Teaching Choice Making

to Children with Visual

Impairments and Multiple
Disabilities in Preschool
and Kindergarten Classrooms
Christine Clark and Andrea P. McDonnell
Abstract: This study examined the effectiveness of an intervention package that
included visual accommodations, daily preference assessments, and naturalistic
instructional strategies on the accuracy of choice-making responses for three
participants with visual impairments and multiple disabilities. It also examined
the participants' ability to maintain and generalize responses across settings,
items, and individuals.
A main focus for educators in creating
appropriate learning environments for
young children with disabilities is the
need to present the children with choices
to allow them to participate in shaping
their learning (Bailey & Wolery, 1992;
Bishop, 1996; McCormick, Jolivette, &
Ridgley, 2003; Sacks, 1998; Sadler,
2003). Engaging children with disabilities
in classroom activities may reduce their
sense of helplessness and increase their
ability to learn. When an individual is
able to influence and create change, such
as by making a choice, he or she begins to
open doors to an endless number of pos-
sibilities. "Choice provides children the
opportunity to use cognitive skills, com-
munication skills, motor skills, and social
skills" (McCormick et al., 2003, p. 5).
Potential strategies for increasing the en-
gagement or choice-making skills of
young children with visual impairments
and multiple disabilities are new areas
that researchers are beginning to explore
(Jolivette, Stichter, Sibilsky, Scott, &
Ridgley, 2002; Roman, 2004).
Typically developing preschool chil-
dren do not require accommodations or
adaptations to assist them in choosing and
participating in activities. These children
learn through watching others or explor-
ing on their own. Several opportunities
for making choices are presented in most
preschool classrooms during large- and
small-group activities, individual learn-
ing sessions, and free-play opportunities
(Stafford, Alberto, Fredrick, Heflin, &
Heller, 2002), encouraging children to
make independent choices based upon
where and with what items they would
like to play. Gradually, children learn the
importance of choosing wisely as they see
the effect of the choices on their interac-
tions and play opportunities (Hanley,
Iwata, & Lindberg, 1999; McCormick
et al., 2003; Stafford et al., 2002).
AFB, All Rights Reserved Journal of Visual Impairment & Blindness, July 2008 3 9 7
Children with disabilities do not de-
velop the ability to choose items or activ-
ities within the classroom as easily as do
their typically developing peers, and this
ability may be substantially reduced be-
cause of the complexity of their disabili-
ties (Church, 2000; Downing & Bailey,
1990; Li, 2003; Sacks, 1998; Utley, Ro-
man, & Nelson, 1998). Many children
with multiple disabilities are diagnosed
with cortical visual impairment (CVI).
Children with CVI have normal eye ex-
aminations, but their vision fluctuates, de-
pending on the environment, because of
damage to the visual systems in their
brains (Blind Babies Foundation, 2000;
Erin, 2004; Roman-Lantzy, 2007; Sacks,
1998). When children have the challenge
of a combination of disabilities, such as
visual impairments and cognitive or phys-
ical disabilities, the necessary level of ad-
aptations these children need may signif-
icantly increase, and they may fail to
respond to a request because of their need
for extended time to process incoming
information (Janssen, Riksen-Walraven,
& Van Dijk, 2003). The best opportuni-
ties for learning for such children may
also require limited stimulation and spec-
ified objects (Alexander, 2001; Downing,
1999). Many adults simply find it easier
to complete tasks or make choices for
these children, rather than to assist them
(Head, 1992; McCormick et al., 2003).
Research has presented a clearer under-
standing of what choice making entails,
the independence and participation it pro-
vides, naturalistic instructional strategies
that may be implemented, and barriers
that need to be overcome to allow oppor-
tunities for all children (Church, 2000;
Daugherty, Grisham-Brown, & Hemme-
ter, 2001; McCormick et al., 2003). When
an individual is able to communicate a
choice, he or she is able to learn about
items, explore his or her environment,
and participate in various activities
(D'Allura, 2002; Stafford et al., 2002).
