Organizational Behavior Management Approaches for Intellectual and Developmental Disabilities

James K. Luiselli, Rita M. Gardner, Frank L. Bird, Helena Maguire, James K. Luiselli, Rita M. Gardner, Frank L. Bird, Helena Maguire

• Éditeur: Routledge
• Année: 2021
• ISBN:
  9781000430752
• Édition: 1
• Sujet: Psychology
• Sous-sujet: History & Theory in Psychology

Comprised of chapters written by notable experts in the field, Organizational Behavior Management Approaches for Intellectual and Developmental Disabilities provides an up-to-date, comprehensive assessment of OBM-IDD.

This edited volume not only provides an overview of the area of OBM-IDD, it also summarizes the extant literature, offers research-to-practice recommendations, and includes operational strategies for building successful service settings. Organizational Behavior Management Approaches for Intellectual and Developmental Disabilities synthesizes the published literature and directs practice and research in the areas of assessment and evaluation, training, supervision, and performance improvement, systems interventions, and organizational development. By providing the most contemporary and effective OBM practices derived from evidence-based research findings and recommendations from experienced scientist-practitioners, this book is an integral aid for professionals looking to improve different aspects of service delivery.

The book is intended principally for professionals within educational, human services, and behavioral healthcare settings serving persons with IDD comprised of psychologists, educators, program administrators, organizational consultants, behavior analysts, and evaluation specialists. In particular, the book should appeal to practicing behavior analysts who hold the Behavior Analyst Certification Board (BACB) credential and are seeking professional development within OBM as well as academic instructors and researchers, graduate students, and trainees completing doctoral internships and post-doctoral fellowships.

Part I

Introduction

1 Introduction to Organizational Behavior Management in Intellectual and Developmental Disabilities

Rita M. Gardner, Frank L. Bird, Helena Maguire, and James K. Luiselli

Organizational behavior management (OBM) is a sub-discipline of applied behavior analysis (ABA) concerned with the application of learning principles and methods to the performance of employees within business, industry, manufacturing, and similar areas (Wilder et al., 2009; Wine & Pritchard, 2018). An OBM approach concentrates on system-wide assessment and intervention targeting numerous performance measures such as employee productivity, safety, environmental care, attendance, and related on-the-job competencies. Additionally, OBM has been effective in diverse elements of healthcare including patient services, procedural compliance, medication administration, and infection control (Ludwig, 2015).

A third focus of OBM is educating, treating, and supporting persons who have intellectual and developmental disabilities (IDD) within school, human services, and behavioral healthcare settings. The practice of OBM with this population has an early history (Reid, 1998; Sturmey, 1998) and research has expanded in new directions and with implications for service delivery (Luiselli, 2018). However, until the present book, no volume has appeared that reviews the contemporary landscape of OBM in IDD, synthesizes the published literature, and informs practice and research on multiple levels.

In a literature review of OBM interventions in human services settings from 1990 to 2016, Gravina et al. (2018) reported that the published research focused mainly on improving procedural integrity among care providers followed by procedures concerned with safety, client engagement, and staff management. Fewer studies included pre-intervention assessment and addressed managers and supervisors as the target population. We included chapters in this book that considered the main points raised by Gravina et al. (2019) as well as other topics that have emerged within OBM practice and research in IDD, specifically assessment and evaluation, training, supervision and performance management, systems interventions, and organizational development.

A starting point for OBM practitioners and researchers is that human services organizations must integrate systems within a unified framework that stresses clinical operations, benchmark measures, continuous progress monitoring, evidence-based interventions, data-driven performance review, and transparent reporting to stakeholder groups. These interrelated components are dependent upon guiding OBM principles (Daniels & Daniels, 2004) that can be adapted to the unique challenges faced by many human services settings (Dixon & Loukus, 2013). Competent leadership with OBM expertise can design and maintain effective practices while other organizations will require external consultation to achieve desired results. Notably, educational and training specialization in ABA and OBM is a contemporary trend that can benefit IDD human services organizations in identifying competent professionals (Luke et al., 2018).

Assessment and Evaluation. This section of the book considers three areas of assessment that bear on optimal OBM practices within human services organizations. Performance diagnostic assessment focuses on organizational obstacles and barriers that impede service delivery among employees and, in particular, the critical skills and competencies required of direct care providers. Poor training, lack of adequate supervision, competing activities, complex procedures, and environmental design limitations all contribute to performance deficiencies and must be assessed in order to formulate correction plans. The development of standardized instruments such as the Performance Diagnostic Checklist-Human Services (PDC-HS: Wilder et al., 2020) makes it possible to conduct such assessment and produce indicated interventions which can be formally evaluated.

Many human services organizations use incentives to motivate employee performance including monetary “rewards” and work privileges of early release time, breaks during the day, and access to a special parking space (Wine, 2017). As more research evidence accumulates about the performance-enhancing effects of incentive programs, it is generally recognized that human service organizations should assess employee preferences before designing motivational contingencies. For example, preferences are likely to differ among employees at different levels of an organization, change over time, and have relative value in relation to the available options. These influences make it necessary to conduct preference assessments reliably and at regular intervals. Further considerations are that human services organizations must evaluate the financial costs required to implement and sustain employee incentive programs, ensure that assessment-informed incentives are distributed equitably in the workforce, and verify empirically that incentives function as reinforcement by virtue of improving targeted performance objectives.

