The Impact of Combined Within- and Across-Activity Choice on the Indices of Happiness and Unhappiness of Autistic Children

Abstract Objectives Autistic children often have fewer opportunities to develop autonomy and demonstrate self-determined behavior, which are key to quality of life. Including opportunities for making choices during discrete trial training (DTT) may promote self-determination. Studies have shown that embedding choice opportunities into DTT can reduce problem behaviors and increase academic engagement, but the effects of choice on quality of life indicators such as signs of happiness have rarely been examined. The purpose of this study was to measure changes in operationally defined individualized indices of happiness and unhappiness of three autistic children during DTT sessions with embedded choice-making opportunities. Methods Three preschool boys on the autism spectrum participated in the study. Their indices of happiness and unhappiness were measured using 15-s partial interval recording, while their task engagement was measured using 15-s whole interval recording. A concurrent multiple baseline across participants design was used to examine the effects of the choice intervention package. Results The additional choice-making opportunities moderately improved the behavioral indicators of happiness and unhappiness of all three children. Small improvements in task engagement were also observed for two of the three children. Conclusions This study demonstrated that various types of choice can be embedded into DTT programs for autistic children and provided preliminary evidence that additional opportunities for choice within DTT can improve the behavioral indicators of mood of autistic children.