Automatic prompting and positive attention to reduce tongue protrusion and head tilting by two adults with severe to profound intellectual disabilities.

Two adults with severe intellectual disability lived in a state facility.

Both stuck their tongue out and tilted their head for hours each day.

Staff set a small box to beep every 30 seconds.

The box said "keep tongue in."

If the adult had no stereotypy when the beep sounded, staff gave praise.

The study ran an A-B-A-B design to be sure the package worked.

Tongue protrusion dropped from over 40% of intervals to near 10%.

Head tilting fell from about 80% to 10%.

Gains held three months later with no extra training.

Staff only needed a few seconds to deliver praise after each beep.

Annable et al. (1979) first used food to reward "tongue-in" during meals.

Smith et al. (2010) shows automatic beeps and praise work too, so edible reinforcers are not required.

Lancioni et al. (2008) and Lancioni et al. (2011) used tilt-sensor napkins to cut drooling in the same population.

All three E-studies kept effects for three months, proving sensor-based self-management is durable.

Irvin et al. (1998) cut hand mouthing with arm restraints but also cut useful arm use.

Prompt plus praise avoids that side effect while still slashing stereotypy.

If you support adults with severe ID and chronic oral stereotypy, try a simple timed prompt and social praise.

A $20 kitchen timer or phone app can deliver the cue.

You avoid restraint, edibles, or fancy gear.

Effects last after you fade the timer volume.

Start with 30-second intervals and thin once the tongue stays in for 80% of checks.