A comparison of in-person, videoconference, and bug-in-ear feedback on treatment integrity with early intervention employees

A COMPARISON OF IN-PERSON, VIDEOCONFERENCE, AND BUG-IN-EAR FEEDBACK ON TREATMENT INTEGRITY WITH EARLY INTERVENTION EMPLOYEES The prevalence of autism has increased substantially over the past decade, bringing early intensive behavioral intervention (EIBI) services into greater demand for families living in both urban and rural areas. Currently there are not enough behavior analysts to oversee these interventions and as a result many behavior analysts must travel long distances to see clients. By providing employee feedback through telemedicine approaches such as bug-in-ear (BIE) and videoconference technology, behavior analysts can assist clients by remotely monitoring the behavior technicians implementing the intervention. Doing so can save time and that time can be used to assist more clients. The current study utilized a multi-element research design to evaluate the relative effectiveness of BIE, videoconference, and in-person feedback on increasing treatment integrity with behavior technicians working for an EIBI company. Results suggest that all three feedback delivery methods were comparable in improving performance. In addition, potential secondary effects of the stimuli present during the feedback methods (i.e., distractibility) were low, particularly during BIE conditions. Participants also reported that in-person and BIE feedback were the most acceptable and effective feedback methods. As such, BIE feedback may be more economically feasible, and logistically flexible alternative to in-person feedback. Crystal Monique Loza December 2016 A COMPARISON OF IN-PERSON, VIDEOCONFERENCE, AND BUG-IN-EAR FEEDBACK ON TREATMENT INTEGRITY WITH EARLY INTERVENTION EMPLOYEES by Crystal Monique Loza A thesis submitted in partial fulfillment of the requirements for the degree of Master of Arts in Psychology in the College of Science and Mathematics California State University, Fresno December 2016 APPROVED For the Department of Psychology We, the undersigned, certify that the thesis of the following student meets the required standards of scholarship, format, and style of the university and the student's graduate degree program for the awarding of the master's degree. Crystal Monique Loza Thesis Author Sharlet Rafacz (Chair) Psychology Marianne Jackson Psychology JP Moschella Psychology For the University Graduate Committee: Dean, Division of Graduate Studies AUTHORIZATION FOR REPRODUCTION OF MASTER’S THESIS X I grant permission for the reproduction of this thesis in part or in its entirety without further authorization from me, on the condition that the person or agency requesting reproduction absorbs the cost and provides proper acknowledgment of authorship. Permission to reproduce this thesis in part or in its entirety must be obtained from me. Signature of thesis author: ACKNOWLEDGMENTS First and foremost, I would like to thank my loving husband Ricky who has supported me through my long journey as a graduate student. I’d also like to thank my parents and sisters for all of the love and support they’ve provided throughout the process of writing my thesis. Lovingly my late friend Janet Cisneros, without her I would not be where I am today. I would like to thank my thesis committee. Thank you to Dr. Sharlet Rafacz, for your encouragement, support, and knowledge. Dr. Marianne Jackson and JP Moschella for your input, patience, and flexibility. I would also like to thank Cris Wilhite, the wonderful individual who introduced me to the science of behavior analysis. You are a person that will never be forgotten. TABLE OF CONTENTS Page LIST OF TABLES . vii LIST OF FIGURES . viii CHAPTER 1: INTRODUCTION . 1 CHAPTER 2: LITERATURE REVIEW . 4 Feedback . 4 Secondary Effects of Feedback . 16 CHAPTER 3: METHODS . 18 Participants . 18 Setting . 18 Telemedicine Equipment . 19 Independent Variables . 19 Dependent Variables . 20 Experimental Design . 21 Procedures . 21 Interobserver Agreement . 25 Treatment Integrity . 25 Social Validity . 26 CHAPTER 4: RESULTS . 27 Performance . 27 Secondary Effects . 35 Social Validity . 54 Interobserver Agreement . 56 Treatment Integrity . 56