Systematic Review of Procedures and Outcomes of Choice-Based Interventions with Children

Abstract

In 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.

A review of the concurrent‐chains arrangement to assess intervention choice: 2018–2023

“…In these cases, clinicians should generally implement the highest preferred treatment if that intervention can be implemented with high fidelity. Additional research is needed to determine the effect that choice-based interventions have on durable behavior change when fidelity errors occur (Kestner et al, 2023). Notably, in Frank-Crawford et al (2019), one participant showed preference for the least efficient intervention.…”

“…This is reflected in the Behavior Analyst Certification Board (BACB) Ethics Code, which states that behavior analysts should consider relevant factors such as client and stakeholder preference when implementing behavior‐change procedures (BACB, 2022). Evaluating choice is one way to obtain information about preference (Kestner et al, 2023). An early evaluation of objective choice for token economy arrangements was reported by Iwata and Bailey (1974); however, that approach remained uncommon for decades.…”