Treatment Integrity

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Treatment Integrity
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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?

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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

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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?

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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!

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Example (Mace, Page, Ivancic, and OBrien, 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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