Use of integrated, general education, and community settings as primary contexts for skill instruction for students with severe, multiple disabilities.
Teaching at natural moments inside regular school and community routines works for students with severe multiple disabilities.
01Research in Context
What this study did
The team worked with students who had severe multiple disabilities. They taught new skills right inside regular classrooms, hallways, and local stores.
Instead of pulling kids out, they waited for natural moments. Examples: counting napkins while setting a lunch table, reading a stop sign on a walk.
They used quick prompts then faded them. A time-delay gave kids a chance to answer first.
What they found
Fifteen of seventeen skills hit the learning goal. Kids mastered things like using a calculator for money math and picking the correct bus route.
Skills stuck because practice happened where they would really be used later.
How this fits with other research
Oh-Young et al. (2015) pooled twenty-four studies and found the same big picture: integrated placements beat separate rooms on both grades and friends.
Hawkins-Lear et al. (2025) later tested embedded teaching with preschoolers. They showed peers can be present without hurting results—helpful when staff is short.
Bassette et al. (2018) used the same prompt-fade plan in public gyms. Teens with autism learned exercise routines and kept using them in new gyms.
Why it matters
You do not need a special booth to teach. Watch the day’s schedule, pick moments that already happen, and slip prompts in. Start with one routine—maybe handing lunch cards in the cafeteria line. Track hits and misses for a week. If the data climb, add the next natural moment.
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02At a glance
03Original abstract
Four students with severe, multiple disabilities learned to use four to five new skills at critical moments within age-appropriate activities. Instruction was provided only at moments critical to the continuation of the activities when natural cues and consequences delineated the need for the target behaviors. This method of intervention was combined with a more traditional package of antecedent prompt-fade procedures and, in a few instances, time delay. The purpose of the study was to analyze the effects of instruction given only at natural critical moments on the acquisition of basic sensory, motor, social, and communication behaviors. A multiple baseline design across skills within separate activities for four participants was employed. Fifteen of 17 skills were acquired to criterion. In addition, "learning to learn" effects occurred within each activity as instruction of new target behaviors was introduced. The outcomes are important for the participant population because they document the effect of integrated educational models for teaching the most basic skills. Discussion of the motivation provided by activity routines in general education and community settings, as well as interpretation of data when participants have the most severe disabilities, is presented.
Behavior modification, 1995 · doi:10.1177/01454455950191003