Abstract
Self-injurious behavior (SIB) is an aberrant behavior that frequently occurs among individuals with intellectual and developmental disabilities. SIB may negatively affect both consumers and staff members. Staff members may not be adequately trained on how to use procedures to effectively reduce SIB or they may use those procedures inconsistently. The purpose of the present study was to evaluate the effectiveness of a staff-training package (i.e., role-playing, in vivo training, feedback paired with contingent money, and an escape contingency) in teaching three staff members (one paraprofessional and two direct care staff members) how to implement intervention plans, with high levels of integrity, developed to reduce SIB. Staff members’ fidelity to the intervention plan was monitored in person and remotely. When the researchers were physically present in the environment, all staff members accurately implemented the intervention plan in role-play situations and with the actual consumers (in vivo training) when they received feedback and money based on their fidelity to the intervention plan. Additionally, in the researchers’ absence, staff members only implemented the intervention plan with high levels of integrity when they received feedback and money based on their fidelity to the intervention plan. The results of this study support the need for ongoing feedback (and perhaps money) to promote high levels of fidelity to intervention plans when used by staff members in the absence of an observer (or researcher).
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Alvero, A., Bucklin, B., & Austin, J. (2001). An objective review of the effectiveness and essential characteristics of performance feedback in organizational settings (1985–1998). Journal of Organizational Behavior Management, 21, 3–29.
Balcazar, F. E., Hopkins, B. L., & Suarez, Y. (1985). A critical, objective review of performance feedback. Journal of Organizational Behavior Management, 7(3–4), 65–89.
Beare, P. L., Severson, S., & Brandt, P. (2004). The use of a positive procedure to increase engagement on-task and decrease challenging behavior. Behavior Modification, 28(1), 28–44.
Bucklin, B. R., & Dickinson, A. M. (2001). Individual monetary incentives: a review of different types of arrangements between performance and pay. Journal of Organizational Behavior Management, 21(3), 45–137.
Carr, E. G. (1977). The motivation of self-injurious behavior: a review of some hypotheses. Psychological Bulletin, 84(4), 800–816.
Carr, E., & Smith, C. (1995). Biological setting events for self-injury. Mental Retardation and Developmental Disabilities Research Reviews, 1(2), 94–98.
Carter, S. (2009). Use of treatment analysis following ambiguous functional analysis results. Behavioral Interventions, 24, 205–213. doi:10.1002/bin.281.
Chowdhury, M., & Benson, B. (2011). Use of differential reinforcement to reduce behavior problems in adults with intellectual disabilities: a methodological review. Research in Developmental Disabilities, 32, 383–394.
Chung, M. C., & Harding, C. (2009). Investigating burnout and psychological well-being of staff working with people with intellectual disabilities and challenging behavior: the role of personality. Journal of Applied Research in Intellectual Disabilities, 22, 549–560.
Cooper, J., Heron, T., & Heward, W. (2007). Applied behavior analysis (3rd ed.). Upper Saddle River: Pearson Education Inc.
Courtemanche, A. B., Sheldon, J. B., Sherman, J. A., Schroeder, S. R. & House, R. (under review). Developing multicomponent interventions for reducing self-injurious behavior in community settings.
Davies, M., Howlin, P., Bernal, J., & Warren, S. (1998). Treating self-injury in a community setting: constraints on assessment and intervention. Child Psychology and Psychiatry Review, 3, 26–32.
Day, R., Rea, J., Schussler, N., Larsen, S., & Johnson, W. (1988). A functionally based approach to the treatment of self-injurious behavior. Behavior Modification, 12, 565–589.
DeLeon, I. G., Anders, B., Rodriguez-Catter, V., & Neidert, P. (2000). The effects of noncontingent access to single- versus multiple-stimulus sets on self-injurious behavior. Journal of Applied Behavior Analysis, 33, 623–626.
