Communication can be difficult for children with conditions such as cerebral palsy because of speech and physical impairments. For this group of children, choice-making is often limited to choices of personal preferences; however, preferences do not reveal intellectual abilities. Therefore, choice-making should be presented to these children in two forms: choices of preference and choices to show knowledge. This article describes a model of levels of choice-making that does not require a child to talk or point. The model provides a more accurate picture of a child's abilities and helps parents and educators to set concrete, realistic goals to aid in the development of more advanced abilities to express choices. It is useful in developing consistent opportunities for children to express their choices at home, school, and in the community. With the aid of the five-level model presented in this article, educators and parents can begin to encourage and guide choice-making opportunities for children. Successful expression of preferences is critical for the development of self-determination and lays the groundwork for making choices that show knowledge or skill. Expressing knowledge and skills nurtures and acknowledges a child's full potential. The more that choice-making of both preferences and knowledge is targeted and encouraged, the more confident, independent, and empowered a child can become. The article includes a chart providing examples of the types of responses a child could provide at each stage of the model. It also includes a case illustration of an eight-year-old girl diagnosed with quadriplegic cerebral palsy showing her difficulties in communicating her preferences.