An evaluation of gentle teaching and visual screening in the reduction of stereotypy.

Gentle teaching and visual screening techniques have been used to control severe behavior problems in persons with mental retardation. An alternating treatments design was used to compare gentle teaching, visual screening, and a task-training condition in the reduction of the high-level stereotypy of 3 persons with mental retardation. Following a baseline phase, a task-training condition using standard behavioral techniques was implemented to establish the effects of training the subjects on the tasks. Results showed a modest decrease in stereotypy. This phase was followed by an alternating treatments phase in which visual screening, gentle teaching, and baseline conditions were compared. Both procedures were superior to the control condition in reducing stereotypic behavior, with visual screening being more effective than gentle teaching. When compared with data from the prior phase, gentle teaching was found to be more effective than task training for 2 subjects but less effective for the 3rd, whose stereotypy increased during gentle teaching. Two succeeding phases in which visual screening was implemented across two and then all three daily conditions reduced stereotypy further to near-zero levels. An additional phase with 1 subject demonstrated that the treatment effects of visual screening were easily replicated across therapists. Mixed and idiosyncratic changes in collateral behaviors occurred. For example, "bonding," the goal of gentle teaching, occurred at the same low levels under both treatments, contrary to the predictions of gentle teaching's proponents. The results indicate that gentle teaching may not be the universal treatment of choice for stereotypy its proponents suggest, and that it requires further empirical evaluation.