Social validity is the third area of assessment emphasized in the book. More than 40 years ago, Wolf (1978) proposed that behavior analysts assess the attitudes and opinions of direct and indirect consumers of services as a subjective outcome measure: do consumers accept and approve the objectives, methods, and results of interventions planned and implemented with them? Through social validity assessment, human services organizations can acquire feedback from employees about the appropriateness of many operations and guidelines, whether procedures should be revised to improve fidelity, the value of gains made with service recipients, and performance goals that might have been overlooked. Comprehensive social validity assessment also extends to external stakeholders involved with organizational practices (e.g., advisory boards, regulatory agencies, third-party payers). The follow-up from social validity assessment should be performance-improvement initiatives by instituting person-specific and systems changes strongly endorsed by consumers and consistent with consensus-based evidence support.

Training, Supervision, and Performance Improvement. Notwithstanding the many training and performance management interventions shown to be effective in human services organizations (DiGennaro Reed et al., 2013; Luiselli, 2018; Reid et al., 2012), the persons responsible for implementation usually have multiple training needs, different levels of expertise, and many performance expectations. How to economize training and performance management with desired outcomes ranks high as an operations priority even when there are adequate numbers of trainers and supervisors. The concerns are magnified within human services organizations that lack the necessary personnel resources.

From a practice perspective, it is desirable to isolate the controlling effects from separate components of antecedent and consequence procedures that typically comprise OBM training and performance management interventions. As one of many examples, antecedent-only interventions through signs, visuals, posted instructions, and similar environmental cues reduce the need for in-person supervision to affect behavior-change, but more research is required to determine the relative effects of variables such as print size, content, location, and static versus variable presentation (Warman et al., 2019). Multi-procedure interventions, also the norm in OBM, should be evaluated to isolate the most time- and effort-efficient combination of methods. Care provider self-management, for example, can be effective as a sole intervention and with the addition of positive reinforcement and performance feedback (Richman et al., 1988; Willis et al., 2020).

Teleconsultation and telesupervision have gained popularity among ABA practitioners (Ferguson et al., 2019; Tomlinson et al., 2018) and can be incorporated efficiently within human services OBM. In illustration, Lerman et al. (2020) described remote coaching approaches to care provider training and performance management of parents who had children with neurodevelopmental disabilities. Schieltz and Wacker (2020) also summarized a telehealth model for teaching care providers how to conduct functional communication training (FCT) in treating child problem behavior. These and other technology advances make it possible for human services organizations to conduct training and supervision virtually while maximizing available resources (see, for example, Newcomb et al., 2019).

A third determinant of training and performance management success is care providers selecting preferred procedures before intervention is introduced. In a study conducted at one of our service settings, Buckley et al. (2020) evaluated an incentive-based OBM intervention with three care providers at a residential school for students with IDD by having them first complete a questionnaire that inquired about their preferences for performance motivators. All of the care providers selected having to complete fewer case management tasks and this preference was incorporated in a negative reinforcement intervention that successfully improved a data recording performance objective. The contribution of pre-intervention assessment of preferences to OBM training and performance management will be strengthened through research that confirms this process yields better outcomes compared to arbitrary and “top-down” selections (Wilder et al., 2018).

Systems Interventions. In this section of the book, we present large-scale interventions that human service organizations should adopt to address several pertinent systems issues. Apropos, employee preference assessment, there are several steps organizations can take to implement incentive-based programs effectively. Beyond the previously cited need to properly identify potential incentives, OBM practitioners must be cognizant about the ability and capacity of employees to demonstrate performance targets. The timing and delivery of behavior-contingent consequences, magnitude of reinforcers, and probabilistic outcomes must also be highlighted. Further, employees will have different opinions about the need for incentive programs, possibly resulting in negative reactions that produce discord and unintended consequences on workplace behavior.

A second topic of interest is the high rate of turnover in human services organizations which can negatively impact program quality, employee morale, strategic planning, and financial resources (Wine et al., 2020). Finding the conditions associated with attrition and systematically applying interventions that address these influences represent OBM priorities. Strouse et al. (2004), for example, were able to reduce employee turnover in a residential program for persons with IDD by resolving problems that were associated with the duration of assigned shifts, weekend work schedules, full-time versus part-time positions, and pay. Reducing turnover begins with strategic hiring and recruitment practices and instituting policies that retain employees for extended tenure.

Most human services organizations for persons with IDD are faced with the challenge of implementing restrictive procedures to safely manage and treat aggression, self-injury, property destruction, pica, elopement, and other high-risk behaviors. Procedures such as response interruption, blocking, contingently applied protective equipment, and physical restraint are often components of behavior support plans that must be clinically justified, implemented with high integrity, shown to be effective, and meet regulatory procedural guidelines (Reed et al., 2013). From an OBM perspective, human services organizations can establish peer review teams, safety committees, and human rights panels whose purpose is to certify acceptable interventions, conduct risk-benefit analyses, ensure mandatory safeguards (e.g., informed consent, written protocols), and monitor outcomes. These operations and functions should be integrated organization-wide and a dominant leadership concern.

We have paid special attention to safety within human services organizations because many persons with IDD are susceptible to injuries from accident...

Table des matières

• Cover
• Half-Title
• Title
• Copyright
• Contents
• List of Contributors
• Preface
• PART I Introduction
• PART II Assessment and Evaluation
• PART III Training, Supervision, and Performance Improvement
• PART IV Systems Interventions
• PART V Organizational Development
• Index