A comparison of behavioral techniques to teach functional independent-living skills to individuals with severe and profound mental retardation.

Bacon et al. (1998) compared two ways to teach daily living skills to 22 adults with severe or profound intellectual disability. One group got the usual prompting, modeling, and gentle physical help. The other group got the same help plus staff training, on-the-spot feedback, and small edible treats for the residents.

The study took place in a large residential facility. Staff kept daily data on tasks like brushing teeth or setting a table.

The package with extra staff training, feedback, and edible reinforcement won. Residents in that group learned the skills faster and kept them better.

The usual prompting alone helped a little, but the gains were smaller and slower.

Stock et al. (1993) ran a similar package in elderly adults. Prompts, feedback, and social praise boosted healthy food choices in a retirement home. The pattern matches: add feedback and reinforcement to prompts and you get stronger living-skill gains.

Blanchard et al. (1979) taught four profoundly disabled adults to walk to school with backward chaining. That study used only chaining, no staff training or edibles. It worked, but Bacon et al. (1998) shows you can get broader daily-living gains when you also train and motivate the staff.

Fabbretti et al. (1997) added staff training in the same kind of facility. Their training cut aggressive incidents and restraint use. Bacon et al. (1998) extends that idea: train staff and add client reinforcement to build new skills, not just reduce problems.

If you run a day program or group home, do not rely on prompting alone. Spend one hour training staff, give them quick daily feedback, and let residents earn a bite of favorite food. This small add-on package can double the speed that adults with severe ID learn dressing, toileting, or kitchen tasks. Try it next week: pick one skill, set a mastery criterion, and track trials until you hit it.