Toward Developing a Science of Treatment Integrity: Introduction to the Special Series.

Abstract. Treatment integrity (also referred to as "treatment fidelity," "intervention integrity," and "procedural reliability") is an important methodological concern in both research and practice because treatment integrity data are essential to making valid conclusions regarding treatment outcomes. Despite its relationship to validity, treatment integrity has been largely overlooked in education research and related fields. Influences over the past 5 years have increased attention to this construct, yet many questions remain in regard to how it should be addressed. The purpose of this article is twofold. First, we provide a brief overview of the current state of (a) conceptual models of treatment integrity; (b) research on assessment, promotion, and relationship to student outcomes; and (c) treatment integrity related to response to intervention models of service delivery. Second, we suggest future directions for research, practice, and policy related to treatment integrity as we move toward a better scientific understanding of this construct. The article concludes with a description of the purposes of this special series. ********** Treatment integrity (also referred to as "treatment fidelity," "intervention integrity," and "procedural reliability") is an important methodological concern in both research and practice because treatment integrity data are essential to making valid conclusions regarding treatment outcomes (Peterson, Homer, & Wonderlich, 1982; Shadish, Cook, & Campbell, 2002). Treatment integrity has been assumed rather than assessed in research and practice across many fields (Dane & Schneider, 1998; Dusenbury, Brannigan, Falco, & Hansen, 2003; McInytre, Gresham, DiGennaro, & Reed, 2007; Weisz, Doss, & Hawley, 2005). Over the past 5 years, however, there has been a growing consensus regarding the need for practitioners and researchers in education to address treatment integrity. This shift has been motivated by multiple influences, including federal legislation (e.g., No Child Left Behind, 2002; Individuals with Disabilities Education Improvement Act, 2004), professional organizations' position statements (e.g., National Association of School Psychologists, 2005), inclusion of treatment integrity data requirements in re- fsearch proposal requests from granting agencies (e.g., Institute for Education Sciences, 2009), and the evidence-based intervention and response to intervention (RTI) movements (Kratochwill, 2007a, 2007b; Kratochwill, Clements, & Kalymon, 2007). Despite growing consensus regarding the need to address treatment integrity, there has been a dearth of empirical attention to the construct. As a result, significant questions remain in regard to what treatment integrity is and how it should be addressed in research and applied settings. The purpose of this article is twofold. First, we provide a brief overview of the current state of (a) conceptual models of treatment integrity; (b) research on assessment, promotion, and relationship to student outcomes; and (c) treatment integrity related to RTI models of service delivery. Second, we suggest implications for research, practice, and policy related to treatment integrity as we move toward a better understanding of this construct. Current State of Treatment Integrity Conceptual Models Dimensions and a working definition. To adequately address treatment integrity within research and practice, it is essential to have a conceptual model that defines treatment integrity as a construct. Recent conceptualizations of treatment integrity, influenced by work in education and related fields (e.g., clinical psychology, prevention science), highlight the complexity and multidimensional nature of this construct (Dane & Schneider, 1998; Fixsen, Naoom, Blase, Friedman, & Wallace, 2005; Jones, Clarke, & Power, 2008; Noell, 2008; Power et al., 2005; Waltz, Addis, Koerner, & Jacobson, 1993). …