Teaching self-administration of nasogastric tube insertion to an adolescent with Crohn disease.

A teen with Crohn disease needed a feeding tube every day. The tube went in through the nose and down to the stomach.

The team built a fake head and chest from plastic. They used real medical gear. The teen practiced every step: lube, angle, slide, check.

No real patient was involved. Just the model, praise, and do-overs until every move was right.

After short daily sessions the teen could slide the tube in alone. Every step hit the safety checklist.

The skill stayed strong. Mom only watched. No more nurse visits for the tube.

Arnold et al. (2020) did the same trick with driving. Young adults used a car simulator, got prompts and scores, and stopped tailgating on real roads. Both studies show one rule: practice in a fake setup can move to the real world.

Rojahn et al. (1987) taught two kids with ID to place their own urinary catheters. They used hand-over-hand prompts, not a model. Same medical goal—self-care—but different tool. The tube study adds simulation as an extra path.

Cox et al. (2017) used prompting plus reward to keep kids with autism still for an MRI. All three papers line up: ABA can tame scary medical steps without sedation or tears.

If a client must do a tough medical step, build a fake version first. Use real supplies, a doll, or VR. Let them rehearse until the chain is smooth. Then fade the help and watch the real thing go just as well. One teen lost the daily nurse. Your learner might lose the daily battle over meds, shots, or tubes.