Choice as an Antecedent Intervention

Study: Rispoli, Lang, Neely, Camargo, Hutchins, Davenport, et al. (2013)

Study Type: Single-Subject Design

Descriptive Information Usage Acquisition and Cost Program Specifications and Requirements Training

Choice-making opportunities implemented as an antecedent intervention. The purpose of choice-making interventions is to promote engagement by providing the opportunity for student decision-making and agency with regard to assignment choice and/or order.

Choice is intended for use in Kindergarten through middle school. The program is intended for use with students with disabilities, intellectual disabilities, emotional or behavioral disabilities, autism, and any student at risk for emotional and/or behavioral difficulties.

The area of focus is externalizing behavior, which includes: physical aggression, verbal threats, property destruction, noncompliance, high levels of disengagement, and disruptive behavior.

Choice as an antecedent intervention is a non-commercial intervention and, therefore, does not have a formal pricing plan.

Choice is designed for use with individual students, small groups of 6-8 students, or with a classroom of students.

Only one interventionist is needed to implement the program.

The program includes highly specified teacher manuals or instructions for implementation.

The program does not require technology for implementation.

No training for the interventionist is required.

No training manuals or materials are available.

There are no minimum qualifications for the interventionist.

The program is not affiliated with a broad school or classwide management program.

There is no ongoing support available for practitioners.


Participants: Partially Convincing Evidence

Risk Status: Students were identified as having needs by their diagnosis of autism, teacher or parent reports of challenging behavior during instruction, and Questions about Behavioral Function rating scale that provided information regarding the function of the behavior. 



Age/ Grade



Socioeconomic status

Disability Status

ELL status

Other Relevant Descriptive Characteristics

Case 1: Alex

11 yrs old/4th grade







Case 2: Dylan

5 yrs old







Case 3: Kelly

11 yrs old/5th grade







Case 4: Eddie

7 yrs old




Asperger’s Syndrome



Training of Instructors: One of the interventionists was a trained graduate student researcher and the other interventionist was the student's classroom teacher.

Design: Convincing Evidence

Does the study include three data points or sufficient number to document a stable performance within that phase? Yes

Is there opportunity for at least three demonstrations of experimental control? Yes

If the study is an alternating treatment design, are there five repetitions of the alternating sequence? Yes

If the study is a multiple baseline, is it concurrent? Not applicable

Implemented with Fidelity: Convincing Evidence

Description of when and how fidelity of treatment information was obtained: Fidelity information was collected throughout the experiment (across baseline and treatment phases) for 30% of the sessions. Task analyses were used to develop a checklist, which was used to assess fidelity. The fidelity was calculated by taking the total number of procedural steps completed correctly divided by the total number of procedural steps, multiplied by 100.

Results on the fidelity of treatment implementation measure: Fidelity results overall was 96% across all conditions with a range of 85-100%.

Measures Targeted: Convincing Evidence

Targeted Measure

Reliability statistics

Relevance to program focus

Exposure to related support among control group

Direct Observation (Rate of challenging behavior)

Inter-observer Agreement-assessed during at least 20% of sessions, was 97% (range, 94.3-100%)

Highly relevant



Broader Measure

Reliability statistics

Relevance to program focus

Exposure to related support among control group






Mean ES Targeted Outcomes: N/A

Mean ES Administrative Outcomes: N/A

Effect Size:

Visual Analysis (Single-Subject Designs): Convincing Evidence

Description of the method of analyses used to determine whether the intervention condition improved relative to baseline phase (e.g. visual analysis, computation of change score, mean difference): This study used visual analysis to assess whether the intervention improved relative to baseline as well as calculating effect size (omnibus Tau-U) for both choice conditions.

Results in terms of within and between phase patterns: During the baseline phase, all participants had high levels of disruptive behavior followed by decrease in level during the choice intervention phases. No trends were apparent during any of the phases. In terms of variability, 3 out of the 4 participants had stable rate of challenging behavior during both baselines, with one participant having high variability. For immediacy of the effects, all the changes in conditions across all participants had a very immediate effect with a large change in level. Overlap and consistency of data patterns across similar conditions were not provided. In addition, effect size (Tau-U) was calculated for the choice conditions, where the "Across Activity" condition effect size was 0.94, with a 90% confidence interval of 0.71 to 1.0, indicating a 94% chance that the data from baseline to intervention showed improvements. For "Within-Activity" condition, the effect size was 0.93, indicating that 93% of data showed improvement (confidence of 90% with a range of 0.7 to 1.0).  

Disaggregated Outcome Data Available for Demographic Subgroups: No

Target Behavior(s): Externalizing

Delivery: Individuals, Small groups (n=6-8), Classrooms

Fidelity of Implementation Check List Available: No

Minimum Interventionist Requirements: No specific qualifications or training needed

Intervention Reviewed by What Works Clearinghouse: No

What Works Clearinghouse Review

This program was not reviewed by What Works Clearinghouse.

Other Research: Potentially Eligible for NCII Review: 0 studies