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were c<strong>on</strong>ducted. During <str<strong>on</strong>g>the</str<strong>on</strong>g> initial baseline<br />
phase in Time Block A (sessi<strong>on</strong>s 1–12), Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w<br />
engaged in h<strong>and</strong> mouthing an average<br />
of 11.4 times (range 2–18) per sessi<strong>on</strong>. When<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> was introduced in Time<br />
Block A (sessi<strong>on</strong>s 13–15), occurrences of h<strong>and</strong><br />
mouthing decreased dramatically to 0–2 occurrences.<br />
Up<strong>on</strong> a return to baseline (sessi<strong>on</strong>s<br />
16–18), h<strong>and</strong> mouthing increased to an average<br />
of 13.7 times (range 6–18) per sessi<strong>on</strong>. In<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> final return to interventi<strong>on</strong> (sessi<strong>on</strong>s 19–<br />
21), h<strong>and</strong> mouthing did not occur <strong>on</strong>ce over<br />
three sessi<strong>on</strong>s.<br />
During <str<strong>on</strong>g>the</str<strong>on</strong>g> baseline phase in Time Block B<br />
(sessi<strong>on</strong>s 1–6), h<strong>and</strong> mouthing occurred an<br />
average of 9 times (range 6–15) per sessi<strong>on</strong>.<br />
When <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> was implemented (sessi<strong>on</strong>s<br />
7–12), an immediate decrease in <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
occurrence of h<strong>and</strong> mouthing to an average<br />
of 1.3 times (range 0–2) per sessi<strong>on</strong> was observed.<br />
When <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> was removed in<br />
sessi<strong>on</strong> 13 <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> teachers began to intervene,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> average occurrence of h<strong>and</strong> mouthing<br />
increased to an average of 5.8 times<br />
(range 3–9) per sessi<strong>on</strong> in <str<strong>on</strong>g>the</str<strong>on</strong>g> remaining five<br />
sessi<strong>on</strong>s. During this last phase in Time Block<br />
B, Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w was out of <str<strong>on</strong>g>the</str<strong>on</strong>g> classroom (na) for<br />
four full sessi<strong>on</strong>s <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> final 15 min interval<br />
for all but <str<strong>on</strong>g>the</str<strong>on</strong>g> first sessi<strong>on</strong>.<br />
Discussi<strong>on</strong><br />
By prompting engagement with curricular materials<br />
<strong>and</strong> implementing a brief h<strong>and</strong>s down<br />
procedure, we were able to remove Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w’s<br />
arm splints <strong>and</strong> maintain low levels of h<strong>and</strong><br />
mouthing across a two hour <strong>and</strong> forty five<br />
minute period in several school envir<strong>on</strong>ments.<br />
Because Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w was not in arm<br />
splints <strong>and</strong> was provided with curricular activities,<br />
he engaged in higher levels of appropriate<br />
behavior. Additi<strong>on</strong>ally, with no training,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> teachers in <str<strong>on</strong>g>the</str<strong>on</strong>g> classroom began to independently<br />
implement <str<strong>on</strong>g>the</str<strong>on</strong>g> curricular comp<strong>on</strong>ent<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> successfully during<br />
Time Block B.<br />
While <str<strong>on</strong>g>the</str<strong>on</strong>g>se results are promising, several<br />
issues should be c<strong>on</strong>sidered. First, we were<br />
<strong>on</strong>ly able to complete this study with <strong>on</strong>e participant.<br />
Although this interventi<strong>on</strong> was successful<br />
with our participant, it is not known if<br />
this procedure would have similar effects with<br />
o<str<strong>on</strong>g>the</str<strong>on</strong>g>r students. This study should <str<strong>on</strong>g>the</str<strong>on</strong>g>refore be<br />
364 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
replicated within natural c<strong>on</strong>texts with o<str<strong>on</strong>g>the</str<strong>on</strong>g>r<br />
participants who have severe to profound disabilities<br />
<strong>and</strong> engage in h<strong>and</strong> mouthing.<br />
A sec<strong>on</strong>d c<strong>on</strong>siderati<strong>on</strong> is that <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong><br />
utilized both a curricular interventi<strong>on</strong><br />
<strong>and</strong> a brief h<strong>and</strong>s down comp<strong>on</strong>ent. One<br />
