Skip to main content

Treatment Integrity in Autism Spectrum Disorder Interventions

  • Chapter
  • First Online:
Interventions for Autism Spectrum Disorders

Abstract

The last few years have seen a remarkable proliferation of treatment programs to ameliorate the symptoms of autism spectrum disorders (ASD; National Autism Center. (2009). The National Autism Center's National Standards Report. Massachusetts: Author.). In addition, there is an increasing legal and ethical burden placed on the practitioner working with an ASD population to use evidence based interventions (EBI) that have been evaluated in the scientific literature (Detrich, R. (2008). Evidence-based, empirically supported, or best practice? A guide for the scientist-practitioner. In J. K. Luiselli, D. C. Russo, W. P. Christian, & S. M. Wilczynski (Eds.), Effective practices for children with autism (pp. 3–25). New York: Oxford University Press.). The vast database of interventions and added pressures make the job of the clinician quite difficult—they must sift through competing evidence bases, spectacular statistical claims, and treatments that “wrap themselves in the cloak of science” (Wilczynski, S. M., Christin, L., & National Autism Center. The National Standards Project: Promoting evidence-based practice in autism spectrum disorders. In J. K. Luiselli, D. C. Russo, W. P. Christian, & S. M. Wilczynski (Eds.), Effective practices for children with autism (pp. 37–60). New York: Oxford University Press.) in order to find treatment programs that will be effective. Fortunately, there exist a variety of resources to help the practitioner identify an EBI. In fact, this book will serve as a very useful guide to help parents and professionals select potentially effective interventions for children with ASD.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Allen, K. D., & Warzak, W. J. (2000). The problem of parental non-adherence in clinical behavior analysis: Effective treatment is not enough. Journal of Applied Behavior Analysis, 33(3), 373–391. doi:10.1901/jaba.2000.33-373.

    Article  PubMed  Google Scholar 

  • American Psychological Association. (2005). Policy statement on evidence-based practice in psychology. http://www.apapracticecentral.org/ce/courses/ebpstatement.pdf Accessed 15 Oct. 2012.

  • American Speech-Language-Hearing Association. (2010). Code of ethics [Ethics]. doi:10.1044/policy.ET2010-00309.

    Google Scholar 

  • Barber, J. P., Gallop, R., Crits-Chirstoph, P., Frank, A., Thase, M. E., Weiss, R. D., et al. (2006). The role of therapist adherence, therapist competence, and alliance in predicting outcome of individual drug counseling: Results from the National Institute Drug Abuse Collaborative Cocaine Treatment Study. Psychotherapy Research, 16, 229–240. doi:10.1080/10503300500288951.

    Article  Google Scholar 

  • Burgio, L. D., Engel, B. T., Hawkins, A. M., McCormick, K., Schieve, A, & Jones, L. T. (1990). A staff management system for maintaining improvements in continence with elderly nursing home residents. Journal of Applied Behavior Analysis, 23, 111–118. doi:10.1901/jaba.1990.23-111.

    Article  PubMed  Google Scholar 

  • Cochrane, W. S., & Laux, J. M. (2008). A survey investigating school psychologists' measurement of treatment integrity in school-based interventions and their beliefs in their importance. Psychology in the Schools, 45, 499–507. doi:10.1002/pits.20319.

    Article  Google Scholar 

  • Codding, R. S., Feinberg, A. B., Dunn, E. K., & Pace, G. M. (2005). Effects of immediate performance feedback on implementation of behavior support plans. Journal of Applied Behavior Analysis, 38, 205–219. doi:10.1901/jaba.2005.98-04.

    Article  PubMed  Google Scholar 

  • Codding, R. S., Livanis, A., Pace, G., & Vaca, L. (2008). Using performance feedback to improve treatment integrity of classwide behavior plans: An investigation of observer reactivity. Journal of Applied Behavior Analysis, 41, 417–422. doi:10.1901/jaba.2008.41-417.

    Article  PubMed  Google Scholar 

  • Cook, C. R., Mayer, G. M., Wright, D. B., Kraemer, B., Wallace, M. D., Dart, E., Collins, T., & Restori, A. (2010). Exploring the link among behavior intervention plans, treatment integrity, and student outcomes under natural educational outcomes. Journal of Special Education, 20, 1–14. doi:10.1177/0022466910369941.

    Google Scholar 

  • Cooper, J. O., Heron, T. E., & Heward W. L. (2007). Applied behavior analysis (2nd ed.). New Jersey: Merrill Prentice Hall.

    Google Scholar 

  • Cowan, R. J., & Sheridan, S. M. (2003). Investigating the acceptability of behavioral interventions in applied conjoint behavioral consultation: Moving from analog conditions to naturalistic settings. School Psychology Quarterly, 18(1), 1–21.

