Concepts and Issues Related to Choice Making and Autonomy among Persons with Severe Disabilities

Cited by 26 publications

References 13 publications

From biscuits to boyfriends: the ramifications of choice for people with learning disabilities

From biscuits to boyfriends: the ramifications of choice for people with learning disabilities

Promoting choice and control in residential services for people with learning disabilities

Identity, self-sufficiency and disability in the context of educational and vocational activity

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