In the field of visual disabilities, students who have visual impairments in addition to other disabilities receive limited amounts of direct service time from a teacher of students who are visually impaired (TVI), leaving most of their education in the hands of special education teachers and paraprofessionals. These professionals can support their students with visual impairments; they just require additional support and training to better understand the unique needs of this population and the teaching strategies that are most effective for these learners. This action research study used a mixed method multiple baselines across participants methodology to first determine if the Teaching Skills Training Program (Parsons et al., 1993) is an effective strategy for training paraprofessionals on the targeted teaching strategy of hand under hand instruction. It then examined student behavioral responses to add to the literature base on the effectiveness of the hand under hand strategy when working with students who are visually impaired. Participants were recruited from three separate classrooms within a level D placement option for students with developmental disabilities, including one paraprofessional and one student from each classroom. The results indicate that the training protocol was effective, with each paraprofessional reaching close to 100% success in implementing hand under hand, acceptability of both the training method and teaching strategy, and improved student performance on all variables. The study suggests possible benefits of regular use of the training methodology when training paraprofessionals, and increased use of the hand under hand strategy within the local context.