Practitioner Implementation of Communication Intervention With Students With Complex Communication Needs.

Hatfield et al. (2019) asked special-education teachers to train their own paraeducators. The goal was more chances for students with complex needs to start a conversation.

Teachers first learned a simple least-to-most prompt chain. They then coached paraeducators in the same room while real lessons ran. The team tracked how often adults gave students a chance to initiate, or OTI.

OTI jumped from zero to about one chance every two minutes. Paraeducators scored 94.5% fidelity without stopping class. Students with intellectual disability or developmental delay used their talkers, signs, or devices more often.

McGonigle et al. (1982) did the first big pyramidal trial. They trained supervisors who then coached 45 institutional staff. Both studies show the same cascade: train one layer, fidelity spreads down.

Ólafsdóttir et al. (2026) moved the model to functional communication training. Their trainers lost some skill later but bounced back after brief retraining. The pattern warns us to plan quick booster sessions.

Gerald et al. (2019) hit 90% staff fidelity too, yet used self-management timers instead of a second person. The two papers do not clash; they give you alternate roads to the same destination.

You already have teachers who know the prompt hierarchy. Let them run a five-minute rehearsal with paras before first period. No extra pay, no pull-outs, just steady 0.58 OTI per minute and near-perfect fidelity. That is free acceleration of student communication tomorrow.