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The purpose of this study was to train teachers and peers to increase social interactions of children who had been identified as having a lack of social interactions in an inclusive preschool in Korea. Four children with disabilities were identified by teachers as lacking social interactions with peers and teachers, and were the focal subjects of the study. The focal children, four teachers, and four classes of peer children participated in two interventions, an initial training on naturalistic teaching strategies with teachers and a training on social skills with peer and focal children, and a combined intervention. A multiple probe design was employed to examine effects of the two interventions during free choice play periods. The four teachers were trained on naturalistic teaching strategies, and peers and focal children in each class participated in a training on social interactions for the first intervention phase. The second intervention was a combined intervention consisting of both naturalistic teaching strategies of teachers and a ‘group game’ in which peer children used social interaction skills with focal children. This study consisted of baseline I, training teachers and children with baseline II, the combined intervention, and the maintenance phase. The results of this study indicate that focal children’s mean percentage of social interactions with teachers and peers in free choice play periods increased from baseline I after the initial training with baseline II. The maintenance phase indicated that mean percentages of social interactions of focal children increased from the mean percentages of social interactions in baseline I. This study may contribute to issues of training teachers on naturalistic teaching strategies and children on social skill interactions in an inclusive preschool in Korea, and the United States, for promoting social interactions with children with disabilities.

C. difficile is the most important cause of antibiotic-associated colitis, but little is known of its sources and epidemiology. Three clusters of C. difficile diarrhea were studied at the University of Michigan Hospital. Using selective media for C. difficile containing cycloserine and cefoxitin (CCFA), cultures were obtained from the environment of patients with the organism in their stools. When stool carriers had diarrhea, 9.3 percent of 910 cultures of floors and surfaces subject to fecal contamination were positive. In control areas where there were no carriers, only 2.6 percent of 497 cultures were positive (p < 0.005). Contamination was also greater in the room environment of a patient with colitis (19.6 percent of samples positive) than in the room of an asymtomatic carrier (6.8 percent positive). C. difficile was also isolated from h and s or stools of hospital personnel. The organism was isolated from surfaces in the hospital laundry, from sewage and soil, and from the home of a patient. Twenty-three air and 25 food cultures were negative. Twenty environmental isolates tested for their cytotoxigenicity were positive. When the organism was inoculated onto an unused hospital floor, it persisted there for five months. The persistence of C. difficile in the environment could be attributable to the residual nature of its spores. The recommended 1:127 dilution of quaternary ammonium chloride compounds commonly used as a hospital disinfectant was not sporicidal, and therefore its efficiency as a germicidal agent was limited. A two percent alkaline glutaraldehyde solution was demonstrated to be sporicidal. This investigation provides evidence that environmentally derived organisms may be important in the spread of antibiotic-associated colitis. The h and s of hospital personnel may be a most important vehicle of transmission. Enteric isolation precautions should be instituted for patients with antibiotic-associated or C. difficile positive stools and diarrhea.