Sam is 23 years of age; he graduated from the local special education program last year. He has a diagnosis of severe mental retardation with an IQ score of 27 and a secondary diagnosis of mild cerebral palsy, as well as a visual impairment. He has a long history of getting his own way by acting out when he gets upset. On occasion this behavior has been directed at teachers when they have attempted to intervene. Typically, however, his aggressive behavior is limited to temper tantrums.