Although past research investigated
children with disabilities in reference to
choice-making opportunities and the de-
velopment of skills, little research has
been conducted on children who struggle
in these areas when dealing with a unique
and individualized combination of two or
more disabilities. Jolivette et al. (2002, p.
396) noted that research has been "incon-
clusive as to what constitutes best prac-
tice for both the delivery and type of
choice-making opportunities for young
children with and without disabilities."
The study presented here examined
the effects of planning by an educa-
tional team to offer choice-making op-
portunities to children with disabilities
and measured the accuracy of the chil-
drens' responses. The following were
the specific research questions that were
addressed:
1. Will the use of CVI accommodations;
daily preference assessment; naturalis-
tic instruction, including response
prompts and constant time delay; and
naturalistic consequences be effective
in increasing the accuracy of choice
making from current levels as demon-
strated by motor response (pointing or
touching) for children with visual im-
pairments and multiple disabilities in
preschool and kindergarten settings?
2. Will children with visual impairments
and multiple disabilities be able to
generalize choice making accurately to
other preschool and home routines?
3 9 8 Journal of Visual Impairment & Blindness, July 2008 2008 AFB, All Rights Reserved
3. Will the classroom staff members be
able to implement procedures accu-
rately and across time?
4. How do the classroom staff members
rate the intervention package with re-
gard to ease of implementation and
effectiveness in increasing choice
making for children with visual im-
pairments and multiple disabilities?
Method
PARTICIPANTS AND SETTINGS
The three participants who were selected
were aged 3 to 6; attended a preschool or
kindergarten classroom a minimum of
two days per week; met the criteria for
legal blindness (visual acuity of 20/200 or
less) or a diagnosis of CVI; and were
diagnosed with multiple disabilities
through formal and informal assessments
in the areas of cognitive, academic, lan-
guage and communication, social, and
sensory motor skills (Utah State Board of
Education, 2000). In addition, their class-
room teachers were interested in develop-
ing choice-making behavior, as deter-
mined through their completion of a
questionnaire.
Participant 1, Aaron, aged 4 years, 10
months (58 months), was diagnosed with
a brain tumor and CVI at age 1. Partici-
pant 2, Carson, aged 5 years, 5 months
(65 months), was diagnosed at birth with
cerebral palsy, moderate hearing impair-
ments, CVI, and severe cognitive disabil-
ities. Participant 3, Cathy, aged 5 years, 8
months (68 months), was diagnosed with
severe developmental delays in cognition,
gross motor skills, and communication;
her visual acuity was approximately 20/
400. The participants did not interact in
classroom activities unless they were di-
rectly assisted by a teacher or paraprofes-
sional. The selected response, based on
individual needs and skills, for all three
participants required them to reach for or
toward a preferred item.
MATERIALS
A variety of materials (such as favorite
objects, foods or beverages, and activities
from both the home and school settings)
were selected by the participants' parents
and classroom teachers. As Roman-
Lantzy (2007) noted, many children with
CVI typically respond best to objects of a
single color, often a preferred color, and
are attracted to objects that have the ap-
pearance of motion. This information as-
sisted in the selection of the materials. A
minimum of 10 items were selected for
each participant. A preference assessment
or observation was completed during
which the identified items were randomly
presented three times over a two-day pe-
riod to determine whether the children
responded to or showed interest in the
items. Potential "neutral" items, or items
that would hold little interest to the par-
ticipants, were also presented during the
preference assessment. The top 6 pre-
ferred (and 4 neutral) items were selected
for use during the baseline and interven-
tion phases of the study, with 4 items
reserved for the generalization probes, as
shown in Table 1. Responses were iden-
tified by the participants' facial expres-
sions (such as smiling), eye gaze (for ex-
ample, looking toward, away, or both), or
touch (for instance, reaching toward and
pushing away). The participants' re-
sponses were noted and discussed by the
researcher and classroom teacher for ac-
curacy in determining preferences. In ad-
dition, the participants' facial expressions
2008 AFB, All Rights Reserved Joumai of Visual Impairment & Blindness, July 2008 3 9 9
Table 1
Participants'
Participant
Aaron
Carson
Cathy
preferred and neutral items.
