When One Door Closes, Build Another: Emphasizing Autonomy Through Choice

Choice is a fundamental part of being human. Whether it’s deciding who to be around, where to live, what to do with your free time – choice is woven into the fabric of daily life. For many individuals (especially those with disabilities, mental health conditions, or other marginalized experiences) choice isn’t always a given. In fact, the ability to say no is a privilege, one that many people don’t even realize they have.

The Privilege of Saying No

Saying no is often seen as a refusal, a rejection, or even defiance. But at its core, saying no is an exercise of autonomy. It means you had a choice to begin with, even if it wasn’t an ideal one. Too often, people with disabilities or those who rely on support systems don’t get the chance to say no because their choices are pre-determined for them. Their decisions are filtered through the lens of what others believe is best rather than what they truly want or need. Recognizing this is critical in shifting how we approach self-determination and autonomy for all individuals.

Understanding Self-Determination

Self-determination is the process of making choices and taking control of one’s own life. Research in psychology and disability studies consistently shows that individuals who are given the ability to make their own decisions – big or small – experience higher levels of satisfaction, motivation, and overall well-being. According to Deci & Ryan’s Self-Determination Theory (2000), autonomy is a core psychological need that drives intrinsic motivation and engagement. Without it, people are more likely to feel powerless, dependent, and disengaged from their own lives.

Supported decision-making (SDM) is one tool that allows individuals who may need assistance to maintain control over their lives while still receiving guidance. Unlike guardianship or substituted decision-making, SDM ensures that individuals retain their voice in choices that impact them. Websites such as The National Resource Center for Supported Decision-Making provide further information on how to implement SDM models effectively.

Creating and Contriving Opportunities for Choice

Choice isn’t always readily available, and sometimes, it needs to be created. For individuals with significant disabilities or those in environments with limited autonomy, contriving opportunities for choice is essential. This means:

• Identifying where choices do exist, even in small ways, and ensuring they are recognized and respected.
• Creating opportunities where choice may not be obvious, such as allowing individuals to select between tasks, activities, or methods of communication.
• Providing multiple avenues for decision-making, including verbal, non-verbal, or assistive communication methods.

5 Tips for Supporting Choice for All

1. Establish Communication Pathways
   Everyone communicates in different ways. Whether through speech, sign language, AAC devices, gestures, or written words, ensuring that all individuals have a method to express their choices is foundational to supporting autonomy.
2. Identify and Expand Choices
   Sometimes, choices are limited or nonexistent. Creating meaningful options, even in structured environments, allows individuals to feel agency in their own lives. If a direct choice isn’t available, consider offering alternatives or finding creative ways to build decision-making into everyday activities.
3. Support Decision-Making, Don’t Control It
   It can be tempting to steer decisions based on what we believe is best. Instead of leading the choice, provide information, context, and support so that individuals can make informed decisions themselves.
4. Navigate Delays and Changes
   Choice is not static. Services change, resources fluctuate, and sometimes, what was once an option may no longer be available. Supporting individuals through these shifts with clear communication, alternatives, and problem-solving strategies is essential.
5. Respect All Choices (Even the “Bad” Ones)
   Everyone makes choices that don’t work out. But experiencing the consequences of a decision, learning from mistakes, and adjusting in the future is part of the human experience. Allowing people to make “bad” choices, within safe boundaries, is a necessary part of fostering true self-determination.

Choice is not a luxury; it’s a necessity. But too many people are denied the dignity of making their own decisions, whether through rigid systems, outdated policies, or well-intentioned but restrictive support. If we truly believe in autonomy, we must actively work to ensure that choice is available to everyone, in every environment, at every level of ability. Whether through self-determination models, supported decision-making, or simply recognizing the power of saying no, we have the responsibility to make choice an accessible reality for all.

For more resources on self-determination and supported decision-making, visit:

• National Resource Center for Supported Decision-Making
• Autistic Self Advocacy Network
• Charting the LifeCourse

Because in the end, having the ability to make a choice is what makes us human.