The exercise of choice by adults with intellectual disabilities: A literature review

This paper reviews recent research concerning the exercise of choice by people with intellectual disabilities, drawing on the fields of social policy and psychology. The concept of choice has been treated differently at policy level, in theories of decisionmaking and within experimental research, although many studies of choice-making offer no definition of the term. At a methodological level, the difficulties inherent in measuring outcomes and a tendency to seek only the views of staff and carers, rather than people with intellectual disabilities themselves, lead to limitations in some studies. While many writers assert the importance and benefits of choice, others have argued that the right to choose maybe at odds with the goals of rehabilitation. Although people living in community settings generally have opportunities to make choices about day-to-day matters, relatively few are encouraged to make decisions about major life events. A range of factors which facilitate or inhibit the exercise of choice are identified from the literature, including those affecting people with profound intellectual disabilities. The reported outcomes of exercising choice are reviewed and, finally, some implications for future research are drawn out.