Date on Master's Thesis/Doctoral Dissertation


Document Type

Doctoral Dissertation

Degree Name

Ph. D.


Special Education, Early Childhood & Prevention Science

Degree Program

Curriculum and Instruction, PhD

Committee Chair

Courtade, Ginevra

Committee Co-Chair (if applicable)

Landrum, Tim

Committee Member

Landrum, Tim

Committee Member

Jimenez, Bree

Committee Member

Scott, Terry

Author's Keywords

Self-determination skills; inclusive rights; extensive support needs; contraceptive choices


There is a long history of individuals with extensive support needs (ESN) being sterilized without their knowledge and consent. Students with ESN are defined as individuals who need continuous and widespread supports necessary for academic, communication, and/or daily living skills. These individuals typically have more than one diagnosis including a developmental disability (DD), intellectual disability (ID), and/or traumatic brain injury (Kurth et al., 2019; Taub et al., 2017). Part of the reason this is able to occur is due to a lack of education about sexual development and a lack of interventions to build skills related to self-determination or informed decision-making. This dissertation aimed to increase these skills for participants with ESN related to their choices in reversible contraceptives. Three participants were first taught about their menstrual cycles and given preference assessments about reversible birth control options. Participants then created individualized graphic organizers to help guide them through the process of asking about choices and recording the information given from doctors. A single-case multiple probe design was used to examine the effectiveness of using behavioral skills training to increase the skills of asking a doctor about choices and recording the information. All three participants were able to reach mastery level within three to four probes. Two participants stayed at mastery level for their generalization and maintenance probes. One participant did not stay at mastery level for their generalization and maintenance probe but was only 3 points away from mastery level, and 29 points above their baseline level. Social validity results were positive and participants reported that they liked being able to talk to a doctor themselves. Future researchers should focus on increasing self-determination skills in other areas related to sex education and breaking down barriers to access education and care centered around dignity for the individual with ESN. This dissertation is divided into five chapters. Chapter One gives an overview of the history of sex education and health care services for individuals with ESN. Chapter Two is a review of literature related to sex education and self-determination skill building for individuals with ESN. This chapter also includes evidence that informed the decisions to include the different study components. Chapter Three details the methodology of the study and Chapter Four details the results for all three participants. Chapter Five explains the results related to previous literature and considerations for future research.