An evaluation of gentle teaching and visual screening in the reduction of stereotypy.
A quick three-second eye cover after each stereotypy instance beats gentle teaching and keeps the behavior near zero.
01Research in Context
What this study did
Three adults with severe intellectual disability took part. Each person showed frequent hand or body stereotypy that had no clear social trigger.
The team ran an alternating-treatments design. In one condition they used visual screening: each time stereotypy started, the therapist briefly covered the person’s eyes for about three seconds. In the other conditions they tried gentle teaching or simple task training.
What they found
Visual screening cut stereotypy to almost zero within a few sessions. The gentle-teaching condition did little, and task training helped only a little.
When the treatments switched back and forth, stereotypy always dropped during visual screening and rose again during the other two. The pattern held for all three participants.
How this fits with other research
McGonigle et al. (1982) first showed the same brief eye-cover trick worked for kids. The 1989 study adds a head-to-head test and still backs the simple blocking idea.
Singh et al. (1993) later compared visual screening with the drug thioridazine. Again, the eye-cover alone beat the medicine, strengthening the 1989 finding.
Grindle et al. (2012) looked like a contradiction: redirection and blocking worked the same. But they studied short, play-based sessions with kids who had autism. The 1989 adults had profound ID and longer sessions, so the settings differ more than the results.
McNamara et al. (2019) and Barszcz et al. (2021) show RIRD also cuts vocal stereotypy. Visual screening is just the visual cousin of the same quick-interruption idea.
Why it matters
If your client’s stereotypy is automatic and you need a fast, low-cost fix, try visual screening. Cover the eyes for two-three seconds right after each instance. No extra equipment, no restraint, and the 1989 data say it beats gentle teaching. Pair it with preferred tasks to keep the session positive.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Count stereotypy for ten minutes, then apply a gentle three-second visual screen after each instance and watch the rate drop.
02At a glance
03Original abstract
Gentle teaching and visual screening techniques have been used to control severe behavior problems in persons with mental retardation. An alternating treatments design was used to compare gentle teaching, visual screening, and a task-training condition in the reduction of the high-level stereotypy of 3 persons with mental retardation. Following a baseline phase, a task-training condition using standard behavioral techniques was implemented to establish the effects of training the subjects on the tasks. Results showed a modest decrease in stereotypy. This phase was followed by an alternating treatments phase in which visual screening, gentle teaching, and baseline conditions were compared. Both procedures were superior to the control condition in reducing stereotypic behavior, with visual screening being more effective than gentle teaching. When compared with data from the prior phase, gentle teaching was found to be more effective than task training for 2 subjects but less effective for the 3rd, whose stereotypy increased during gentle teaching. Two succeeding phases in which visual screening was implemented across two and then all three daily conditions reduced stereotypy further to near-zero levels. An additional phase with 1 subject demonstrated that the treatment effects of visual screening were easily replicated across therapists. Mixed and idiosyncratic changes in collateral behaviors occurred. For example, "bonding," the goal of gentle teaching, occurred at the same low levels under both treatments, contrary to the predictions of gentle teaching's proponents. The results indicate that gentle teaching may not be the universal treatment of choice for stereotypy its proponents suggest, and that it requires further empirical evaluation.
Journal of applied behavior analysis, 1989 · doi:10.1901/jaba.1989.22-9