Intervention Assessment

Director of Research and Development - Behavior Interventions Inc.

In working towards greater utilization of experimentation within treatment and research, one of the more significant barriers behavior analysts face are the views of family members and other professional staff on the use of experimentation.  The use of experimental technology to determine the function of behavior has gained some ground within general treatment environments, though there seems to still be an overreliance on non-experimental observation-based functional assessments (Hanley, 2012).  However, there appears to be an aversion to the use of experimentation related to implementation of treatment interventions despite that being one of the core dimensions of our discipline (Baer, Wolf, & Risley, 1968).  One repertoire that could likely be strengthened among many behavior analysts is how we discuss and advocate for the use of experimentation to evaluate treatment effectiveness (Bailey, 1991; Foxx 1996).  The term intervention assessment is proposed within this article, which may serve as a means to more effectively communicate the power of treatment experimentation on the outcomes of behavioral programming.

Behavior analytic practitioners are likely comfortable and effective speaking about assessments related to identifying skill deficits and functions of problem behavior.  Applying a similar verbal framework to the process of experimentally analyzing the effects of intervention(s) on behavior may be beneficial to promoting further discussion and use of these techniques.  While behavior analysts utilize their experience (learning history) of applying interventions to different behaviors, as well as relying on research to inform their selection of interventions, there is an additional process which sets behavior analysis apart as a scientific solution to changing behavior.  Intervention assessment can be defined as the process of changing the intervention or parts of the intervention in order to verify that the intervention itself, not some uncontrolled variable, is causing the behavior change.  In layperson terms, intervention assessment can be defined as the changing of the intervention or parts of the intervention to find out if it is working as expected.  Thus, connecting the process of experimental analysis to the overall outcomes for the individual could be helpful in reducing some of the distaste for manipulation of an already implemented behavioral intervention. 

In speaking about intervention assessment, it may also be beneficial to embed this experimental practice within the context of treatment and to not separate them as different components.  In general, many people view assessment as work done before treatment occurs. This view can promote a sense of urgency to complete the assessment as soon as possible so that the intervention can be started, and the behavior changed.  However, this can unfortunately lead to a rushed or abbreviated assessment of the behavior(s) and environmental variables controlling the behavior, which may lead to less effective treatment.  Thorough assessment and identification of controlling variables is at the core of behavior analysis and it is important for behavior analysts to have a strong repertoire to describe both the process of assessment and its importance.  In relation to intervention assessment, behavior analysts must be well versed in describing the technology of single-case research designs to investigate the effect of the intervention on the behavior as well as ruling out extraneous variables.  In addition, behavior analysts must be able to explain how the use of time and resources during program implementation is valuable to refine the interventions so that they meet the needs of the individual. Outlining intervention assessment as an embedded and essential aspect of effective treatment may generate more buy-in for treatment team members to be open to the use of experimentation within treatment.

Explaining the process of intervention assessment may also benefit from associating these practices with other types of intervention practices that similarly rely on continued assessment and refinement of treatment. For example, medical treatment often follows this practice of ongoing assessment and alteration of treatment based on those assessments.  Other examples could include the assessment of academic behaviors in school, along with the changing of teaching strategies to best meet the child’s current abilities.  If behavior analysts utilize their own verbal behavior to normalize this experimental process, it is more likely that others will be on board with intervention assessment. To build this verbal repertoire, behavior analysts, their supervisors, and those supervising potential behavior analysts must continually practice, reinforce, and shape discussion of the logistics and importance of analytic experimentation in treatment (Love, Carr, LeBlanc, & Kisamore, 2013).

In summary, the term intervention assessment is proposed as a way to provide a less technical description of experimental analysis.  In addition, a call to action for current behavior analysts and those training future behavior analysts to work on developing successful verbal behavior to describe the value of engaging in intervention assessment is necessary.  Below this article is a general task list of the components that could be a part of a conversation about intervention assessment.  Hopefully this provides an initial framework for developing this verbal repertoire and working with other treatment team members in order to incorporate experimentation into treatment.

This article first appeared as a part of the second issue of the R2PABA Newsletter.

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References

Baer, D. M., Wolf, M. M., & Risley, T. R. (1968). Some current dimensions of applied behavior analysis. Journal of Applied Behavior Analysis, 1, 91-97.

Bailey, J. S. (1991). Marketing behavior analysis requires different talk. Journal of Applied Behavior Analysis, 24, 445-448.

Foxx, R. M. (1996). Translating the covenant: The behavior analyst as ambassador and translator. The Behavior Analyst, 19, 147-161.

Hanley, G. P. (2012). Functional assessment of problem behavior: Dispelling myths, overcoming implementation obstacles, and developing new lore. Behavior Analysis in Practice, 5(1), 54-72. doi:10.1007/BF03391818

Love, J. R., Carr, J. E., LeBlanc, L. A., & Kisamore, A. N. (2013). Training behavior research methods to staff in an early and intensive behavioral intervention setting: A program description and preliminary evaluation. Education and Treatment of Children, 36(1), 139-160. doi:10.1353/etc.2013.0003

Bridging Research to Practice: Advocacy of Intervention Assessment

·     Develop a non-technical definition of intervention assessment that places this process within the context of treatment (not as a separate process)

·     Develop examples of similar assessment/experimental processes in other fields in which the group you are advocating to may be more familiar with

·     Develop a comparison between treatment in which intervention is not continually assessed through experimentation and how treatment can be refined to be more individualized and effective when assessing interventions

·     Develop a non-technical way to explain the proposed experimental assessments and how they would be potentially implemented

·     Provide a written or spoken performance of the arguments for intervention assessment to a supervisor or colleague in order to obtain feedback on the clarity, sense of importance, and connection to individualized treatment that is presented

·     Provide the argument for the importance of intervention assessment to the treatment team members and ask for their feedback on the overall goal of experimentation within treatment and the potential logistics for implementing intervention assessment with the specific individual and their environment

Optional step – develop a written contract which outlines the experimental procedures, general timelines for experimentation and decision-making, steps for feedback on the process, as well as ways to suspend experimentation if it is felt to be harming the individual