Ensuring Staff Competence

Question 1

AKA: Procedural Fidelity; Fidelity of Implementation; Program Integrity

• The degree to which a treatment plan is implemented as it is written.
• Not correctly collecting data or waiting to start the program, but HOW THE STEPS OF THE PROGRAM ARE IMPLEMENTED.

Answer 1

Treatment Integrity

Question 2

How do you know you are providing good quality services?

Answer 2

1. Significant clinical outcomes.
2. The individual has acquired new skills.
3. Challenging behaviors are reduced.
4. Service providers and administrators are motivated and reinforced.
5. The individual is motivated and reinforced.

Question 3

• The people who implement behavior support plans and interventions are crucial to the outcome of the client’s success. Their skill level, training, consistency, and natural consequences must be securely in place.
• Interventionist’s Success = Client’s Success
• Here we describe the steps for training the people who work with the client to implement a behavior support plan. It is very important that the people who train these staff persons are capable trainers. The people providing the training must be able to not only describe the skill, but to perform the skill as well.
• Providing constructive learnable feedback must also be in the skill set of a staff trainer.

Answer 3

Competency-Based Training (For Staff)

Question 4

Four (4) Ways to Create a Procedural Integrity System: STMR

Answer 4

1. Specify: Clearly specify what staff must do to implement the plan.
2. Train: Train staff on procedures using competency-and performance-based strategies.
3. Monitor: Routinely monitor staff performance.
4. Reinforce: Reinforce correct performance.

Question 5

Two (2) Methods for Measuring Treatment Integrity (Gresham, 1989):

Answer 5

1. ) Direct Methods: (Observation)

2. ) Indirect Methods: (Self-reports, Questionnaires, Behavior Rating Scales)

Question 6

1. ) A precise DESCRIPTION of the skill to be taught.
2. ) A brief WRITTEN description (task analysis) of the skills to be taught. This reinforces what is taught and acts as a permanent product for staff to maintain and review.
3. ) DEMONSTRATION: A trainer to MODEL the skill in the closet approximation of the conditions in which the skill will be utilized.
4. ) (Newer) Learning through VIDEO MODELING.
5. ) An opportunity to practice and learn through ROLE-PLAY. -Makes training fun; easy to contrive learning opportunities. (Training setting > Natural setting > Natural setting with clients)
6. ) A trainer to OBSERVE the individual performing the skill in the training setting, as well as in the job setting. Competency should be observed on the job before competency can be determined. This is also known as “REHEARSAL”.
7. ) A trainer providing immediate, positively-minded performance FEEDBACK on proficiency explaining how improvements can be made.
8. ) REPEAT the aforementioned processes until mastery.

Answer 6

How to Use Competency-Based Training for Mediators

Question 7

-You should design and use reinforcement systems in a way that improves student/supervisee/client performance and provide documented, timely feedback regarding the performance of a supervisee on an ongoing basis.

Detailed Protocol:

a. ) Start with a positive empathetic statement.
b. ) Identify skills performed correctly.
c. ) Identify skills performed incorrectly.
d. ) Specify how to change or improve performance problems.
e. ) Allow individual to ask questions.
f. ) Describe what should be done next.
g. ) End with a positive and supportive statement.

Answer 7

A Protocol for Providing Feedback

Question 8

• How supervisors can ensure that their staff is carrying out the procedures as intended.
• Involves systematic data collection in order to provide objective performance measurement. Ensures staff will receive feedback more openly.
• Another way for supervisors to determine if the plan is working to help the client.

Answer 8

Systematic Performance Monitoring

Question 9

Systematic Performance Monitoring Accomplishes 2 Goals:

Answer 9

1. ) Provides means for evaluating staff performance and program implementation.
2. ) Exhibits a program’s effect on the individual’s target behavior.

Question 10

Performance Monitoring Looks at:

Answer 10

• Knowledge of the target behavior.
• How the environment is arranged.
• Understanding of antecedents.
• Use of consequences
• An understanding of behaviors to increase and staff response to these behaviors (teaching replacement behaviors).
• An understanding of behaviors to decrease and staff response to these behaviors (reactive strategies).
• How staff conform to specified routines.
• Practice of discrete trial training.