    Google Scholar 

  • Coyle, C., & Cole, P. (2004). A video-taped self-modeling and self-monitoring treatment program to decrease off-task behaviour in children with autism. Journal of Intellectual and Developmental Disability, 29, 3–15. doi:10.1080/08927020410001662642.

    Article  Google Scholar 

  • Detrich, R. (2008). Evidence-based, empirically supported, or best practice? A guide for the scientist-practitioner. In J. K. Luiselli, D. C. Russo, W. P. Christian, & S. M. Wilczynski (Eds.), Effective practices for children with autism (pp. 3–25). New York: Oxford University Press.

    Google Scholar 

  • DiGennaro, F. D., Martens, B. K., & McIntyre, L. L. (2005). Increasing treatment integrity through negative reinforcement: Effects on teacher and student behavior. School Psychology Review, 34(2), 220–231.

    Google Scholar 

  • DiGennaro, F. D., Martens, B. K., & Kleinman, A. E. (2007). A comparison of performance feedback procedures on teachers' treatment implementation integrity and students' inappropriate behavior in special education classrooms. Journal of Applied Behavior Analysis, 40, 447–461. doi:10.1901/jaba.2007.40-447.

    Article  PubMed  Google Scholar 

  • DiGennaro-Reed, F. D., Codding, R., Catania, C. N., & MaGuire, H. (2010). Effects of video modeling on treatment integrity of behavioral interventions. Journal of Applied Behavior Analysis, 43, 291–295. doi:10.1901/jaba.2010.43-291.

    Article  PubMed  Google Scholar 

  • Dusenbury, L., Brannigan, R., Falco, M., & Hansen, W. B. (2003). A review of research on fidelity of implementation: implications for drug abuse prevention in school settings. Health Education Research: Theory and Practice, 18(2), 237–256. doi:10.1093/her/18.2.237.

    Article  Google Scholar 

  • Elliot, S. N. (1988). Acceptability of behavioral treatments in educational settings. In J. C. Witt, S. N. Elliott, & F. M. Gresham (Eds.), Handbook of Behavior Therapy (pp. 121–150). New York: Plenum.

    Chapter  Google Scholar 

  • Erhardt, K. E., Barnett, D. W., Lentz, F. E., Stollar, S. A., & Raifin, L. H. (1996). Innovative methodology in ecological consultation: Use of scripts to promote treatment acceptability and integrity. School Psychology Quarterly, 11, 149–168. doi:10.1037/h0088926.

    Article  Google Scholar 

  • Etchdeit, S. K. (2006). Behavioral intervention plans: Pedagogical and legal analysis of themes. Behavior Disorders, 31(2), 223–243.

    Google Scholar 

  • Foster, S., & Cone, J. (1986). Design and use of direct observation. In A. Ciminero, K. Calhoun, & H. Adams (Eds.), Handbook of behavioral assessment (2nd ed., pp. 253–324). New York: Wiley Interscience.

    Google Scholar 

  • Foxx, R. M. (1996). Twenty years of applied behavior analysis in treating the most severe problem behavior: Lessons learned. The Behavior Analyst, 19(2), 225–235.

    PubMed  Google Scholar 

  • Frentz, C., & Kelley, M. L. (1986). Parents' acceptance of reductive treatment methods: The influence of problem severity and perception of child behavior. Behavior Therapy, 17(1), 75–81. doi:10.1016/S0005-7894(86)80116-2.

    Article  Google Scholar 

  • Gresham, F. M. (1989). Assessment of treatment integrity in school consultation and prereferral intervention. School Psychology Review, 18, 37–50.

    Google Scholar 

  • Gresham, F.M. (1996). Treatment integrity in single-subject research. In R. D. Franklin, D. B. Allison, B. S. Gorman (Eds.), Design and analysis of single-case research (pp. 93–117). Mahwah: Lawrence Erlbaum Associates.

    Google Scholar 

  • Gresham, F. M. (2005). Treatment integrity and therapeutic change: Commentary on Perepletchikova and Kazdin. Clinical Psychology: Science and Practice, 12(4), 391–394. doi:10.1093/clipsy/bpi048.

    Article  Google Scholar 

  • Guercio, J. M., Dixon, M. R., Soldner, J., Shoemaker, Z., Zlomke, K., Root, S., & Small, S. (2005). Enhancing staff performance measures in an acquired brain injury setting: Combating the habituation to organizational behavioral interventions. Behavioral Interventions, 20, 91–99. doi:10.1002/bin.174.

    Article  Google Scholar 

  • Happe, D. (1982). Behavior intervention: It doesn't do any good in your briefcase. In J. Grimes (Ed.), Psychological approaches to problems of children and adolescents (pp. 15–41). Des Moines: Iowa Department of Public Instruction.

    Google Scholar 

  • Hayes, S. C., & Wilson, K. G. (1993). Some applied implications of a contemporary behavior-analytic account of verbal events. The Behavior Analyst, 16(2), 283–301.

