Section 9: Ensuring Staff Competence

Question 1

Treatment Integrity

Answer 1

(Procedural Fidelity; Fidelity of Implementation; Program Integrity)

• the degree to which a treatment plan is implemented as it is written and intended
• not correctly collecting data or waiting to start the program, but how the steps of the program are implemented
• looks at the steps of the technology and how they are implemented in the treatment package

Question 2

How do you know you are providing good quality services?

Answer 2

• significant clinical outcomes
• the learner has acquired new skills
• challenging behaviors are reduced
• service providers and administrators are motivated and reinforced
• the individual is motivated and reinforced

Question 3

Compentency Based Training for Staff

Answer 3

• the skill level, training, consistency, and natural consequences must be securely in place
• interventionist’s success = client’s success
• the people who train staff must be capable trainers who can not only describe the skills but perform them as well
• staff trainer must be skilled at providing constructive learnable feedback

Question 4

4 Ways to Create a Procedural Intergrity System

Answer 4

STMR - Supverisors Trained Me Repeatedly

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
   
   • ETHICS WARNING- you designing and using reinforcement systems in a way that improves student/supervisee/client performance is your ethical duty

Question 5

2 Methods for Measuring Treatment Integrity

Answer 5

• Direct Methods
  
  • observation
• Indirect Methods
  
  • self-reports
  • questionnaires
  • behavior rating scales

Question 6

8 Steps for Using Competency Based Training for Mediators

Answer 6

• a precise description of the skill to be taught
• a brief written descritpion (TA) of the skills be be taught. This reinforces what is taught and acts as a permanent product for staff to maintain and reivew.
• demonstration- a trainer to model the skill in the closest approximation of the conditions in which the skill will be utilized
• learning through video models
• an opportunity to practice and learn through role play
  
  • in the training setting, natural setting, and natural setting with clients
• a trainer to observe the individual performing the skill in the training setting as well as the job setting = Rehearsal. Competency must be observed on the job before it can be determined.
• A trainer should provide immediate, postiviely minded, performance feedback on proficiency and explain how improvements can be made
  
  • feedback must be immediate and specific
• Repeat all the steps of the process until the mediator has mastered it

Question 7

Protocol for Providing Feedback

Answer 7

• ETHICS WARNING- it is the supervisor’s responsibility to use reinforcement systems that improve performance and provide documented timely feedback on an ongoing basis
• 7 Steps
  
  • start with a postive empatheitc statement
  • identify skills performed correctly
  • identify skills performed incorrectly
  • specify how to change or improve performance problems
  • allow individual to ask questions
  • describe what should be done next
  • end with a positive and supportive statement

Question 8

Systematic Performance Monitoring

Answer 8

• Accomplishes 2 Goals:
  
  • provides means for evaluating staff performance and program implementation
  • exhibits a program’s effect on the individual’s target behavior
• how supervisors can ensure that their staff is carrying out the procedures as inteded
• 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

Question 9

Things to Look at in Performance Monitoring

Answer 9

• knowledge of the target behavior
• how the enviornment is arranged
• understanding of antecedents
• use of consequences
• an understanding of behaviors to increase and staff response to these behaviors (i.e. teaching replacement behaviors)
• an understanding of behaviors to decrease and staff response to those behaviors (e.g. reactive strategies)
• how staff conform to specified routines
• practice of discrete trial training

Question 10

4 Ways to Effectively Monitor Staff Performance

Answer 10

IFOF- I Feel Overwhelmed Frequently

• INFORM the staff they are being monitored and WHY
• be FRIENDLY, polite, and courteous to staff
• Monitory staff OVERTly
• Give immediate FEEDBACK

Question 11

Choice Measures in Staff Competence

Answer 11

• a tool given to employees to evaluate if they like how their employers are monitoring and supervising them that involves items that they must choose between on the meausres
• choice measures are more sensitive than questionaires
  
  • questionnaires are usually used in OBM (Organizational Behavior Management) and usually use Likert scales (responses rated from 1 to 10)
• Ex. When your supervisor comes for an observation, do you prefer a surprise observation or being notified ahead of time?

Question 12

Data Based Measures of Staff Performance

Answer 12

• Time Sampling Data Collection
  
  • brief observation periods
• Evaluate Data Collection
  
  • correct procedure used, data taken daily and on time
• Permanent Product Data Collection
  
  • behavior measured through permanent change in the environment (e.g. video recording, paperwork, data collection, reports, monitoring forms, etc)
    
    • less invasive and intimidating
    • easier for staff because its less stressful
    • easier for supervisor to schedule

Question 13

What Staff Performance Data Measures and How its Reported

Answer 13

• the number of outcomes (e.g. how many of something were produced)
• Rating Scales
  
  • scores for specific tasks of a staff’s responsibilities. Each skills can be weighted with varying values or have equal weights
• Ranking
  
  • least preferred method
  • can create competitiveness and ill feelings
• Point Systems
  
  • helps to determine specific reinforcement and can be used to evaluate an individual’s progress over time
• Qualitative and Quantitative measures should be used