intervention
Preferred
Ciear ball
Star stacker
Rain stick
Telephone
Roiling dog
Boat with balls
Roliing dog
Bubbies
Butterfly
Buggy rattle
Spinner
Ladybug
Octopus
Switch with iights
Switch with glitter
Red ball
Glitter dumbbell
Toothbrush
Neutral
Block
Bubbles
Kleenex
Picture
Kieenex
Block
Elastic bandage
Yeiiow Post-it
Weight
Kleenex
Picture
String
Maintenance and
Preferred
Clifford
Pink bail
Hairy ball
Feathers
Jukebox
Dumbbell
Bead curtain
Reflective paper
Tape player
Yellow ball
Track ball
Hairy ball
generalization
Neutral
String
White rabbit
String
Picture
Spoon
Rubber band
and reaches were discussed to identify the
specific desired responses for the study.
MEASUREMENT AND DESIGN
The dependent measure for this study was
the percentage of choices that were com-
pleted successfully by the participants
reaching for or touching the items. Each
participant was presented with a preferred
item and a neutral item while being
prompted to make a choice through a
predetermined method for him or her. The
teacher recorded the number of times the
participants exhibited the target behavior
and calculated the percentage of correct
responses from the number of possible
opportunities.
A multiple baseline probe design (Taw-
ney & Gast, 1984) was used for all par-
ticipants to evaluate the effectiveness of
the intervention package on teaching
young participants with visual impair-
ments and multiple disabilities to make
choices within activities.
PROCEDURES
The study consisted of the following four
phases: the preliminary assessment phase,
baseline phase, intervention phase or im-
plementation of the intervention package,
and follow-up phase.
Preliminary assessment
A functional visual assessment (Levack,
1991) was completed to help determine
the participants' functional vision and
specific visual accommodations. The as-
sessment was modified to eliminate items
that were not relevant to the participants.
The appropriate physical placement of
items was noted on the Visual Accommo-
dations Checklist. Passive visual accom-
modations combined the placement and
color of the preferred items. Active visual
4 0 0 Journal of Visual Impairment & Blindness, July 2008 2008 AFB, All Rights Reserved
Table 2
Participants' Visual Accommodations.
Accommodations
Passive accommodations
Placement of object
Field
Distance
Color of object
Single "preferred" color
1 to 2 colors
Multiple colors
Active accommodations
Task lighting
Regular classroom
Dimmed classroom
Back lighting
Front task lighting
Other
Modification of environment
Regular classroom
Separate room
Solid color backdrop
Modification of object
Movement or reflective properties
Sound
Aaron
Central
6" to 8"
No
Yes
Yes
Yes
No
No
Yes
No
Yes
Yes
No
Yes
Yes
Carson
Central/upper
1"to6"
No
Yes
No
Yes
No
No
Yes
No
Yes
Yes
No
Yes
Yes
Cathy
Central/right
Up to 12"
No
No
Yes
Yes
No
No
No
No
Yes
Yes
No
Yes
Yes
accommodations included modification
of the location, lighting, and object qual-
ities (for example, reflective qualities).
The specific passive and active visual ac-
commodations for each participant are
presented in Table 2.
A daily preference assessment was
completed to ensure the use of preferred
items and to reduce the possibility that a
participant would not respond because he
or she did not desire an object on a par-
ticular day. The assessment required four
preferred items and three neutral items to
be presented to the participant briefly in
random order and the participant's re-
sponse to the items to be noted. A second
observer (the researcher or a member of
the classroom staff) participated in the
daily preference assessment to monitor
the accuracy of the process. The two pre-
ferred items that the participant re-
sponded to with the most interest were
used as the preferred items during the
intervention for that day. The neutral
items were selected after observing the
participant's lack of interest in the items
during the daily assessment.
Baseline phase
During each subsequent phase, the partic-
ipants were given five opportunities
within each activity (free choice and
snack time) to make a choice. During the
baseline phase, appropriate passive visual
accommodations were provided (like the
color and texture of an object) for each
participant as a preferred item and a neu-
tral item and were presented to the par-
ticipant within the identified distance. Af-
ter the participant visually located both
2008 AFB, All Rights Reserved Journal of Visual Impairment & Blindness, July 2008 4 0 1
items, he or she was asked to respond by
the teacher randomly stating one of the
following: "Show me what you want,"
"what do you want," or "touch what you
want to play with [or eat]." If the partic-
ipant made a choice, the teacher provided
verbal reinforcement ("You want the "
and "That's right!" for example) in ad-
dition to the positive natural conse-
quence of a two- to three-minute period
in which the participant was allowed to
explore, play with, or eat the item. The
participant received the chosen item re-
gardless of whether he or she chose the
preferred or neutral item. The conse-
quences for an incorrect response in-
volved the participant not being able to
acquire either item, since the items were
briefly removed from the participant's
immediate environment.
Probe trials during the baseline phase
were conducted to determine the parti-
cipants' ability to make a choice before
the intervention strategy was introduced
(Tawney & Gast, 1984). Once a stable
baseline was established that allowed for
the prediction of future responses through
data probes, the intervention phase was
implemented (Horner et al., 2005).
Intervention phase
During the first intervention, the active vi-
sual accommodations, including move-
ment, reflective properties, and specific
placement of the preferred items, were im-
plemented. Again, the participant was asked
to respond as a preferred item and a neutral
item were presented, as described for the
baseline phase. The second intervention
included the addition of the independent
variable (naturalistic instruction, response
prompts, and constant time delay in addi-
tion to the CVI accommodations). The
teacher initiated the verbal request, fol-
lowed by a one-second time delay, before
the desired response prompt. The verbal
(stimulus) prompt cued the participant that
a response was requested, and the physical
controlling prompt was provided to assist
the participant in responding correctly. The
prompts were reduced as quickly as possi-
ble, allowing the participant the opportunity
to respond independently. Partial physical
prompts (such as nudging and light push-
ing) were used to encourage the participant
to exert the effort to respond correctly to the
teacher's request. The one-second delay
was presented during the first four days of
the intervention phase, providing a mini-
mum of 40 opportunities prior to the imple-
mentation of a brief delay before the class-
room teacher physically prompted the
desired response. A one-second delay,
rather than the more typical no-second de-
lay, was used because of the substantial
increase in accuracy of choice making with
the inclusion of the active visual accommo-
dations. The one-second delay gave the par-
ticipant the opportunity to initiate the de-
sired response before the teacher presented
the controlling prompt. However, the
teacher was positioned immediately to pro-
vide a physical prompt for the correct re-
sponse if the participant did not initiate re-
sponding after one second. Beginning on
the fifth day of the intervention, a constant
five-second delay was implemented. If the
participant did not respond within the time
delay, the teacher provided the controlling
response prompt, and the correct prompted
response was reinforced. When the partici-
pant was responding correctly prior to the
response prompt for a minimum of 80% of
the opportunities each day for two weeks
(four to eight days), the intervention phase
ended.
4 0 2 Journal of Visual Impairment & Blindness, July 2008 2008 AFB, All Rights Reserved
Follow-up
During the follow-up phase, probes on the
maintenance and generalization of skills
were collected. Maintenance data were
collected using probe trials during free-
choice activities and snack time to deter-
mine whether the participants continued
to use the newly acquired skill of making
a choice. Generalization data were col-
lected using probe trials during a variety
of activities, with different individuals
(such as members of the classroom staff),
and the additional four preferred items
were set aside for this phase.
