Staff interactive style during multisensory storytelling with persons with profound intellectual and multiple disabilities.
MSST training without live feedback keeps caregiver style stuck at mediocre — add real-time coaching to lift interaction quality.
01Research in Context
What this study did
Researchers watched ten weekly multisensory storytelling (MSST) sessions between caregivers and adults with profound intellectual and multiple disabilities.
They scored how often caregivers gave choices, waited for responses, and shared excitement.
No extra coaching was given after the first MSST workshop.
What they found
Caregiver scores stayed in the mid-range for all ten weeks.
Warm tone and turn-taking did not improve on its own.
Simply teaching the MSST steps left interaction quality flat.
How this fits with other research
Ruppel et al. (2023) and Ausenhus et al. (2019) show the missing piece.
Their staff hit 90 % fidelity after one Zoom feedback session.
Real-time coaching, not hand-outs, lifted skill.
Howard et al. (2023) and McCammon et al. (2022) echo the same lesson in caregiver telehealth.
Five-minute video plus feedback made parents ace mand training.
The flat MSST scores line up with these wins once feedback is added.
Sengupta et al. (2025) widen the lens: without system-level support, even good caregiver programs fade.
Why it matters
If you run MSST, add live coaching.
Sit in, tag waits and affect, and give praise plus correction on the spot.
One feedback loop per week may be all you need to move the interaction needle.
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02At a glance
03Original abstract
BACKGROUND: Multisensory storytelling (MSST) is an individualised activity for people with profound intellectual and multiple disabilities (PIMD) in which a story is being told with an emphasis on sensory experiences and social interaction. MSST is a promising approach, but needs more empirical research evidence. In general, there is a lack of research about staff interaction during specific activities with people with PIMD. In the present study, we explored the possibility to describe staff interactive style during MSST making use of a global coding instrument. METHODS: Twenty dyads of a person with PIMD and a professional caregiver participated in an observation study. The caregivers received training in MSST and told a multisensory story to their client once a week, for a period of 10 weeks. The first, fifth and last session were recorded on video. Staff interactive style was coded using an adapted version of the Maternal Behavior Rating Scale, with a consensus rating procedure. RESULTS: Professional caregivers scored moderately on the Maternal Behavior Rating Scale. Repeated measures analyses showed no change in time. We did not find a relationship between staff interactive style and client or staff characteristics. CONCLUSIONS: The Maternal Behavior Rating Scale contributes to our understanding of staff interactive style during activities with people with PIMD. Specifically for MSST, the moderate scores on the interactive style dimensions were unexpected, because the individualised MSST activity created an optimal situation for high-quality interaction with people with PIMD. Because the interactive style did not improve through the repetition of the activity either, these results might point to a need for staff training in achieving high-quality interaction during activities like MSST.
Journal of intellectual disability research : JIDR, 2012 · doi:10.1111/j.1365-2788.2011.01448.x