Dick, K., Gleeson, K., Johnstone, L., & Weston, C. (2010). Staff beliefs about why people with learning disabilities self-harm: a Q-methodology study. British Journal of Learning Disabilities, 39, 233–242. doi:10.1111/j.1468-3156.2010.00660.x.
DiGennaro, F., Martens, B., & McIntyre, L. (2005). Increasing treatment integrity through negative reinforcement: effects on staff and student behavior. School Psychology Review, 34(2), 220–231.
DiGennaro, F., Martens, B., & Kleinmann, A. (2007). A comparison of performance feedback procedures on staffs' treatment implementation integrity and students' inappropriate behavior in special education classrooms. Journal of Applied Behavior Analysis, 40(3), 447–461.
Favell, J. E., Azrin, N. H., Baumeister, A. A., Carr, E. G., Dorsey, M. F., Forehand, R., & Solnick, J. V. (1982). The treatment of self-injurious behavior. Behavior Therapy, 13(4), 529–554.
Feldman, M., Condillac, R., Tough, S., Hunt, S., & Griffiths, D. (2002). Effectiveness of community positive behavioral intervention for persons with developmental disabilities and severe problem behavior. Behavior Therapy, 33, 377–398.
Freeman, M. (1994). The differential impact on carers dealing with challenging behaviours. Journal of Community and Applied Social Psychology, 4, 181–187.
Furniss, F., & Biswas, A. (2012). Recent research on aetiology, development, and phenomenology of self-injurious behavior in people with intellectual disabilities: a systematic review and implications for treatment. Journal of Intellectual Disability Research, 56, 453–475. doi:10.1111/j.1365-2788.2012.01534.x.
Gilbertson, G., Witt, J., LaFleur Singletary, L., & VanDerHeyden, A. (2007). Supporting teacher use of interventions: effect of response dependent performance feedback on teacher implementation of a math intervention. Journal of Behavioral Education, 16, 311–323.
Gorman-Smith, D., & Matson, J. L. (1985). A review of treatment research for self-injurious and stereotyped responding. Journal of Mental Deficiency Research, 29(4), 295–308.
Harchik, A., Sherman, J., Hopkins, B., Strouse, M., & Sheldon, J. (1989). Use of behavioral techniques by paraprofessional staff: a review and proposal. Behavioral Residential Treatment, 4, 331–357.
Harchik, A., Sherman, J., Sheldon, J., & Strouse, M. (1992). Ongoing consultation as a method of improving performance of staff members in a group home. Journal of Applied Behavior Analysis, 25, 599–610.
Hastings, R., & Remington, B. (1993). ‘Is there anything on… why “good behavioral programs fail?”’ a brief review. Clinical Psychology Forum, 55, 9–11.
Horner, R. D. (1980). The effects of an environmental “enrichment” program on the behavior of instutionalized profoundly retarded children. Journal of Applied Behavior Analysis, 13(3), 473–491.
Horner, R., Todd, A., Lewis-Palmer, T., Irvin, L., Sugai, G., & Boland, J. (2004). The School-Wide Evaluation tool (SET): a research instrument for assessing school-wide positive behavior support. Journal of Positive Behavior Interventions, 6, 3–12. doi:10.1177/10983007040060010201.
Iwata, B. A., Dorsey, M. F., Slifer, K. J., Bauman, K. E., & Richman, G. S. (1982). Toward a functional analysis of self-injury. Analysis and Intervention in Developmental Disabilities, 2, 3–20.
Iwata, B., Pace, G., Willis, K., Gamache, & Hyman, S. (1986). Operant studies of self-injurious hand biting in the rett syndrome. American Journal of Medical Genetics, 25, 157–166.
Johnson, W. L., & Baumeister, A. A. (1978). Self-injurious behavior: a review and analysis of methodological details of published studies. Behavior Modification, 2(4), 465–487.
Kahng, S., Iwata, B. A., & Lewin, A. B. (2002). Behavioral treatment of SIB, 1964–2000. American Journal on Mental Retardation, 107, 212–221.
