Increasing treatment integrity through negative reinforcement: Effects on teacher and student behavior

Abstract. The current study examined the extent to which treatment integrity was increased and maintained for 4 teachers in their regular classroom settings as a result of performance feedback and negative reinforcement. Teachers received daily written feedback about their accuracy in implementing an intervention and were able to avoid meeting with a consultant to practice missed steps by implementing the procedure with 100% integrity. Treatment integrity increased for all 4 teachers and gains were maintained over time. Decreases in off-task behavior were observed for 3 of the 4 student participants. Results suggest that an intervention package of performance feedback and negative reinforcement may be a viable, time-efficient technique for increasing the integrity of plan implementation by teachers in the classroom. ********** Prereferral intervention is a consultation-based service with the potential to decrease the number of children referred and ultimately placed in special education (e.g., McDougal, Clonan, & Martens, 2000; Rosenfield, 1992). As a result, most states currently mandate some form of prereferral intervention services in their schools (Erchul & Martens, 2002; Zins, Kratochwill, & Elliott, 1993), and children's responsiveness to these interventions has been proposed as an alternative approach to special education classification (Gresham, 2002; Vaughn & Fuchs, 2003). Because consultation is an indirect service-delivery model, responsibility for implementing interventions developed therein rests primarily with the teacher (Gutkin & Curtis, 1999). In order to be effective, most school-based intervention programs require more direct approaches to instruction (e.g., word list training, passage previewing), more frequent progress monitoring (e.g., curriculum-based measurement), or more structured forms of reinforcement (e.g., goal setting and charting, point systems) (Erchul & Martens, 2002). This often places teachers who serve as consultees in the position of acquiring new skills and behaviors and using these behaviors consistently over a long enough period of time to evaluate intervention effectiveness (e.g., 4 to 6 weeks) (McDougal et al., 2000) Consistent and accurate implementation of a school-based intervention in the way it was intended is termed treatment integrity and is considered a necessary condition for effective consultation (Gresham, 1989; Mortenson & Witt, 1998; Wickstrom, Jones, LaFleur, & Witt, 1998). Although Bergan and Kratochwill (1990) originally emphasized antecedent verbal instruction by the consultant as a means of promoting treatment integrity, the available data suggest that teachers fail to implement agreed-upon plans in the absence of ongoing consultative support. For example, Wickstrom et al. examined teachers' treatment integrity during behavioral consultation as a function of two interviewing approaches: (a) collaborative in which teacher input about intervention options was sought and (b) prescriptive in which an intervention was selected by a consultant. Three measures of integrity were collected during the study and included daily scatterplots of student behavior, the presence of intervention materials at the student's desk, and direct observations of intervention use. Results indicated that intervention materials were present in 62% of cases, scatterplots were completed during 54% of the required intervals, and treatment was applied to only 4% of target student behaviors. No significant differences were observed between the two verbal interaction conditions. In a series of investigations, Noell and his colleagues (Mortenson & Witt, 1998; Noell, Witt, Gilbertson, Ranier, & Freeland, 1997; Witt, Noell, LaFleur, & Mortenson, 1997) examined teachers' treatment integrity after initial training and following implementation of a performance feedback package. In each study, the intervention plan was first described to the teacher, materials needed to implement the plan were provided, and the teacher was coached in how to implement the plan in the classroom until 100% integrity was observed. …