Question 11

Four (4) Ways to Effectively Monitor Staff Performance: IF OF

Answer 11

1. ) Inform: Inform staff they are being monitored and WHY.
2. ) Friendly: Be friendly, polite, and courteous to staff.
3. ) Overt: Monitor staff overtly, as covert monitoring brings negative feelings.
4. ) Feedback: The feedback should be given to staff as soon as possible.

Question 12

• A tool given to employees evaluate if they like how their employers are monitoring and supervising them that involves items that they must CHOOSE between on the measure.
• _________ _________ are more sensitive than QUESTIONNAIRES.

Answer 12

Choice Measures

Question 13

Usually, employees are given _____________ to evaluate how they feel about how their employers monitor and supervise them in organizational behavior management (OBM).

-_________________ usually involve Likert scales with responses ranging from “extremely disliked” to “likely extremely”.

Answer 13

Questionnaires

Question 14

• Time Sampling: Brief observation periods (staff prefer shorter observation periods because it is less intimidating and stressful; time flexible).
• Evaluate Data Collection: Correct procedure, data taken daily, on time, etc.
• Permanent Product: Behavior measured through permanent change in the environment, video recording (paper work, data collection, reports, monitoring forms, etc.). Is less invasive and intimidating, easier for staff to handle than literally being observed; easier for the observer because it can happen at any time.

Answer 14

Measuring Staff Performance (Data-Based)

Question 15

What Does Staff Performance Data Measure?

Answer 15

• The # of outcomes (how many of something was produced).
• Rating Scales: Scores for specific tasks of a staff’s responsibility. Each skill can be weighted with varying values for each skill or un-weighted with equal values for each skill.
• Ranking: Least preferred method. It can create competitiveness and ill feelings between staff because there is a first place, etc.
• Point Systems: Help to determine specific reinforcement and can be used to evaluate an individual’s progress over time.
• Should utilize qualitative (narrative measurement), as well as quantitative.

Question 16

• Consider the reasons for the current behavioral challenge.
• This will help you get information on the current contingencies of reinforcement.
• If your client does NOT possess the skill: You would then design your interventions accordingly to focus on teaching that skill.
• If your client does possess the skill, but still does not engage in the behavior: You would design your interventions accordingly to focus on effectively reinforcing the client’s use of that skill.

Answer 16

Identify the Contingencies Governing the Behavior of those Responsible for Carrying out Behavior-Change Procedures and Design Interventions Accordingly

Question 17

• Evaluation system that uses narrative description, incident reporting, and measurable ratings.
• Since score is based on descriptive information as well as quantitative measurement, feedback is specific and less judgmental.

Answer 17

Behaviorally Anchored Rating Scale

Question 18

Authorizing A Behavior Support Plan

Answer 18

1. ) Overseeing the Implementation of A Plan
2. ) Things to Consider When Developing A Behavior Support Plan
3. ) Ensuring Success and Support when Conducting a Behavior Support Plan
4. ) Ensuring Meaningful Activities
5. ) Including Functional Skills in Treatment Plans

Question 19

-Ideally, the person who wrote the plan is involved in the supervisory/monitoring process. He/she is most equipped, as he/she understands the rationale and the specific treatment procedures.

Answer 19

Overseeing The Implementation of a Plan

Question 20

Things to Consider when Developing a Behavior Support Plan

Answer 20

1. ) Resources: Do you have the right # of staff, and are they available.
2. ) Staff Deployment: Where are your staff located? Can they be where they need to be to carry out the plan?
3. ) Onsite Presence of a Supervisor: Frequent supervision ensures proper implementation
4. ) Staff Absenteeism and Turnover: Although difficult to control, must be considered.

