This chapter focuses on the observation and analysis of spoon-feeding behavior; the effect of satisfaction versus deprivation in the reinforcement process; the effect of positive and negative reinforcement; and scheduling of reinforcement. Data are presented on the child's skills in dressing, toilet, bathing and grooming, ambulation, and communication, since these are areas in which nurses’ help provide care to the retarded child. A program to initiate self-help skills of feeding was based on the principles of operant learning theory. The withdrawal of the continuous reinforcement schedule after the sixth session demonstrated that the use of positive reinforcement was the factor responsible for the maintenance of spoon feeding. The case study of Ann augments a rapidly growing body of evidence that the systematic use of reinforcement provides a sufficient, and perhaps a necessary, basis for establishing skills in the child who is not developing self-help skills in the normal sequence of child development.