The Use of a Behavior Chain Interruption Strategy to Teach Mands for Help with an Adult with Intellectual Disability and Deaf-Blindness

The team worked with one adult who has severe intellectual disability and is both deaf and blind.

They broke a chain of steps he already knew, like opening a locked container.

When the chain stopped, they gave him a small pager button. If he pressed it, staff came and helped.

The goal was to teach him to ask for help only when he truly needed it.

The man pressed the pager every single time the chain was broken.

He never pressed it when nothing was wrong.

The skill stayed strong when staff later tested it in new rooms and new tasks.

Dagnan et al. (2005) also broke chains, but with children with autism who used picture cards. They showed that shorter chains win. The new study keeps the chain short and adds a sound-free pager for someone who cannot see or hear.

Taylor et al. (1993) used brief stops and quick corrections to turn gestures into true requests. The pager study uses the same interrupt idea, only the request is a button press instead of a hand signal.

Heinicke et al. (2012) reviewed 687 single-case lessons and found that almost every learner with ID masters chained tasks when prompts are clear. The pager case is one more example in that long line of wins.

If you serve adults with severe or multiple disabilities, try breaking a mastered routine and dropping in a simple switch or pager. One press can replace crying, grabbing, or doing nothing. No voice, no pictures, no problem. You get a quick mand for help that works in the dark and the quiet.