Katz, R., Johnson, C., & Gelfand, S. (1972). Modifying the dispensing of reinforcers: some implications for behavior modification with hospitalized patients. Behavior Therapy, 3, 579–588.
Lambrechts, G., Van Den Noortagte, W., Eeman, L., & Maes, B. (2010). Staff reactions to challenging behaviour: an observation study. Research in Developmental Disabilities, 31, 525–535. doi:10.1016/j.ridd.2009.12.004.
Lambrecths, G., Kuppens, S., & Maes, B. (2009). Staff variables associated with the challenging behaviour of clients with severe or profound intellectual disabilities. Journal of Intellectual Disability Research, 53, 620–632.
Matson, J., & LoVullo, S. (2008). A review of behavioral treatments for self-injurious behaviors of persons with autism spectrum disorders. Behavior Modification, 32, 61–76. doi:10.1177/0145445507304581.
McCord, B. E., Thomson, R. J., & Iwata, B. A. (2001). Functional analysis and treatment of self- injury associated with transitions. Journal of Applied Behavior Analysis, 34(2), 195–210.
Mills, S., & Rose, J. (2011). The relationship between challenging behavior, burnout and cognitive variables in staff working with people with intellectual disabilities. Journal of Intellectual Disability Research, 55, 844–857. doi:10.1111/j.1365-2788.2011.01438.x.
National Institutes of Health. (1991). National Institutes of Health Consensus Development Conference Statement. In Treatment of destructive behaviors in persons with developmental disabilities (NIH Publication No. 91–2410). Washington, DC: U.S. Department of Health and Human Services.
Noell, G., Witt, J., LaFleur, L., Mortenson, B., Ranier, D., & LeVelle, J. (2000). Increasing intervention implementation in general education following consultation: a comparison on two follow-up strategies. Journal of Applied Behavior Analysis, 33, 271–284.
Noell, G., Witt, J., Slider, N., Connell, J., Gatti, S., Williams, K., & Resetar, J. (2005). Treatment implementation following behavioral consultation in school: a comparison of three follow-up strategies. School Psychology Review, 34, 87–106.
Oliver, C. (1995). Annotation: self-injurious behavior in children with learning disabilities: recent advances in assessment and intervention. Journal of Child Psychology and Psychiatry, 30, 909–927.
Oliver, C., Murphy, G. H., & Corbett, J. A. (1987). Self-injurious behaviour in people with mental handicap: a total population study. Journal of Mental Deficiency Research, 31(2), 147–162.
Parrish, J., Iwata, B., Dorsey, M., Bunck, T., & Slifer, K. (1985). Behavior analysis, program development, and transfer control in the treatment of self-injury. Journal of Behavior Therapy and Experimental Psychiatry, 16, 159–167.
Petscher, E., Rey, C., & Bailey, J. (2009). A review of empirical support for differential reinforcement of alternative behavior. Research in Developmental Disabilities, 30, 409–425.
Pomerleau, O., Bobrove, P., & Smith, R. (1973). Rewarding psychiatric aides for the behavioral improvement of assigned patients. Journal of Applied Behavior Analysis, 6(3), 383–390.
Pommer, D., & Streedbeck, D. (1974). Motivating staff performance in an operant learning program for children. Journal of Applied Behavior Analysis, 7(2), 217–221.
Poppes, P., van der Putten, A., & Vlaskamp, C. (2010). Frequency and severity of challenging behavior among people with profound intellectual and multiple disabilities. Research in Developmental Disabilities, 31, 1269–1275. doi:10.1016/j.ridd.2010.07.017.
Reid, D., & Parsons, M. (2002). Essential procedures for training staff to implement behavior support programs. In D. Reid & M. Parsons (Eds.), Working with staff to overcome challenging behavior among people who have severe disabilities: a guide for getting support plans carried out (pp. 151–166). Morgantown: Habilitative Management Consultants.
