Theses and Dissertations

Date of Award


Document Type


Degree Name

Doctor of Education (EdD)


Abraham S. Fischler College of Education


Steven A. Hecht

Committee Member

Emmy Maurilus


applied behavior analysis, autism, intellectual disability, prompting


The problem identified in this research was that the most-to-least (MTL) prompting strategies used for individuals with intellectual disability (ID) had not been consistently demonstrated in research for personal hygiene, specifically tooth brushing. It has been well known that people with ID acquire skills differently than typically developing individuals (Cengher et al., 2018). Difficulty with developing hygiene skills such as brushing teeth is not limited only to those with physical disabilities because individuals with ID can struggle with hygiene skills as well. MTL prompt fading procedures have been used to teach many skills to individuals with ID (Drummond, 2018).

The design used in this research was a multiple-probe-across-participants design, which is defined as the current performance of the task to identify a starting point for instruction (Creswell, 2012). All probe sessions were nonconsequential and included no prompting. Two preintervention probe sessions were conducted for each participant prior to entry into the intervention. Probe sessions were conducted following mastery of each intervention objective. For each participant, once all intervention objectives were achieved, two maintenance probes were conducted. The maintenance phase entailed two probe sessions, consisting of eight nonconsequential trials each, to determine whether the participant continued to correctly brush teeth without prompting.

The participants in this study did not gain independence in tooth-brushing skills using MTL prompt fading. Moreover, tooth-brushing skills were not maintained over time using MTL prompting. In this research, MTL prompt fading was ineffective in leading children with ID to independence with tooth-brushing skills. Results indicated that MTL prompting could be ideal to use as an intervention for children with ID and to improve maintenance of skills; however, the findings were inconclusive because one participant averaged one of eight steps in the probe session.