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Treatment Integrity

Treatment Integrity. Treatment Integrity. Implementing treatment requires human judgments

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Treatment Integrity

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  1. Treatment Integrity

  2. Treatment Integrity • Implementing treatment requires human judgments • Example: A teacher is supposed to give a token to a student every 5 min (IV) if the child does not engage in problem behavior (DV). Does the teacher actually give the tokens on time and only when the child behaves correctly? • Example: A therapist is supposed to deliver verbal praise (IV) to a child every time the child correctly matches words to pictures (DV). Does the therapist deliver praise every time? What exactly does “praise” consist of?

  3. Treatment Integrity • Treatment integrity: the extent to which the IV was implemented as the experimenter intended • AKA procedural integrity, independent variable integrity, procedural fidelity (and other variations) • Failure to assess treatment integrity poses threats to: • Internal validity • If an effect is observed, how do we know it is due to the IV? • If an effect is not observed, it may have been because tx was implemented incorrectly • External validity • Treatments that are not described specifically cannot be accurately replicated

  4. Treatment Integrity • The “curious double standard” in ABA research: • We operationally define and measure the DV but not the IV • Gresham et al. (1993) found that • Only 1/3 of the studies in JABA between 1980 and 1990 provided op defs of the IV • Only 15% reported measuring the IV • Why?

  5. How do we ensure treatment integrity? • Measure the IV as we do the DV • Sometimes called “manipulation checks” • Operationally define the IV in terms of • When • Where • What is said • What is done • Collect data on correct implementation of tx • How often? 25% of sessions is good standard • Collect IOA on tx integrity during 25% of these • Provide scripts and easy-to-follow protocols • Train therapists well!

  6. Example (Mace, Page, Ivancic, and O’Brien, 1986) • Immediately following the occurrence of a target behavior… • The therapist said, “No, go to time out”… • Led the child by the arm to a pre-positioned time-out chair • Seated the child facing the corner

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