Question 21

• Involves GUARDIAN and/or SUPPORTIVE STAFF in the creation of the plan, because this will ensure their participation and support. Be sure to consider how they will support the individual in skill acquisition (appropriate consequences, prompt levels, etc.).
• Consider how the individual’s new skills will be REINFORCING TO family members, group home staff, etc.
• Will there be NATURAL REINFORCERS TO MAINTAIN THE BEHAVIOR after treatment ends? What are they?
• Determine what SKILLS or BEHAVIORS THE INDIVIDUAL SHOULD ACQUIRE to contact natural reinforcers.
• Consider INPUT FROM PARAPROFESSIONALS, as they have more personal contact with clients.
• COLLABORATE with other professionals to achieve clinical outcomes. Provide the behavioral angle (data collection, task analyses, reinforcement schedules, & strategies) to goals and programs of other services (teachers, effects of medicine, diet plans, etc.).

Answer 21

Ensuring Success and Support When Conducting A Behavior \Plan

Question 22

• Ensuring that an environment has a lot of available meaningful activity options can help reduce challenging behavior.
• It is our responsibility to evaluate and measure how individuals engage in meaningful activities. We should also evaluate how our staff promotes meaningful activity involvement. Staff who are successful should be rewarded.
• Is the challenging behavior occurring in an environment with limited meaningful activity options? If yes, the ENVIRONMENT is the problem.

Answer 22

Ensuring Meaningful Activities

Question 23

Including Functional Skills in Treatment Plans

Answer 23

• Critical therapeutic component.
• Without functional skills training, challenging behaviors are likely to be continuous.
• Should be taught systematically and frequently.

Question 24

1. Involve activities that someone else would have to do for an individual if the individual could not do the activities.
2. The MORE FREQUENTLY the individual is likely to perform a skill, the more functional the skill is to teach.
3. Choose skills for which an individual can be paid to perform as part of a job.
4. Choose skills that allow an individual to get something wanted out to get of something unwanted without displaying challenging behavior.

Answer 24

Functional Skills Guidelines

Question 25

Four (4) Essential Components of a Behavior Support Plan: BACE

Answer 25

1. ) Behaviors: Specification of behaviors for increase and behaviors for decrease.
2. ) Antecedents: These should be clearly identified because they can aid staff in prevention of behavior-evoking antecedents.
3. ) Consequences: Description of what to do when target behavior occurs.
4. ) Environmental Set-Ups (AKA: Preventative Procedures, Proactive Strategies, Setting Events): Setting up the environment to prevent or reduce challenging behavior. (What should or should not be in place?)

Question 26

• Know when behavior treatment will end with your client, you want to constantly be assessing the current levels of the target behaviors to see if your data tells you that you have accomplished your goals.
• You must start to provide documentation of behavioral services from the very beginning of the program to the very end.
• Continue to collect data until the behavior change is MEANINGFUL and DURABLE.
• Ongoing documentation of professional work is outlined in both The Right to Effective Education (Barrett et al. (1991)) & the Professional and Ethical Compliance Code for Behavior Analysts (the code) (BACB, (2016)).

Answer 26

Ongoing Documentation of Behavioral Services

Question 27

Taking Data Consistently from day One Helps to Show::

Answer 27

1. Procedural Fidelity: Interventions have been implemented correctly.
2. The effectiveness of your awesome interventions (or if they maybe weren’t too awesome at first, you would know that you needed to make changes based on your data too!).

Question 28

The Many Rules About Supervision in the Professional and Ethical Compliance Code for Behavior Analyst (the code):

• You must ________ ___________ ____ __________ _______ from the start. If you cannot do so consistently from day ONE, then it is advisable you should NOT take on the case.
• You supervise only within your areas of defined competence.
• You take on only a volume of supervisory activity that is commensurate with your ability to be EFFECTIVE.
• You delegate to your supervisees only those responsibilities that such persons can reasonably be expected to perform competently, ethically, and safely.
• If the supervisee does not have the skills necessary to perform competently, ethically, ethically, and safely, you provide conditions for the acquisitions for the acquisition of those skills.
• You ensure that supervision and trainings are behavior-analytic in content, effectively and ethically designed, and meet the requirements for licensure, certification, or other defined goals.

Answer 28

Provide Supervision For Behavior-Change Agents