Five adults with profound physical and intellectual disabilities were taught to respond to photographs of preferences embedded in Microsoft PowerPoint (Microsoft, 1997) presentations by operating microswitches that functioned as mouse clicks. Rate of responding was generally correlated with changes in types of presentation, although variability in rate was often high, and session durations were quite short. Two participants showed substantial increases in responding when fitted with switches that were easier to manipulate. This exploratory study demonstrates that people with extremely limited physical and cognitive abilities can be taught to operate switches that produce changes in visual arrays on a computer screen and sometimes differentially so. Implications for responding to photographic representations of preferences, rather than the tangible preferences themselves, are discussed.

After a slow start, the popularity of applied behavior analysis for people with severe behavior problems peaked in the 1970s and was then battered down by the effects of methodological behaviorism, the aversives controversy, overregulation, and the inherent limitations of congregate living. Despite the ethical, technical, and conceptual advancements in behavior analysis, many people with challenging behavior live in futile environments in which the behavior analyst can only tinker. A radically behavioristic approach has become available that has the power to change these conditions, to restore the reciprocity necessary for new learning, and to bring residential behavior analysts more in contact with the contingencies of helping and teaching. The approach is consistent with alternatives that behaviorists have suggested for years to improve the image and effectiveness of applied behavior analysis, although it will take the behaviorist far from the usual patterns of practice. Finally, the approach promotes its own survival by promoting access to interlocking organizational contingencies, but its antithetical nature presents many conceptual and practical challenges to agency adoption.

We conducted a longitudinal comparative evaluation of person-centered planning processes and outcomes for 20 individuals with intellectual disabilities and problem behavior (former residents of Willowbrook) and a matched contrast group, who received traditional interdisciplinary service planning (ISP). At the inception of the study, all participants were living in one of four other developmental centers (institutions) in New York City. Process and outcome data obtained from questionnaires completed by team members approximately every 8 months at four time periods showed that the rate of improvement in both person-centered planning process and outcomes for the intervention group was significantly greater than that of the comparison group. Eighteen of 19 person-centered planning participants moved to community living arrangements, as did 5 of 18 in the contrast group.

This article argues that the popular, but at times, misapplied approaches of person-centered planning can be remedied through scientific practices. Person-centered planning is described in the context of an evolving disabilities culture that is selecting practices that achieve the values of the new paradigm. Operationalizing outcomes that constitute aspects of quality of life (QOL) can be challenging, but the main obstacle to an empirical analysis of person-centered planning appears to be reliable implementation of its complex process. Resolution of these problems is seen as a cutting edge for expanding our applied research technology in assisting people with disabilities achieve the values to which they aspire.

Although person-centered planning is a popular approach in the field of developmental disabilities, there has been little systematic assessment of its process and outcomes. To measure person-centered planning, we developed three instruments designed to assess its various aspects. We then constructed variables comprising both a Process and an Outcome Index using a combined rational-empirical method. Test-retest reliability and measures of internal consistency appeared adequate. Variable correlations and factor analysis were generally consistent with our conceptualization and resulting item and variable classifications. Practical implications for intervention integrity, program evaluation, and organizational performance are discussed.