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The applicability of Klein's Mediational intervention for sensitizing caregivers (MISC) to adolescents and adults with intellectual disability (ID) was examined, and the quality of paraprofessionals' interactions with these populations in special education schools and in vocational rehabilitation centres was compared. Interactions were video taped and coded. The findings support the MISC suitability for adolescents and adults with ID, but demonstrate significant differences between facilities. Opportunities for choice making, expanding and encouraging with explanation were observed more at the schools, whereas mediation of verbal instructions and physical assistance were observed more in the centres. Negative attitudes of staff towards modifiability of adult persons with ID may be a possible explanation.