A program to increase manual signs with severely/profoundly mentally retarded students in natural environments

A classroom teacher and 12 residential staff members were taught to increase the opportunities for manual sign use with three severely/profoundly mentally retarded students, to use those opportunities for asking the students to sign-request, and, if necessary, to provide prompts. A multi-faceted package consisting of written instructions, modeling, video presentation, visual cueing, feedback, and group discussion was used in a multiple-baseline design across situations. During intervention, (a) the number of opportunities for sign use increased in both classroom situations but remained stable on the ward, (b) the number of signs made by the students in response to the question increased across each of the situations, and (c) the number of spontaneously emitted signs increased.