Simulation procedures for teaching independent menstrual care to mentally retarded persons

Four mentally retarded adolescent females participated in a program for assessment and training of independent menstrual care skills. Three task analyses served as the basis for instruction: (a) menstrual stain on underwear, (b) menstrual stain on a sanitary pad, and (c) menstrual stain on both sanitary pad and underwear. During individual training sessions, subjects were taught to perform correct sequences via simulation training with a small doll, in which a trainer utilized instructions, praise, modeling, and corrective feedback. Three types of assessment probes were conducted prior to training, upon completion of specified mastery criteria, and during post-training follow-up sessions. Doll probes assessed performance with the toy doll, self-probes assessed naturalistic performance but under conditions of simulated menstruation, and in vivo probes assessed performance during actual menstruation. Results of a multiple baseline analysis indicated that subjects emitted few correct responses during baseline probes, but showed consistent improvements that corresponded to the introduction of training. Generalization to untrained skills was noted with all subjects. Follow-up assessments indicated maintenance of skills for periods up to 30 weeks following termination of training.