69 The Treatment Implementation Process

There are five steps that should be followed during the data driven decision making process towards effective intervention implementation. These steps are listed below:

1. Conduct an assessment

It is important to assess an individual’s current level of skills/behaviors before attempting to teach any new skills (or implementing interventions for behaviors). Without a proper assessment, it is hard to know where to start teaching or whether any progress is being made once the intervention begins. There are many ways to assess skills, both formal and informal. One advantage to formal assessments is that they have been carefully designed to ensure they measure what they intend to measure. Formal assessments have usually been tested on many individuals in the past. This factor makes it easy to interpret scores because comparisons are built into this scoring.

In addition, formal measures are conducted in a consistent and methodical way by those trained to administered and can also be used again, after intervention has begun, to determine if any intervention gains and skill improvements have occurred. However, informal assessment or systematic observations are also useful in that these measures can be administered by anyone with knowledge of the individual and typically involve input from systematic observation in natural contexts. The use of a combination of formal and informal methods as well as various formats for data collection (e.g., observation, rating scales, interviews) ensure a more comprehensive evaluation of strengths and weaknesses

2. Select and implement the curriculum and/or intervention

Once a comprehensive assessment is done, you will have a sense of the individual’s strengths and weaknesses. An individualized curriculum (lesson plan) and/or intervention (e.g., behavioral, medical) can then be chosen. The plan should build on strengths to improve areas of weakness. For instance, the plan for an individual who is very good at reading, but has difficulty knowing what to say in a social situation might focus on teaching social interaction by reading about them. Curriculum and intervention  should also focus on the individual’s unique areas of need.

Various individuals may have challenges with conversation but one may have more with initiation and another with responding. The curriculum or intervention should  also give the individual multiple and ongoing chances to practice and receive feedback on the skills being taught. This often involves teaching initially in one to one settings and then evolving into more group and varied natural contexts, settings, and tasks to encourage generalization of skills.

3. Monitor the program and continually reevaluate and adjust as necessary and appropriate

Though a curriculum or intervention is carefully chosen for an individual does not ensure it will work. The best way to ensure that the program is meeting an individual’s needs is to reevaluate skills and behaviors targeted for change often. Reevaluation can occur in a few ways. One way is to re-do a formal assessment. There are guidelines on how often this can occur to ensure a valid administration.

However, ongoing data can be collected in a variety of ways to inform progress. This might involve talking to those who work with the individual or reviewing data collected that is most meaningful to detect change. It is important for the data collected to fit the aspect of behavior of concern to measure (e.g., if we want to see if tantrums improve, we might look at frequency, intensity or duration).

Data should be used to help determine how to adjust intervention. Typically, a combination of methods will be used to analyze outcomes. If there is no progress, there needs to be consideration of any adaptations to programming to ensure impact. If there has been progress, then new goals should be considered for development as a team.

4. Make sure the staff is competently trained

The people who work with your child have the proper training and knowledge base to do so effectively. Ask questions when meeting with staff. You need to know how long they have been doing this type of work. You should ask about the background they have, the training they have received, and whether they continue to receive any on-going training.

Simply because a person is friendly and nice, does not mean he or she can work effectively with an individual. Be sure that the staff members who work with your child are not simply nice people, but also trained in providing the specific intervention and educational support with fidelity and with effective teaming and collaboration.

5. Be systematic

As a final note, remember to systematically impose one intervention at a time so you know which intervention influenced your child, as well as how much of an effect it had.