Improving Education and Treatment in Autism with Organizational Behavior Management 2009 National Autism Conference, August 3, 2009

Transcription

1 Improving Education and Treatment in Autism with Organizational Behavior Management 2009 National Autism Conference, August 3, 2009 Richard K. Fleming, PhD E. K. Shriver Center at UMASS Medical School Note: This presentation will be updated online and reposted for you. Objectives This presentation will describe how OBM can be used to train and support team members who work with persons with autism. By the end of this presentation you should be able to: Describe, discuss and practice OBM as an operant approach to personnel training and performance management. Analyze key aspects of organizational systems and culture that influence OBM effectiveness and child/consumer outcomes. Consider (throughout) your own use of OBM as consultant, supervisor, trainer. Evaluate how media and technology options can be used to educate and train personnel in diverse organizational contexts. OBM: An Operant Approach to Training and Performance Management 1

2 What is OBM/Performance Management? OBM is the application of principles of behavioral psychology and the methodologies of behavior modification / behavior analysis to the study and control of individual or group behavior within organizational settings. (Frederiksen & Lovett, 1980, p. 196) OBM and the Three Term Contingency: Antecedents Antecedents in OBM Instructions, demonstrations and prompts Goal setting Broadly speaking, training alone, without follow-up consequences on the job Can be proximal (stimulus control) or distal (rule governance) Are antecedent interventions ever enough? How is training conducted in your organizations? Is it effective in your estimation? (List and examine approaches from an OBM perspective) OBM and the Three Term Contingency: Behavior & Outcomes Behavior and Outcomes (classes) Knowledge acquisition, verbal behavior (typical training expectations?) Skilled performance, examples: Applying interventions directly with children (paras, aides, parents) Conducting a functional assessment in a family/home context (behavior analyst) Consulting with and training other members of the organization (behavior analysis consultant) Child/consumer outcomes Skill acquisition Behavior reduction Skill generalization, maintenance Other: diet and nutrition, sleep, physical activity What behaviors and outcomes are important in your organizations? (List and discuss implications for OBM) 2

3 OBM and the Three Term Contingency: Consequences Consequences used in OBM Feedback Most common intervention by far Parameters: form, schedule, provider, public or private A reinforcer, discriminative stimulus, motivating operation? Does it matter? Reinforcement Social Tangible, monetary, potentially problematic What consequences are important and practical in your organizations? Begin with a Needs Anaylsis Who is the target audience? What are they expected to do? Standards of performance? How is performance discrepant from standard? Where and when are they expected to perform? What do they need to learn? Is it a training problem? Is it a performance problem? Antecedent Intervention: Training for Skill Acquisition Parent training: Acquisition and skill generalization of discrete trials teaching skills with parents of children with autism (Research in Developmental Disabilities, Crockett, Fleming, Doepke & Stevens, 2007) Provides example of OBM training design: Operational definitions & measurement Training procedures Emphasis on generalization of use of procedures (results) Challenge: Can parent training generalize from training setting to home and community? 3

4 Discrete Trials Procedure Defined for Training and Measurement Presenting antecedents Delivering consequences Conducting inter-trial intervals Recording the child s behavior Training Procedures Intsructions Demonstration Practice Feedback Intervention staggered to gradually promote generalization % C O R R E C T SUCCESSIVE TRIALS 4

5 Consequence Interventions: Examples of Performance Feedback To be added Practice Framing OBM Projects in Autism Problem: Goal: Behavior & outcomes measurement Antecedent procedures Consequence procedures Behavioral Systems Analysis and Organizational Culture Conceptual and practical analysis of the context in which OBM interventions are planned and conducted 5

6 Behavioral Systems Analysis Complex contingencies in organizations (Ludwig & Houmanfar, JOBM, 2009) The needs for a systems approach (Hyten, JOBM, 2009) Contingencies affecting personnel training and management in autism services Organizational Culture Operant definition of culture applied to organizations OBM within structural and cultural constraints: An example from the human service sector (Sulzer-Azaroff, Pollack & Fleming, 1992) Discussion of organizational cultures in autism services Online and Media Options for Educating and Training Autism Personnel and Parents Consider blending online education to better prepare personnel for hands-on training. Some ongoing NIH-funded studies 6

7 Educating Parents: Behavioral Intervention in Autism, Phase I (NIMH, R41MH071130) Project goals: parent knowledge and advocacy skills (verbal behavior) Single module (feasibility): Introduction to BIA Online lecture pages: 1-2 pages in length, moderately sophisticated Short units Video exercises: brief teaching demonstrations: What does behavioral intervention look like? Self-check quizzes: optional Book reviews: recommended reading Selected resources/links: scientific, e.g., CDC: Autism Information Center, NIMH- Autism Spectrum Disorders Course Development Shriver s Instructional Design Protocol Applied to each course/curriculum Analysis Target audience/s: priority needs, resources, level Formative evaluation: Surveys, focus groups Kirkpatrick 4: Reactions, Learning, Performance, Results Design Taxonomies: Cognitive, Psychomotor, Affective Development and classification of learning objectives Objectives <-> taxonomy LMS and media options Development Content experts Instructional conditions: mastery learning, small units, study guides, functional graphics, video and feedback Implementation Weekly team meetings Beta testing w/small N Field testing and Evaluation Kirkpatrick 4 Commercialization, Marketing & Dissemination for Sustainability 7

8 Discovering Behavioral Intervention, Phase II (NICHD, R42HD055021) Phase II modules: 1: Introduction to BIA (revised) 2: Teaching with Discrete Trial Training 3. Teaching with Naturalistic Methods 4. Functional Assessment and Analysis of Maladaptive Behavior 5. Behavioral Interventions for Reducing Maladaptive Behaviors 6. Data and Accountability in Behavioral Intervention 7: Advocacy and Behavioral Intervention: The Education System Selecting Qualified Behavioral Intervention Personnel Behavioral Intervention Skills for Entry-Level Practitioners NIH-funded grant to provide distance learning in basic behavioral intervention (BI) skills. Provide knowledge and introduce personnel to core procedures in BI Not designed to replace actual training in applied settings, under the direction of qualified personnel 8

9 Format of Course Fully hosted Web-based distance learning instructional program (Blackboard Vista 4) Comprised of: Introduction Module 1: Positive Reinforcement: Selection and Use of Reinforcement Module 2: Relationship Building: Pairing and Teaching Cooperation Module 3: Prompting and Prompt Fading Pre/Post-Test for Paraprofessionals Pre Test Score Post Test Score Test Score (% Correct) participants (Paraprofessionals) Learning Objects *Example from autism dentistry; others on autism instruction to be added 9

10 Video-Based Training Interviews Demonstration Interactive video Teleconferencing Discussion As time permits: What have we missed in the this presentation and discussion? OBM Resource List *List of resources to be added Books Journals Web sites Conferences Articles Media resources me: or call: