| by Nathan E. Ory, M.A.
Registered Psychologist (B.C.)
Challenging Behavior Analysis and Consultation
There are subtle aspects about how we verbally
interact with persons with disabilities that sometimes
make a great difference in their ability to respond.
Closed choice: "Do you want to do XXXXX?"
Only one option is offered. The answer is "yes"
For some people this is a perfect way to assist
them to focus on the option that is available
to them. There are no further concerns. For the
person who is capable of coming up with their
own alternative, this approach leaves them with
the option to self-initiate "I'd rather do
For some people this type of question or choice
will always be answered with a "No!"
This can lead to attempts by caregivers to attempt
to persuade, bargain with or confront the person.
The "automatic no" may be an answer
which serves several purposes:
If you state the question in this manner you
imply that person has the option to say no. Having
the control and being able to say "no"
may be more important to the person than doing
the offered activity.
If you do not mean to accept whatever answer
the person is going to give, don't ask in this
If person doesn't know what they want to do,
giving an automatic "no" solves their
If this is the issue it often helps to "talk
to the atmosphere" before you offer the choice
or question to the person. This means to "talk
out-loud" to yourself about what you are
thinking about doing. State the positives and
negatives that you think may be going through
the mind of the person you are offering to make
this choice. Then turn to the person and ask this
question. You will have already stated and resolved
the uncertainties. The person will be aware of
the "right answers", and only have to
recognize which of these are relevant to themselves
at the moment. This makes it easier for them to
be certain about whether they actually want to
say "yes" or "no".
If person has language processing problems,
or does not know exactly what you mean, the automatic
"no" protects person from getting into
something that may be unwanted. The automatic
"no" also gives person time to think.
If this is the issue, often the person will come
along or participate if you simply start doing
the activity yourself. The "choice"
is offered non-verbally, through your own actions.
The person's "decision" is whether or
not they participate.
Person may say "no" because they feel
like they are not being given a real choice.
If this is the issue, it may be better to offer
the person a choice between two options in the
form of a "forced choice."
Forced choice: "Do you want to do this or
that?" Two options are offered. The answer
is one or the other.
For some people this is the perfect way to offer
choices or questions. The options are defined
by the question. The person only needs to recognize
which is their preferred option. Whichever option
the person chooses will be the "right"
choice. For the person who is capable of coming
up with their own alternative, this approach leaves
them with the option to self-initiate "I'd
rather do something else."
For some people, forced choices may cause them
great anxiety. They may not know which choice
they want, or they may want both choices and be
unable to resolve their own conflict.
It is better to use "closed", single-option
questions and choices for people with difficulty
resolving conflict, who are unable to recognize
what they want, or who are unwilling to make the
Some people will refuse any idea that was not
their own idea.
If this is the case it may be better to offer
an "open-ended" choice.
Open-ended choice: "What do you want to
do? Person is offered the choice to come up with
their own option.
For some people this is the perfect way to offer
a choice. It gives them a sense of being in control,
being responsible and being expected to think
and decide for themselves.
For some people this causes great anxiety. They
may have no idea what they want to do. They may
have no idea what you mean. They may be unable
to sort out their own confusion or conflict about
what they want to do.
If this is the case the person may become unable
to orient, may "freeze", may become
agitated, angry or aggressive towards the person
who has asked a question or given a choice in
this manner. Person experiences this type of question
If you see that person has difficulty with "open-ended"
choice, it may be better to offer "closed
choice" or "forced choice" type
For some people, who intepret language literally,
offering "open-ended" choice ("What
do you want to do?") may be interpreted by
them as licence and permission to do anything
that comes into their mind at that moment. They
may not understand that the question was a request
for them to state their preferences, rather than
an obligation assumed by their caregiver to immediately
do whatever was requested.
They may become quite angry that the choice they
made (now it is in their mind) is not able to
happen at the immediate moment they make it.
If you see that a person interprets open ended
choices in a manner that results in frustration
and conflict it may be better to offer "forced-choice"
or "closed choice" type questions where
the caregiver defines the context. This way "the
customer is always right" and can pick either
choice and have whichever one they asked for.
Nathan E. Ory, M.A.
23 November 2000
Island Mental Health Support Team