INTEROBSERVER AGREEMENT
Interobserver agreement was used to
determine the accuracy of the data that
were collected through the assessment
of consistency, minimization of bias,
and definition of the target behavior a
minimum of once per week, achieving a
percentage of agreement within the rec-
ommended percentage range (Kazdin,
1982; Kennedy, 2005). The classroom
teacher and researcher collected data on
the participant at the same time and re-
viewed the data for accuracy. When the
agreement was lower than 100% in a set-
ting, they reviewed the data to clarify and
reduce the potential for future disagree-
ments. The range for interobserver agree-
ment for all participants was 88% to 97%.
During periods in which the researcher
was collecting data on the participants'
behavior, data were also collected on the
accuracy of the presentation of the inter-
vention package. Procedural fidelity was
completed through the use of a checklist
in which each step of the intervention was
checked off after the step occurred (ap-
propriate prompting and interspersing
other interactions between learning prac-
tice trials). If the data were less than 90%
accurate, or any deviations were noted
from the predetermined steps, the data
were reviewed with the classroom teacher
to clarify the process.
DATA ANALYSIS
The data collected regarding the depen-
dent variable were plotted on a graph to
allow for a visual analysis of potential
changes in the level of responses for each
participant among the baseline, interven-
tion, and follow-up phases (Tawney &
Gast, 1984). The graphs were reviewed
for patterns that assisted the researcher in
drawing conclusions about what occurred
and the implementation of the next step or
phase of the intervention (Kennedy, 2005;
Wolery & Dunlap, 1999).
Results
ACCURACY OF CHOICE MAKING
During the baseline phase, the three par-
ticipants exhibited minimal choice-
making skills. For all opportunities of un-
prompted choices, the average percentage
of unprompted correct responses were as
follows: 12.5% (Aaron), 10% (Cathy),
and 8.3% (Carson) (see Figure 1). It is
important to note that a miscommunica-
tion between the teacher and researcher
regarding Aaron's data for Session 4 ini-
tiated the beginning of the intervention
before a stable baseline was reached. The
first intervention phase resulted in an im-
mediate and substantial increase in the
average number of correct choices, with
an average of 58% (Aaron), 73% (Cathy),
and 57% (Carson) for all opportunities of
unprompted choices. The second phase of
the intervention brought Carson's accu-
racy to 100% and Aaron's and Cathy's to
88% each. After four days of presenting
2008 AFB, All Rights Reserved Journal of Visual mpairment & Blindness, July 2008 4 0 3
Baseline
(Passive visual
accommodations)
Intervention
(Active visual
accommodations)
1-second 5-second
delay ; delay
Maintenance/
generalization Correct before prompt
Correct after prompt
Maintenance
Generalization
Figure 1. Percentage of correct responses.
the controlling prompt with the one-
second delay, the five-second delay was
implemented. During this portion of the
intervention, Carson averaged 90% and
Aaron and Cathy averaged 80% on cor-
rect unprompted choices. When the par-
ticipants did not respond within five sec-
onds, a delayed prompt was provided.
With the delayed controlling prompt, Car-
son and Cathy averaged 100% and Aaron
averaged 94% on correct unprompted and
prompted choices.
Maintenance and generalization
During the two months of weekly main-
tenance and generalization probes, Aaron
averaged 78% (maintenance) and 67%
(generalization) for correct unprompted
choices. The generalization probes for
Aaron were collected in the classroom
during a variety of nontraining activities
(like small groups and library time) and
20 25
Session
by members of the classroom staff who
were not involved in the intervention
phase. Data were collected only once dur-
ing this phase for Carson because of a
severe injury that had occurred outside
school that kept him home for the remain-
der of the school year. The school year
ended before maintenance and generali-
zation probes could be collected for
Cathy.
Child outcomes in individual settings
The foregoing findings focused on the
combined data from the two settings. An
examination of the data for each setting
independently provided additional infor-
mation on the impact for each participant
(see Figures 2 and 3). The data were also
reviewed for potential effects in the par-
ticipants' responses (e.g. increase or de-
crease) because of the presentation of the
preferred item on the right or left side. For
4 0 4 Journal of Visual Impairment & Blindness, July 2008 2008 AFB, All Rights Reserved
Baseline
(Passive visual
accommodations)
Intervention
(Active visual
accommodations)
1-second
delay
5-second
delay
Maintenance/
generalization
Correct before prompt
Correct after prompt
Maintenance
Generalization
20 25
Session
40
Figure 2. Percentage of correct responses for free-choice setting.
Aaron and Carson, no significant differ-
ence was noted in the number of accurate
choices when the preferred item was
placed in the teacher's left or right hand.
A difference was noted for Cathy, who
completed more accurate choices when
the preferred item was presented in the
teacher's right hand than in the left
hand, perhaps because Cathy' s vision
was slightly better in her left eye.
SOCIAL VALIDITY
Perceptions of the classroom teachers
District preschool special education and
diagnostic kindergarten teachers whose
caseload included children with multiple
disabilities, visual impairment, or both
were given a questionnaire on the impor-
tance of choice-making skills and oppor-
tunities within the classroom before the
study was conducted. Fifteen teachers
(100%) responded to the questionnaire
and agreed that choice making is an im-
portant skill for their students to have,
that many students have difficulty making
choices when choices are presented
within the classroom, and that most of
their students have the potential to learn
to make choices and to benefit from mak-
ing choices.
A review of a postintervention ques-
tionnaire, completed by the participating
teachers, showed that two strongly agreed
and one was neutral that the intervention
package was effective in increasing the
students' accuracy in making choices and
that the students were likely to continue to
use this newly learned or enhanced skill.
The teachers further agreed that the inter-
vention package was easy to implement
and did not interfere with classroom
activities and that the time required to
implement the package was worth the
outcome. In addition, the teachers
2008 AFB, All Rights Reserved Journal of Visual Impairment & Blindness, July 2008 4 0 5
Baseline
(Passive visual
Intervention
(Active visual
accommodations) accommodations)
1- second 5- second
delay .
Maintenance/
generalization
-- Correct before prompt
- Correct after prompt
A Maintenance
X Generalization
15 20 25
Session
Figure 3. Percentage of correct responses for snack time setting.
agreed that other students in their class-
rooms could benefit from the interven-
tion package.
Discussion
The purpose of this study was to deter-
mine whether children with visual im-
pairments and multiple disabilities could
increase the accuracy of their choice
making through a predetermined motor
response on the basis of an intervention
package that included CVI accommoda-
tions, daily preference assessments, natu-
ralistic instruction, response prompts,
constant time delay, and naturalistic con-
sequences. The study also examined
whether the children could accurately
generalize the skill of choice making to
other preschool, kindergarten, and home
routines; whether the classroom staff
members were able to implement proce-
dures accurately and across time; and
how the classroom staff members rated
the intervention package for ease of im-
plementation and effectiveness in increas-
ing the opportunities for the children to
make choices.
The results suggest that the interven-
tion package was successful in increasing
the accuracy of the participants choices
when the participants were presented with
preferred and neutral items. Additional
findings included the beneficial impact of
active visual accommodations on the
level of accuracy of the participants'
choices. In addition, systematic instruc-
tion further increased the accuracy of
choices made. Since no other known stud-
ies included children with visual impair-
ments and multiple disabilities regarding
choice making, this study contributes to
the literature and provides a reference
for future research. The findings are also
important because the effectiveness of
4 0 6 Journal of Visual Impairment & Blindness, July 2008 2008 AFB, All Rights Reserved
active visual accommodations on the par-
ticipants' acquisition of skills is an area in
which research is being implemented but
has yet to be reported.
