The opportunity to make active choices can mean the difference between becoming a passive or active participant within her world. If she is not given enough opportunity to interact as independently as possible, she may just sit back and watch the world go by, depending completely on others to decide for her. If she has a reasonable means to communicate, she will be reinforced by the communication itself and will be more willing to keep on trying.

Following are some ways to assist her in choice-making:

• Make sure the choices involve objects, people, or activities that are motivating and desirable to her, and that are available when the choice is made. Determine the method of making the choice which requires the least effort and time on her part. You want her energy to go into communicating, not improving her motor skills. Always give her plenty of time to respond, and be aware that she may need to gear her body up with other movements to get started.
• When beginning, offer her only two choices at a time. As her clarity and skills improve you can increase the number of choices to as many as she can handle at a time, usually 3-4. Make sure to show her you understood her choice by naming it and providing it immediately. For example, "Oh, you want the music. Here it is!" Each successful communication will lead to more motivation to communicate again.
• You can start by offering her only choices of things you expect her to want. If her choice making seems random, you can try pairing something she really likes with something neutral, such as a Barney tape with a pair of pants. Remember, she gets what she chooses, so she will learn quickly to choose her favorite.
• Determine whether she can recognize pictures, and how realistic they need to be, starting with familiar photos as most concrete, and moving to line drawings as most abstract. If pictures are difficult for her, use real objects, miniatures, or parts of objects, such as a rope to signify her swing. You can then pair the picture with the object and eventually fade out use of the object.
• She may require some extra cues at first. For example, you can hold or point to the choice on the left while naming it, then do the same with the one on the right. You can cue visually by shining a flashlight on each picture or moving your finger toward it to help her eyes track and to draw her attention. You can use auditory signals such as tapping each picture or snapping your fingers to remind her to look. Physical cues include hand-over-hand assistance to help her touch a desired choice, nudging her elbow toward a choice, or gently touching her face to help her turn toward a choice.
• You may be able to fade out cues, then need to increase them again when introducing new concepts. Having pictures available during ongoing activities may help to introduce her to them before she must make active choices.
• If she will not make a choice, try changing to something else which may be more motivating. If you are pretty sure she wants one of the choices, try making it clear that she must communicate first. For example, "First show me which you want, then you can have the coke or cookie."
• Remember that if she is not used to making choices it can be very tiring for her at first. She may also wonder why you suddenly cannot anticipate her needs. She may also take the choices a step further than you expect. 

Choosing vocabulary is important. It may help to make a schedule of daily activities, such as eating, tooth brushing, dressing, group activities, free time, television. Determine possibilities for choice-making within each activity. For example, choosing which article of clothing to take off next at night. Remember to include fun actions and social comments, not just objects. Many people start with "yes" and "no" for the first choices. For some girls this works well, but for others, use of more concrete choices is better. Think of typical toddlers and their first words. "No" comes pretty early, but it follows other social words and requests.