|Examination of Treatment Integrity on Client Outcomes
|Sunday, May 30, 2010
|4:30 PM–5:50 PM
|Texas Ballroom Salon D (Grand Hyatt)
|Area: EDC/DDA; Domain: Applied Behavior Analysis
|Chair: Florence D. DiGennaro Reed (Melmark New England)
|CE Instructor: John Eshleman, Ed.D.
|Abstract: Treatment integrity refers to the extent to which an intervention is implemented as designed and is an area of research gaining increased interest. This symposium highlights four talks that share advances in treatment integrity research regarding its impact on client outcomes. The first talk presents findings from a study investigating the effects of errors of commission during discrete trial instruction on student performance. Next, the impact of types of integrity failures on a writing task will be presented. In the third presentation, the effects of errors of omission and commission during implementation of a fixed-time schedule of reinforcement will be shared. The symposium concludes with a talk that presents results of two literature reviews summarizing impact of treatment integrity on client outcomes. Presenters will discuss implications of their findings in educational and clinical settings.
|Effects of Errors of Commission During Discrete Trial Teaching on Student Performance
|FLORENCE D. DIGENNARO REED (Melmark New England), Derek D. Reed (Melmark New England), Helena Maguire (Melmark New England), Cynthia N. Catania (Melmark New England)
|Abstract: Previous research has demonstrated that systematically varying levels of treatment integrity impacts student performance (Wilder, Atwell, & Wine, 2006). The purpose of this presentation is to share findings from a study that assessed the effects of systematic changes in levels of treatment integrity by altering errors of commission (i.e., reinforcer delivery at inappropriate times) during error correction procedures as part of discrete trial teaching. Specifically, we taught receptive nonsense shapes under three conditions (0%, 50%, or 100% integrity) using a multi-element design. Students exhibited higher levels of performance during perfect implementation. Performance was low and showed no differentiation in the remaining conditions. Findings suggest that 50% integrity is as detrimental as 0% integrity on student performance.
|An Evaluation of Integrity Failures During Token Economies with Students With Autism
|ALLISON TETREAULT (West Virginia University), Claire St. Peter Pipkin (West Virginia University), Tonya M. Marsteller (West Virginia University), Mia Caccavale (West Virginia University)
|Abstract: In a previous study, we examined the impact of errors of commission (unscheduled reinforcers delivered) and omission (scheduled reinforcers not delivered) on academic behavior maintained by token economies with six typically developing students. Treatment integrity failures did not affect response rate, but the quality of the compositions decreased during some of the failure phases. In the current investigation, we examined the effects of treatment integrity errors on the writing of students diagnosed with autism. We exposed students to baseline, a token system with full integrity (implemented perfectly), and reduced levels of integrity with both errors of omission and commission in a multiple-baseline-across-participants design. The reduced integrity conditions produced few detrimental effects on rate of writing. However, all students exhibited textual stereotypy (e.g., excessive repetition of words and phrases within the composition) when treatment integrity errors occurred, and this stereotypy maintained with the return to 100% integrity conditions. These findings suggest that, while token systems may maintain a consistent rate of behavior regardless of integrity of implementation, the effect on quality of writing may produce substantial negative side effects for students with autism that may require specific intervention to reverse.
|Treatment Integrity Failures During Fixed-Time Schedules of Reinforcement
|Claire St. Peter Pipkin (West Virginia University), ELLEN NICOLE BROSH (West Virginia University)
|Abstract: Research on treatment integrity failures has found that errors of commission, accidently reinforcing problem behavior, are more detrimental to treatment outcomes than errors of omission, accidently failing to reinforce appropriate behavior. Little is known however, about the impact of treatment integrity failures during fixed-time schedules of reinforcement (FT). Although FT schedules are often easier to implement than other reinforcement-based schedules, they may not always be implemented as planned. The current study examined the differential effects of errors of omission, errors of commission, and a combination of these errors on responding maintained by FT schedules of reinforcement. Response rates were compared during baseline, omission errors, commission errors, and blended errors (omission and commission errors). Response rates were higher during blended and commission errors than omission errors. The results indicate that treatment integrity failures have differential effects on responding, in that errors of commission and blended errors are more detrimental to treatment outcome than errors of omission.
|Examining the Role of Treatment Integrity for Practitioners
|NICOLE C. GROSKREUTZ (Utah State University), Timothy A. Slocum (Utah State University)
|Abstract: Since practitioners typically have too many responsibilities, it is important to identify when the benefits of collecting treatment integrity data outweigh the costs of the time and effort required to collect those data. We propose that, in practice, the decision to monitor treatment integrity is driven by client outcomes, with assessment of treatment integrity becoming important (1) when client outcomes are not as desired, or (2) when client outcomes are exceptionally good and practitioners wish to identify the controlling variables. Two separate segments of literature were reviewed to inform our understanding of the relationship between treatment integrity and client outcomes. The first review included a small number of studies in which treatment integrity was experimentally manipulated, as the effects on client outcomes were measured. The second review included 37 studies from the Journal of Applied Behavior Analysis in which levels of treatment integrity were manipulated, and treatment integrity and client outcomes were both reported as dependent measures. The importance of treatment integrity to practice will be discussed, while considering treatment integrity to be a multi-dimensional, complicated construct that should not be over-simplified when reviewing the literature.