Rojahn, J., Schroeder, S. R., & Hoch, T. A. (2008). Self-injurious behavior in intellectual disabilities. Amsterdam: Elsevier.
Roscoe, E., Fisher, W., Glover, S., & Volkert, V. (2006). Evaluating the relative effects of feedback and contingent money for staff training of stimulus preference assessments. Journal of Applied Behavior Analysis, 39(1), 63–77.
Schroeder, S., Schroeder, C., Smith, B., & Dalldorf, J. (1978). Prevalence of self-injurious behaviors in a large state facility for the retarded: a three-year follow-up study. Journal of Autism and Childhood Schizophrenia, 8(3), 261–269.
Schroeder, S., Kanoy, R., Mulick, J., Rojahn, J., Thios, S., Stephens, M., et al. (1982). Environmental antecedents which affect management and maintenance of programs for self-injurious behavior. In J. Hollis & C. E. Meyers (Eds.), Life threatening behavior: analysis and interventions (Vol. 5). Washington: American Association on Mental Deficiency.
Schroeder, S. R., Oster-Granite, M. L., & Thompson, T. (2002). Self-injurious behavior. Gene-brain-behavior relationships. Washington, DC: American Psychological Association.
Shore, B., Iwata, B., DeLeon, I., Kahng, S., & Smith, R. (1997). An analysis of object manipulation and self-injury as competing responses. Journal of Applied Behavior Analysis, 30, 21–41.
Sloman, K., Vollmer, T., Cotnoir, N., Borrero, C., Borrero, J., Samaha, A., & St. Peter, C. (2005). Descriptive analyses of caregiver reprimands. Journal of Applied Behavior Analysis, 38, 373–383.
Strouse, M., Sherman, J. A., & Sheldon, J. B. (2013). Do good, take data, get a life and make a meaningful difference in providing residential services. In D. Reed, F. DiGennaro Reed, & J. Luiselli (Eds.), Handbook of crisis intervention for individuals with developmental disabilities (pp. 441–466). New York: Springer.
Taylor, L., Oliver, C., & Murphy, G. (2011). The chronicity of self-injurious behaviour: a long-term follow: a total population study. Journal of Applied Research in Intellectual Disabilities, 24(2), 105–117.
Tiger, J., Fisher, W., & Bouxsein, K. (2009). Therapist- and self-monitored DRO contingencies as a treatment for the self-injurious skin picking of a young man with Asperger syndrome. Journal of Applied Behavior Analysis, 42, 315–319. doi:10.1901/jaba.2009.42-315.
Vollmer, T., Marcus, B., & LeBlanc, L. (1994). Treatment of self-injury and hand mouthing following inconclusive functional analyses. Journal of Applied Behavior Analysis, 27, 331–344.
Ward, P., Johnson, M., & Konukman, F. (1998). Directed rehearsal and preservice staffs’ performance of instructional behaviors. Journal of Behavioral Education, 8(3), 369–380.
Witt, J. C., Martens, B. K., & Elliott, S. N. (1984). Factors affecting teachers’ judgments of the acceptability of behavioral interventions: time involvement, behavior problem severity, and type of intervention. Behavior Therapy, 15(2), 204–209.
Wolf, M. (1978). Social validity: the case for subjective measurement. Journal of Applied Behavior Analysis, 11, 203–214.
Wolff, J., Clary, J., Harper, V., Bodfish, J. W., & Symons, F. (2012). Evidence for reciprocal interaction effects among adults with self-injury and their caregivers. American Journal on Intellectual and Developmental Disabilities, 117, 225–232. doi:10.1352/1944-7558- 117.3.225.
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Courtemanche, A., Sheldon, J., Sherman, J. et al. Assessing the Effects of a Staff Training Package on the Treatment Integrity of an Intervention for Self-Injurious Behavior. J Dev Phys Disabil 26, 371–389 (2014). https://doi.org/10.1007/s10882-014-9372-6
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DOI: https://doi.org/10.1007/s10882-014-9372-6