Independent and social play among profoundly mentally retarded adults: training, maintenance, generalization, and long-term follow-up.

The team worked with adults who had profound intellectual disability. Most sat and rocked or flicked their fingers all day.

Staff gave a verbal cue like "play with blocks." If the adult did nothing, they added gentle hand-over-hand help. Prompts were faded as soon as possible.

The study used a multiple baseline across participants. Skills were probed in new rooms and with new staff to check real learning.

Play time jumped from near zero to high levels for every adult. Stereotypy dropped at the same time.

Gains lasted up to one year with no extra training. The adults also played with new toys and new caregivers, showing true generalization.

Smith et al. (2010) later used automatic beeps instead of staff cues to cut tongue protrusion and head tilting. Both studies show prompting plus social attention can suppress stereotypy in adults with profound ID.

Covey et al. (2021) switched the focus to school kids and trained peer models with BST. Their students also doubled interactive play and kept it 13 weeks later. The 1987 adult study and the 2021 kid study line up: prompting or BST can produce big, durable play gains.

Christopher et al. (1991) moved from play to conversation skills and replaced prompting with behavioral skills training. They call their work a "systematic replication" of earlier adult social-skills research. Together the papers build a roadmap: start with prompts for basic play, then use BST for complex social chains.

You do not need fancy toys or token boards to expand the lives of adults with profound ID. A simple prompt hierarchy—say it, show it, guide the hands—can create meaningful leisure and slash stereotypy in one shot. Schedule monthly booster probes; the data show the skill can stick for a year, freeing you to tackle new goals.