LIMITATIONS
Limitations relevant to this study include
the generalizability of findings to other
students, locations, or activities; the lim-
ited data on maintenance and generaliza-
tion; the difficulty encountered when col-
lecting data on students with multiple
disabilities and health problems; and
the inability of parents to observe the
intervention.
Three children participated in the
study, and all but one of the classrooms
were located within the same school dis-
trict. Thus, the small number of partici-
pating children and their extended ab-
sences may limit the maintenance and
generalizability of the results, especially
to teachers who may be less willing to
implement the intervention package due
to large caseloads or concerns regarding
the additional, although minimal, time re-
quired to implement the intervention.
Replications of the study through an in-
creased number of participants, disabili-
ties, teachers, and environments may pro-
vide information that is necessary to
increase the generalizability of the find-
ings. Future research using longer periods
for data collection may provide a more
comprehensive look at the long-term suc-
cess of the intervention package within a
population that experiences a high absen-
tee rate because of health issues.
IMPLICATIONS FOR FUTURE RESEARCH
The accuracy of the participants' choice-
making skills increased markedly from
the baseline levels. However, future re-
search is needed to determine whether
this skill is maintained over time and may
be generalized to a variety of items; to
other staff, peers, and family members;
and to settings outside the participants'
classrooms. Replication of the results
with other students with visual impair-
ments and multiple disabilities is also
needed to increase the generalizability of
the findings. Future research should also
focus specifically on the impact of active
visual accommodations and other compo-
nents of the intervention separately. The
immediate increase in the accuracy of the
choices made by the participants with
the implementation of the active visual
accommodations, in addition to the pas-
sive accommodations that were present in
the baseline phase, are worthy of further
review to examine the impact of each
component of the intervention package.
Active visual accommodations alone may
provide educators and parents with sim-
ple ways to assist children to see their
world with limited vision, making both
systematic instruction and incidental
learning more effective. Furthermore, re-
search should be conducted on the inter-
rater reliability of the functional visual
assessment and on determination of the
individual active and passive accommo-
dations to determine the impact of the
selection of these accommodations for
participants.
References
Alexander, P. K. (2001). Cortical visual im-
pairment. FOCUS, 18(4), 5-16.
Bailey, D. B., & Wolery, M. (1992). Teaching
infants and preschoolers with disabilities.
Englewood Cliffs, NJ: Prentice Hall.
Bishop, V. E. (1996). Teaching visually im-
paired children. Springfield, IL: Charles C
Thomas.
2008 AFB, All Rights Reserved Journal of Visual Impairment < Blindness, July 2008 4 0 7
Blind Babies Foundation. (2000). Pdiatrie
visual diagnosis fact sheets. San Francisco:
Author.
Church, E. B. (2000). Making choices. Scho-
lastic Early Childhood Today, 14{1), 28-
29.
D'Allura, T. (2002). Enhancing the social in-
teraction skills of preschoolers with visual
impairments. Journal of Visual Impairment
& Blindness, 96, 576-585.
Daugherty, S., Grisham-Brown, J., & Hem-
meter, M. L. (2001). The effects of embed-
ded skill instruction on the acquisition of
target and nontarget skills in preschoolers
with developmental delays. Topics in Early
Childhood Special Education, 21, 213-
221.
Downing, J. E. (1999). Critical transitions:
Educating young children in a typical
preschool. In D. Chen (Ed.), Essential el-
ements in early intervention: Visual im-
pairments and multiple disabilities (pp.
378-415). New York: AFB Press.
Downing, J., & Bailey, B. (1990). Developing
vision use within functional daily activities
for students with visual and multiple dis-
abilities. RE:view, 90(21), 209-221.
Erin, J. N. (2004). When you have a visually
impaired student with multiple disabilities
in your classroom: A guide for teachers.
New York: AFB Press.
Hanley, G. P., Iwata, B. A., & Lindberg, J. S.
(1999). Analysis of activity preferences as
a function of differential consequences.
Journal of Applied Behavior Analysis, 32,
419-435.
