Large‐scale evaluation of staff training in programs for adults with intellectual and developmental disabilities

Kamana et al. (2024) tested if BST plus on-the-job feedback works in real-world IDD homes.

They trained many staff across many community houses. Staff learned four key practices for adults with IDD.

The study used single-case methods to track each worker’s skill over time.

Staff quickly hit high accuracy on all four practices.

Skills stayed strong even when new hires replaced old ones.

The package scaled: one trainer could run the whole program.

Courtemanche et al. (2021) already showed large-group BST works. They trained 36 adults at once with peer feedback. Kamana adds on-the-job feedback in IDD homes and keeps skills alive during turnover.

McGonigle et al. (1982) used pyramidal BST plus daily feedback for 45 institutional staff. Kamana skips the pyramid and still wins, proving direct large-scale BST plus feedback is enough.

Ólafsdóttir et al. (2026) later pushed pyramidal BST even further. Kamana’s direct model sits between the 1982 pyramid and the 2026 update, showing a simpler path now exists.

You can roll out BST plus on-the-job feedback across your whole agency. Train everyone at once, then give quick feedback in the natural setting. Skills stick, even with new staff walking in. No need for train-the-trainer chains unless you want them.