Autism & Developmental

Interventions supporting health‐related routines for children with intellectual and developmental disabilities: A systematic literature review

St. Joseph et al. (2022) · Behavioral Interventions 2022
★ The Verdict

Show a short video of a peer doing the steps, then hand out tokens—this simple package helps young children with IDD master tooth-brushing, hand-washing, and even sit through blood draws.

✓ Read this if BCBAs and RBTs serving preschool and early elementary clients with IDD in clinic, school, or home settings.
✗ Skip if Practitioners whose caseload is mostly adults or teens without daily living goals.

01Research in Context

01

What this study did

St. Joseph et al. (2022) looked at 24 studies that used behavioral packages to help kids with intellectual or developmental disabilities stick to health routines. They pulled papers on tooth-brushing, hand-washing, dental exams, and blood draws.

The team asked one question: do video models plus rewards make these routines easier for children with IDD?

02

What they found

Most studies showed the packages worked. Kids watched short clips of peers doing the task, then got praise or tokens for copying the steps. Dental visits and blood draws caused less crying and escape behavior.

Almost all evidence came from preschool and early elementary ages. The authors note we still lack data for older kids and for children with severe or profound ID.

03

How this fits with other research

Lang et al. (2011) covered earlier behavioral work on rumination and vomiting in the same population. They saw a field-wide shift from punishment to reinforcement. St. Joseph et al. (2022) extends that trend: every reviewed study used praise, tokens, or stickers—no aversive procedures.

Taylor et al. (2017) found large sleep gains with behavioral packages for people with ID. The new review mirrors those gains but in daytime health routines. Both reviews flag the same gap: weak long-term follow-up.

Maïano et al. (2014) showed activity-based lifestyle programs trimmed weight in youth with ID. St. Joseph et al. (2022) adds fine-grain detail: single routines, not broad lifestyle change, are where behavior analysts currently have the strongest proof.

04

Why it matters

If you run sessions with young children who have IDD, you now have a ready-made protocol: film a peer model, break the task into three to five steps, and deliver immediate rewards. Start with tooth-brushing or hand-washing—those skills transferred to the dental chair and doctor’s office in several studies. For older clients or those with more complex needs, keep collecting data; the evidence base is still growing.

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→ Action — try this Monday

Film a 30-second clip of a peer brushing teeth, queue it on a tablet, and run three reinforced trials before breakfast.

02At a glance

Intervention
not applicable
Design
systematic review
Population
intellectual disability, developmental delay
Finding
not reported

03Original abstract

AbstractThis systematic literature review evaluates research on interventions to increase successful participation in medical procedures and health‐promoting routines by children and youth with intellectual and developmental disabilities (IDD). Electronic database searches of Eric, PsycInfo, and MEDLINE and ancestral review were conducted to identify studies published between 1968 and 2020. Across the 24 studies meeting inclusion criteria, a variety of behavioral interventions have been implemented to prevent or decrease challenging behavior and increase participation during medical procedures and health‐promoting routines. The results are discussed in relation to (a) participants and intervention setting, (b) intervention procedures and targeted behavior, (c) the rigor of the study methodology according to Reichow's Evaluative Method, and (d) outcomes including magnitude of intervention effect. Findings demonstrate that dental or medical examinations, blood draws, toothbrushing, and handwashing were the most often targeted procedures or routines. Behavioral intervention packages including strategies such as video‐modeling and positive reinforcement were generally effective in increasing successful completion of medical procedures and health promoting routines. However, most studies have focused on early childhood and fail to reflect the support and educational needs of individuals with IDD across the lifespan. We discuss future research directions.

Behavioral Interventions, 2022 · doi:10.1002/bin.1851