Head, D. (1992). Learned helplessness in
children with visual handicaps: A pilot
study of expectations, persistence, and at-
tributions. Phoenix: Division of Special
Education, Arizona State Department of
Education.
Homer, R. H., Carr, E. G., Halle, J., McGee,
G., Odom, S., & Wolery, M. (2005). The
use of single-subject research to identify
evidence-based practice in special educa-
tion. Exceptional Children, 71, 165-179.
Janssen, M. J., Riksen-Walraven, J. M., &
Van Dijk, J. P. M. (2003). Toward a diag-
nostic intervention model for fostering har-
monious interactions between deaf-blind
children and their educators. Journal of
Visual Impairment & Blindness, 97, 197-
214.
Jolivette, K., Stichter, J. P., Sibilsky, S., Scott,
T. M., & Ridgley, R. (2002). Naturally
occurring opportunities for preschool chil-
dren with or without disabilities to make
choices. Education and Treatment of Chil-
dren, 25, 396-414.
Kazdin, A. E. (1982). Single-case research
designs. New York: Oxford University
Press.
Kennedy, C. H. (2005). Single-case designs
for educational research. Boston: Pearson
Education.
Levack, N. (1991). Low vision: A resource
guide with adaptations for students with
visual impairments. Austin: Texas School
for the Blind and Visually Impaired.
Li, A. (2003). A model for developing pro-
grams to improve the use of vision in
students who are visually impaired with
multiple disabilities. RE:view, 55(1), 31
47.
McCormick, K. M., Jolivette, K., & Ridgley,
R. (2003). Choice making as an interven-
tion strategy for young children. Young Ex-
ceptional Children, 6(2), 3-10.
Roman, C. (2004, November). [CVI Over-
view, assessment & intervention]. Unpub-
lished raw data.
Roman-Lantzy, C. (2007). Cortical visual im-
pairment: An approach to assessment and
intervention. New York: American Foun-
dation for the Blind.
Sacks, S. Z. (1998). Educating students who
have visual impairments with other dis-
abilities. In S. Z. Sacks & R. K. Silber-
man (Eds.), Educating students who have
visual impairments with other disabili-
ties (pp. 3-38). Baltimore: Paul H.
Brookes.
Sadler, F. H. (2003). The itinerant special
education teacher in the early childhood
classroom. Teaching Exceptional Children,
35(3), 8-12.
Stafford, A. M., Alberto, P. A., Fredrick,
L. D., Heflin, L. J., & Heller, K. W. (2002).
Preference variability and the instruction of
4 0 8 Journal of Visual Impairment & Blindness, July 2008 2008 AFB, All Rights Reserved
choice making with students with severe
intellectual disabilities. Education and
Training in Mental Retardation and Devel-
opmental Disabilities, 37, 70- 88.
Tawney, J., & Gast, D. (1984). Single-subject
research in special education. New York:
Merrill.
Utah State Board of Education. (2000). Spe-
cial education rules. Salt Lake City: Utah
State Office of Education.
Utley, B. L., Roman, C, & Nelson, G. L.
(1998). Functional vision. In S. Z. Sacks &
R. K. Silberman (Eds.), Educating students
who have visual impairments with other
disabilities (pp. 371-405). Baltimore: Paul
H. Brookes.
Wolery, M., & Dunlap, G. (1999). Reporting on
studies using single-subject experimental
methods. Journal of Early Intervention, 24,
85-89.
Christine Clark, Ph.D., assistant professor. De-
partment of Special Education, Illinois State
University, Campus Box 5910, Normal, IL
61790: e-mail: <cclark@ilstu.edu>. Andrea P.
McDonnell, Ph.D., professor. Department of
Special Education, University of Utah, Milton
Bennion Hall, 1705 East Campus Center Drive,
Salt Lake City, UT 84112-9253: e-mail:
<andrea.mcdonnell@ ed.utah.edu>.
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