Focus on communication: improving interaction between staff and residents who have severe or profound mental retardation.

Cameron et al. (1996) tested a short staff-training package called NCAST. The goal was to help staff talk and play better with adults who have severe or profound intellectual disability.

They ran two group workshops and two on-the-job coaching visits. Staff practiced watching videos and scoring their own behavior. No control group was used.

Staff used slightly more positive touches and smiles after the training. The gains were small and did not last in every room.

Residents showed almost no change in their own communication or engagement. In short, the training helped staff a little, but clients stayed the same.

van Vonderen et al. (2010) ran a similar staff-training study but added video feedback. Their staff prompting accuracy shot up right away and the kids’ correct responses doubled. This newer package clearly outperforms the 1996 NCAST model.

McMillan et al. (1999) and Cohen-Almeida et al. (2000) used Active Support training instead. They saw medium-sized jumps in resident engagement and made staff help more effective. Again, stronger results than the small NCAST gains.

Chou et al. (2011) repeated Active Support in Taiwan and still found only modest benefits, matching the weak NCAST outcome. The pattern is clear: brief staff training, no matter the brand, rarely produces big client changes.

If you run a day or residential program, do not expect a one-off workshop to move the needle for clients. Pair short instruction with video feedback or full Active Support coaching for larger, lasting gains. Track resident behavior, not just staff smiles, to see if your training really works.