    PubMed  Google Scholar 

  • Hogue, A., Henderson, C. E., Dauber, S., Barajas, P. C., Fried, A., & Liddle, H. A. (2008). Treatment adherence, competence, and outcome in individual and family therapy for adolescent behavior problems. Journal of Consulting and Clinical Psychology, 76(4), 544–555. doi:10.1037/0022-006X.76.4.544.

    Article  PubMed  Google Scholar 

  • IDEA. (2004). P.L. 108–446, § 665 [b][1][B], 118 Stat. 2787 [2005].

    Google Scholar 

  • Kazdin, A. E. (1986). Comparative outcome studies of psychotherapy: Methodological issues and strategies. Journal of Consulting and Clinical Psychology, 54, 95–105. doi:10.1037/0022-006X.54.1.95.

    Article  PubMed  Google Scholar 

  • Kazdin, A. E. (2011). Single-case research designs. New York: Oxford University Press.

    Google Scholar 

  • Koegel, R. L., Russo, D. C., & Rincover, A. (1977). Assessing and training teachers in the generalized use of behavior modification with autistic children. Journal of Applied Behavior Analysis, 10(2), 197–205. doi: 10.1901/jaba.1977.10-197.

    Article  PubMed  Google Scholar 

  • LeBlanc, M., Ricciardi, J. N., & Luiselli, J. K. (2005). Improving discrete trial instruction by paraprofessional staff through an abbreviated performance feedback intervention. Education and Treatment of Children, 28(1), 76–82.

    Google Scholar 

  • Lentz, F. E., Allen, S. J., & Erhardt, K. E. (1996). The conceptual elements of strong Interventions in school settings. School Psychology Quarterly, 11, 118–136. doi:10.1037/h0088924.

    Article  Google Scholar 

  • Livanis, A., & Mercer, S. H. (2011). The effects of graduated treatment introduction and performance feedback on treatment integrity for complex behavior intervention plans. School Psychology Review. (Manuscript submitted for publication)

    Google Scholar 

  • Lloyd, K. E. (1994). Do as I say, not as I do. The Behavior Analyst, 17(1), 131–139.

    PubMed  Google Scholar 

  • McLeod, B. D., Southam-Gerow, M. A., & Weisz, J. R. (2009). Conceptual and methodological issues in treatment integrity measurement. School Psychology Review, 38(4), 541–546.

    Google Scholar 

  • Meichenbaum, D., & Turk, D. C. (1987). Facilitating treatment adherence: A practitioner's guidebook. New York: Plenum.

    Book  Google Scholar 

  • Mortensen, B. P., & Witt, J. C. (1998). The use of weekly performance feedback to increase teacher implementation of a prereferral intervention. School Psychology Review, 27, 613–627.

    Google Scholar 

  • Mouzakitis, A. (2010). The effects of self-monitoring training and performance feedback on the treatment integrity of behavior support plans for children with autism. Unpublished doctoral dissertation, The Graduate Center of the City University of New York: NY.

    Google Scholar 

  • National Association of School Psychologists. (2010a). Principles for professional ethics. http://www.nasponline.org/standards/2010standards/1_%20Ethical%20Principles.pdf Accessed 15 Oct. 2012..

  • National Association of School Psychologists. (2010b). Model for comprehensive and integrated school psychological services. http://www.nasponline.org/standards/2010standards/2_PracticeModel.pdf Accessed 15 Oct. 2012.

  • National Autism Center. (2009). The National Autism Center's National Standards Report. Massachusetts: Author.

    Google Scholar 

  • Nezu, A. M., & Nezu, C. M. (2008). Treatment integrity. In D. McKay (Ed.), Handbook of research methods in abnormal and clinical psychology (pp. 351–363). New York: Sage.

    Google Scholar 

  • Noell, G. H., Witt, J. C., Gilbertson, D. N., Ranier, D. D., & Freeland, J. T. (1997). Increasing teacher interventions implementation in general education settings through consultation and performance feedback. School Psychology Quarterly, 12, 77–88. doi:10.1037/h0088949.

    Article  Google Scholar 

  • Noell, G. H., Witt, J. C., LaFleur, L. H., Mortenson, B. P., Ranier, D. D., & LeVelle, J. (2000). Increasing intervention implementation in general education following consultation: A comparison of two follow-up strategies. Journal of Applied Behavior Analysis, 33, 271–284.

    Article  PubMed  Google Scholar 

  • Perepletchikova, F., & Kazdin, A. E. (2005). Treatment integrity and therapeutic change: Issues and research recommendations. Clinical Psychology: Science and Practice, 12(4), 365–383. doi:10.1093/clipsy/bpi045

    Google Scholar 

  • Petscher, E. S., & Bailey, J. S. (2006). Effects of training, prompting and self-monitoring on staff behavior in a classroom for students with disabilities. Journal of Applied Behavior Analysis, 39, 215–226. doi:10.1901/jaba.2006.02-05.