might argue that, even though both procedures<br />
were in effect, <str<strong>on</strong>g>the</str<strong>on</strong>g> decrease in h<strong>and</strong><br />
mouthing might have been due to <strong>on</strong>ly <strong>on</strong>e<br />
comp<strong>on</strong>ent of <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> (i.e., curricular<br />
interventi<strong>on</strong> or brief h<strong>and</strong>s down). Based<br />
<strong>on</strong> all of <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> data in both Time<br />
Blocks A <strong>and</strong> B, <str<strong>on</strong>g>the</str<strong>on</strong>g> use of <str<strong>on</strong>g>the</str<strong>on</strong>g> brief h<strong>and</strong>s<br />
down procedure was <strong>on</strong>ly utilized in 10% of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> intervals, <strong>and</strong> implemented<br />
<strong>on</strong>ly 14 times out of 234 possible opportunities.<br />
This might suggest that <str<strong>on</strong>g>the</str<strong>on</strong>g> brief h<strong>and</strong>s<br />
down comp<strong>on</strong>ent of <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> could<br />
naturally be faded out as h<strong>and</strong> mouthing c<strong>on</strong>tinued<br />
to decrease. This data also suggests that<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> curricular interventi<strong>on</strong> had a significant<br />
impact <strong>on</strong> h<strong>and</strong> mouthing, as 85% of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
intervals in <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> phases had no<br />
occurrences of h<strong>and</strong> mouthing.<br />
On <str<strong>on</strong>g>the</str<strong>on</strong>g> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r h<strong>and</strong>, when <str<strong>on</strong>g>the</str<strong>on</strong>g> teachers implemented<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> without <str<strong>on</strong>g>the</str<strong>on</strong>g> brief<br />
h<strong>and</strong>s down comp<strong>on</strong>ent, <str<strong>on</strong>g>the</str<strong>on</strong>g> decrease in h<strong>and</strong><br />
mouthing was not as significant as during interventi<strong>on</strong><br />
sessi<strong>on</strong>s c<strong>on</strong>ducted by <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher.<br />
One reas<strong>on</strong> for <str<strong>on</strong>g>the</str<strong>on</strong>g> decreased effectiveness<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> teacher interventi<strong>on</strong> might be<br />
that <str<strong>on</strong>g>the</str<strong>on</strong>g> teachers did not implement <str<strong>on</strong>g>the</str<strong>on</strong>g> brief<br />
h<strong>and</strong>s down comp<strong>on</strong>ent. A sec<strong>on</strong>d reas<strong>on</strong> may<br />
be due to <str<strong>on</strong>g>the</str<strong>on</strong>g> fact that <str<strong>on</strong>g>the</str<strong>on</strong>g> teachers were not<br />
trained to implement any comp<strong>on</strong>ent of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
interventi<strong>on</strong>, but simply began to include Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w<br />
in curricular activities. The data do indicate<br />
that when <str<strong>on</strong>g>the</str<strong>on</strong>g> teachers were working with<br />
Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w, he <strong>on</strong>ly engaged in h<strong>and</strong> mouthing<br />
four times out of 63 possible opportunities,<br />
which is an average of less than <strong>on</strong>e occurrence<br />
per sessi<strong>on</strong>. This might suggest that by<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> time <str<strong>on</strong>g>the</str<strong>on</strong>g> teachers began to independently<br />
implement <str<strong>on</strong>g>the</str<strong>on</strong>g> curricular aspect of <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong>,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> brief h<strong>and</strong>s down procedure was<br />
no l<strong>on</strong>ger necessary. A final reas<strong>on</strong> for <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
increased occurrence during <str<strong>on</strong>g>the</str<strong>on</strong>g> teacher interventi<strong>on</strong><br />
might be that Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w was more<br />
likely to engage in high levels of h<strong>and</strong> mouthing<br />
when given independent tasks that did not<br />
involve any engagement with an adult. Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w<br />
was given such tasks in 10 of <str<strong>on</strong>g>the</str<strong>on</strong>g> 31<br />
teacher interventi<strong>on</strong> sessi<strong>on</strong>s. In <str<strong>on</strong>g>the</str<strong>on</strong>g>se 10 ses-