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| Procedural Integrity of Clinical Programming in Applied Settings |
| Monday, September 30, 2019 |
| 10:30 AM–12:20 PM |
| Stockholm Waterfront Congress Centre, Level 2, Meeting Room 24/25 |
| Area: OBM/DDA; Domain: Service Delivery |
| Chair: Jill Harper (Melmark New England) |
| Discussant: Helena L. Maguire (Melmark New England) |
| CE Instructor: Jill Harper, Ph.D. |
| Abstract: The effectiveness of clinical systems, such as the implementation of Behavior Support Plans (BSP), relies not only on the technological sophistication of the written plan, but also on the ability of direct service staff to accurately and consistently implement the system. This symposium will include three presentations incorporating the staff training, supervisory training, and performance-monitoring systems for clinical programming that have evolved over the past 20 years at Melmark New England: a private, not for profit, community-based organization serving children and adults with autism spectrum disorders, acquired brain injury, neurological diseases and disorders, and severe challenging behaviors. The first presentation will provide a brief review of the OBM literature on effective systems development. Following this review, system development will be exemplified through behavior support plan systems. The third presentation will detail how knowledge and performance based systems are incorporated into new hire and on-the-job training ensure initial competency. The final presentation will outline a system of supervisory training essential to monitoring and maintenance of staff performance. The goal of this symposium will be to provide participants with empirically-based systems to ensure competent and accurate implementation of clinical systems. |
| Instruction Level: Intermediate |
| Keyword(s): Procedural Integrity, Staff Monitoring, Staff Training, Supervisory Training |
| Target Audience: Information presented during this symposium would be appropriate for students and those training in ABA and OBM programs, professionals within the field of Special Education, ABA/OBM, middle management, as well as administration and leadership personnel human service organizations. |
| Learning Objectives: At the conclusion of the symposium, participants will be able to:(1) describe examples of the application of OBM to clinical systems within applied settings; (2) identify the components of an effective staff training program; (3) describe the essential components of training systems necessary for supervisory staff; (4) identify areas where performance-monitoring tools and systems should be developed. |
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| Organizational Behavior Management: What’s Behind the Development of Systems to Ensure Integrity |
| KIMBERLY L. DUHANYAN (Melmark New England), Helena L. Maguire (Melmark New England), Jill Harper (Melmark New England), Silva Orchanian (Melmark New England) |
| Abstract: Organization Behavior Management (OBM) involves the systematic application of the science of behavior at the organizational level, including individual behavior within the organizational structure (Sundberg, 2016). This presentation will provide a comprehensive review of OBM and the application of this science to clinical systems within applied settings. First, an overview of the major areas of OBM including behavior-based safety, performance management, and systems analysis will be covered. Next, the concept of procedural integrity will be introduced and then an extension of this concept to organizational systems will be provided. Within this discussion, the essential roles of overarching knowledge management systems in the establishment of procedural integrity across all organizational systems will be highlighted. A similar discussion of the necessity of ongoing systems analysis in maintaining high levels of procedural integrity across users will follow. Finally, the presentation will end with a review of examples of different types of organizational systems to which these practices should be applied. |
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A Case Example of the Development of Clinical Systems: Behavior Support Plans |
| Melissa Clark (Melmark New Engalnd), HELENA MAGUIRE (Melmark New England), Frank L. Bird (Melmark New England) |
| Abstract: The application of the science of behavior of the organization, or organizational behavior management (OBM) can be described and implemented in a process that parallels the application of the science of the individual, or applied behavior analysis (ABA). Through an example of the development an organization-wide behavior support plan (BSP) system, this presentation will review the process of case conceptualization of OBM. Several variations of case conceptualization in OBM are presented throughout the literature. This presentation will summarize these steps as described by Wilder, Austin, and Casella (2009) in its description of the development of an organization-wide BSP system over 20 years of service delivery. Following the sequence of case conceptualization, the presentation will begin with a description of the overall goals of the BSP system and specific targets to be addressed. The discussion will then continue through the process with a description of the variability in BSP design and implementation prior to the development of the organizational system and assessment of variables responsible for such variability. The conclusion of the presentation will complete the case conceptualization through a description of the system that was developed, the results of implementation, and ongoing evaluation of the system. |
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| Training the User: Overview of New Hire and On-the-Job Training Systems |
| JILL HARPER (Melmark New England), Helena L. Maguire (Melmark New England), Silva Orchanian (Melmark New England) |
| Abstract: Once a system has been developed, users of that system must be trained to implement that system with integrity. A rich literature exists on evidence-based methods of staff training. A brief review of common evidence-based training methods, such as Behavior Skills Training, will be provided. The scope of this presentation will quickly extend beyond any single method of training to focus on the development and implementation staff training systems at the organizational level. A discussion of key components and benefits of staff training systems and how such systems differ from single training events will be presented. Following this overview, two separate, yet integrated staff training systems will be reviewed: New hire and on-the-job training. Components of each training system will be outlined, examples will be provided, and outcome measures presented. The relation between components of these two training systems and integrity of clinical systems will be highlighted throughout the presentation through the inclusion of performance competencies. |
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| Monitoring and Maintaining Performance: Supervisory Training Systems |
| SILVA ORCHANIAN (Melmark New England), Helena L. Maguire (Melmark New England), Jill Harper (Melmark New England) |
| Abstract: Supervision is an essential component to the maintenance of the procedural integrity with which organizational systems are implemented. Supervising the implementation of any given system by others is not synonymous with one’s own implementation of that same system. In other words, doing is not the same as overseeing. Thus, effective supervision requires specific training, training in the component skills of supervision itself. This presentation will outline a supervisory training system developed over a period of time to ensure effective, efficient, and acceptable training and ongoing supervision of staff within a human service organization. A description of the general structure and content areas of this training system will be reviewed and examples will be provided. Specific component skills such as conducing procedural integrity checks and providing feedback will then be described in detail to highlight training methods incorporated into the supervisory training system that result in the targeted outcome measures. The presentation will end with selected exemplars of performance management competencies of supervisors who completed this supervisory training series over the past several years. |
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