    Article  PubMed  Google Scholar 

  • Reed, F. D., & Codding, R. S. (2011). Intervention integrity assessment. In J. K. Luiselli (Ed.), Teaching and behavior support for children and adults with autism spectrum disorder (pp. 38–47). New York: Oxford University Press.

    Google Scholar 

  • Reichow, B., & Volkmar, F. R. (2011). Evidence-based practices in autism: Where we started. In B. Reichow, P. Doehring, D. V. Cicchetti, & F. R. Volkmar (Eds.), Evidence-based practices and treatments for children with autism (pp. 3–24). New York: Springer. doi:10.1007/978-1-4419-6975-0_1.

    Chapter  Google Scholar 

  • Richman, G. S., Riordan, M. R., Reiss, M. L., Piles, D. A. M., & Bailey, J. S. (1988). The effects of self-monitoring and supervisor feedback on staff performance in a residential setting. Journal of Applied Behavior Analysis, 21, 401–409. doi:10.1901/jaba.1988.21-401.

    Article  PubMed  Google Scholar 

  • Schulte, A. C., Easton, J. E., & Parker, J. (2009). Advances in treatment integrity research: Multidisciplinary perspectives on the conceptualization, measurement, and enhancement of treatment integrity. School Psychology Review, 38(4), 460–475.

    Google Scholar 

  • Singh, N. N., & Katz, R. C. (1985). On the modification of acceptability ratings for alternative child treatments. Behavior Modification, 9(3), 375–386. doi:10.1177/01454455850093006.

    Article  PubMed  Google Scholar 

  • Sterling-Turner, H. E., Watson, T. S., Widmon, M., Watkins, C., & Little, E. (2001). Investigating the relationship between training type and treatment integrity. School Psychology Quarterly, 16(1), 56–67. doi:10.1521/scpq.16.1.56.19157.

    Article  Google Scholar 

  • Taylor, J., & Miller, M. (1997). When timeout works some of the time: The importance of treatment integrity and functional assessment. School Psychology Quarterly, 12(1), 4–22. doi:10.1037/h0088943.

    Article  Google Scholar 

  • Tingstrom, D. H., McPhail, R. L., & Bolton, A. B. (1989). Acceptability of alternative school-based interventions: The influence of reported effectiveness and age of target child. The Journal of Psychology, 123, 133–140.

    Article  Google Scholar 

  • Wheeler, J. J., Baggett, B. A., Fox, J., Blevins, L. (2006). Treatment integrity: A review of intervention studies conducted with children with autism. Focus on Autism and Other Developmental Disabilities, 21(1), 45–54. doi:10.1177/10883576060210010601.

    Article  Google Scholar 

  • Wilczynski, S. M., Christin, L., & National Autism Center. The National Standards Project: Promoting evidence-based practice in autism spectrum disorders. In J. K. Luiselli, D. C. Russo, W. P. Christian, & S. M. Wilczynski (Eds.), Effective practices for children with autism (pp. 37–60). New York: Oxford University Press.

    Google Scholar 

  • Witt, J. C., Elliott, S. N., & Martens, B. K. (1984). Acceptability of behavior interventions used in classrooms: The influence of teacher time, severity of behavior program, and type of intervention. Behavioral Disorders, 10, 204–209.

    Google Scholar 

  • Witt, J. C., Moe, G., Gutkin, T. B., & Andrews, L. (1984). The effect of saying the same thing in different ways: The problem of language and jargon in school-based consultation. Journal of School Psychology, 22, 361–367. doi:10.1016/0022-4405(84)90023-2.

    Article  Google Scholar 

  • Witt, J. C., Noell, G. H., LaFleur, L. H., & Mortenson, B. P. (1997). Teacher use of interventions in general education: Measurement and analysis of the independent variable. Journal of Applied Behavior Analysis, 30, 693–696. doi:10.1901/jaba.1997.30-693.

    Article  Google Scholar 

  • Yeaton, W. H., & Sechrest, L. (1981). Critical dimensions in the choice and maintenance of successful treatments: Strength, integrity, and effectiveness. Journal of Consulting and Clinical Psychology, 49(2), 156–167. doi:10.1037/0022-006X.49.2.156.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Andrew Livanis .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer Science+Business Media New York

About this chapter

Cite this chapter

Livanis, A., Benvenuto, S., Mertturk, A., Hanthorn, C.A. (2013). Treatment Integrity in Autism Spectrum Disorder Interventions. In: Goldstein, S., Naglieri, J. (eds) Interventions for Autism Spectrum Disorders. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5301-7_2

Download citation

Publish with us

Policies and ethics