Question 14

Identify the Contingencies Governing Staff Behavior and Intervene Accordingly

Answer 14

• consider the reasons for the current behavioral challenge
• gather information on the current contingencies of reinforcement
• if your staff does not possess a skill
  
  • you would then design interventions to teach the skill
• if your staff does possess the skill but does not engage in the behavior
  
  • you would design your intervention to foucs on effectively reinforcing staff’s use of that skill

Question 15

Behaviorally Anchored Rating Scale for Staff Monitoring

Answer 15

• evaluation system that uses narrative description, incident reporting, and measurable ratings
• since the score is based on descriptive information as well as quantitative measurement, feedback is specific and less judgmental
• a numeric scale, a descriptive scale, and an example of what would qualify receiving that number on the scale

Question 16

Sample of Monitoring Form to Evaluate Staff Performance

Answer 16

Components:

• environmental set up
• antecedents
• behaviors to increase
• staff response to behaviors to increase
• behaviors to decrease
• staff’s response to behaviors to decrease

Question 17

Sample of a Behavior Support Summary Form

Answer 17

• used to evaluate staff knowledge
• Components
  
  • defining target behviors for increase and decrease
  • what should and should not be in the environment
  • what are the antecedents to problem behavior and what is the appropriate response
  • what are the consequences for problem behaviors and what are the consequences for desireable behaviors

Question 18

Authroing A Behavior Support Plan: Overseeing Implementation

Answer 18

• the person who wrote the plan should be involved in the supervision and monitoring process

Question 19

Authroing A Behavior Support Plan: Things to Consider

Answer 19

• Resources
• Staff Deployment- where are staff located and can they be where they need to be to carry out the plan? (e.g. problem occurs on the bus ride to school but staff cannot ride the bus with the child)
• Onsite Presence of a Superlvisor
• Staff Absences and Turnover

Question 20

Authroing A Behavior Support Plan:

Ensuring Success and Support When Conducting a Behavior Support Plan

Answer 20

• involve guardian and/or supportive staff in the creation of the plan to ensure their participation and support.
  
  • be sure to consider how they will support the learner in skill acquistion
• Consider how the learner’s new skills will be reinforcing to their family members, group home staff
• Will there be natural reinforcers to main the bheavior after treatment ends? What are they?
• Determine what skills or behaviors the individual should acquire to contact natural reinforcers
• Consider input from paraprofessionals
• Collaborate with other professionals to achieve clinical outcomes

Question 21

Authroing A Behavior Support Plan:

Ensuring Meaningful Activities

Answer 21

• ensuring that an enviornment has a lot of available meaningful activity options that can help reduce challenging behavior
• evalute and measure how individuals engage in meaningful activities and how our staff promotes meaningful activity involvement
  
  • staff who are successful should be reinforced
• is the challenging behavior occuring in an environment with limited meaningful activity options? If yes, the enviornment is the problem

Question 22

Authroing A Behavior Support Plan:

Include Functional Skills in Treatment Plans

Answer 22

• critical!
• without functional skills training, challenging behaviors are likely to continue
• functional skills should be taught systematically and frequently
• Guidelines:
  
  • involve activities that someone else would have to do for a learner if they could not do the activities themselves
  • the more frequently the learner is likely to perform a skill, the more functional the skill is to teach
  • choose skills for which the learner could use in a paid job
  • choose skills that allow the learner to get something they want or to get something they don’t want removed without displaying challenging behavior

Question 23

4 Essential Components of a Behavior Support Plan

Answer 23

BACE

• Behaviors
  
  • specification of behaviors for increase and decrease
• Antecedents
  
  • clearly defined as they can aid in staff prevention of behavior evoking antecedents
• Consequences
  
  • description of what to do when a target behavior occurs
• Enviornmental Set Ups (Preventative Procedures; Proactive Strategies; Setting Events)
  
  • ​setting up the environment to reduce or prevent challenging behaviors
  • what should and should not be in place

Question 24

Ongoing Documentation of Behavioral Services

Answer 24

• ETHICS WARNING- to know when behavior treatment will end with your client, you want to constantly assess current levels of target behaviors to see if your data tells you that you have accomplished your goals
• documentation must start from the very beginning of the program until the end
• you will continue to collect data until the behavior change is meaningful and durable
• consistent data collection from day 1 helps to show
  
  • Procedural Fidelity- the interventions have been implemented correctly
  • the effectiveness of the intervention

Question 25

Provide Supervision for Behavior Change Agents

Answer 25

• ETHICS WARNING- you must provide supervision for the behavior change agents from the start–if you can’t, DON’T TAKE THE CASE
• you supervise only within your areas of defined competence
• you only take on a volume of supervisory activity that is commensurate with your ability to be effective
• you delegate to your supervisees only those responsiblities that they can perform competently, ethically, and safely
• if supervisee doesn’t have the skill, you must provide conditions for the acquisition of those skills
• ensure that supervision and trainings are behavior analytic in conetent, effetively and ethically designed, and meet the requirements for licensure, certification, or toher defined goals