Multifaceted Training Programs in Human Service Settings: There is Still Hope

by Michelle Garruto and Alicia Alvero
Queens College and the City University of New York Graduate Center

Personnel in human services settings often lack the professional and clinical training needed to provide effective treatment to persons with developmental disabilities. While many perceive the main goal of human services settings to be the management of the consumers’ behavior, an equally important mission is to establish and maintain the proficiency of the staff. Many current training packages lack both in-depth skills training and proficiency maintenance. However, programs which are well-developed and all-encompassing tend to show more success in terms of maintaining staff proficiency (Reid & Parsons, 2004). Though rare, such programs do exist, and an example of one will be discussed.

Successful training programs in human service settings have been shown to use a multifaceted approach, one which addresses both methods used to acquire skills as well as methods used to maintain those skills (Parsons, Schepis & Reid, 1987; Dyer, Schwartz & Luce, 1984). Most common training programs only include performance modeling, practice and feedback, and verbal and written instructions. While these components are essential to the training of proficient staff, the issue of maintaining proficiency is not addressed. It is for this reason that adequate training packages should encompass a multifaceted approach, aimed both at training and maintaining the skills necessary to provide effective treatment.

A daytime institution for developmentally disabled children in the Northeast region of the United States makes use of such a multifaceted training approach. New employees undergo rigorous training to ensure proficiency and maintenance of applied behavior analytic skills. The training procedures described in the present article refer to the training of both permanent and temporary employees. Temporary employees are typically employed for a period of four months.
Trainees begin with a rigorous weekend-long introduction to the institution and to the approach of applied behavior analysis. On the first day, training concentrates on the history of the institution, safety procedures, and an introduction to data collection. In learning about the history of the institution, trainees are exposed to information such as child demographics, and the training program developed for the new staff. In discussing safety procedures, trainees are exposed to Occupational Safety and Health Administrative (OSHA) guidelines, safety procedures within the classroom, emergency procedures, etc.

When introducing the instructional material and program format, trainers ensure that each trainee understands each component of the data sheet they are to use and the program format before introducing the methods of data collection. Trainers then teach trial-by-trial observations using a performance modeling procedure. The programs provided for the trainees illustrate the use of verbal instruction, while the demonstration of data collection illustrates the use of performance modeling.
On the second day of training, a number of children from the institution volunteered by their families assist with the program. It is within this section of the training program that performance modeling plays a vital role. Trainees are broken up into small training groups to maximize individual attention. Trainers model performance for running numerous types of programs, and collecting goal-directed and behavioral data with the children. The training program then utilizes performance practice by allowing the trainees to practice running the programs and collecting data with the children under the supervision of trainers. This further allows the other members of the small training group to observe the performance practice and feedback of other trainees. Trainers provide performance feedback for each new staff member. Each small group is exposed to this training procedure with different children in order to introduce the trainees to different types of programs and different behaviors that each child may engage in. At the end of the second day, trainees are assigned to 2-3 children to work with for a ten week period.

Following the weekend training, the first prerequisite of the training program is to participate in 5 hours of observation. Trainees divide these observation hours as evenly as possible among the children assigned to them, during which they observe a trained employee running each child’s programs. Trainees are required to learn their children’s programs and behavioral plans, outside of the 5 observation hours.

Trainees are then tested on their understanding of the institution’s staff manual. The manual includes, but is not limited to, information regarding ethical standards, safety precautions, general and dangerous behavior management strategies, and emergency procedures. Trainees must pass the exam with a score of 90% or higher, but have three chances to do so. If the trainees do not pass the exam on the third chance, they are not permitted to work at the institution, but are welcome to try again the following year. Trainees must then pass a performance test, during which they run a program with a trainer who role-plays as a child. Often the trainer exhibits a large array of behaviors in order to allow the trainee the opportunity to demonstrate his/her proficiency in using various behavioral management skills. A second trainer is present during the performance test in order to collect performance data. The two sets of data, those collected from the trainee and the second trainer in the room, are then compared for interobserver agreement. Performance exams must be completed with a grade of 80% or higher, and trainees are again given three opportunities to pass.
Upon passing both the written and performance exams, the trainees are allowed to begin working with the children to whom they were previously assigned. The above components of the training program ensure the acquisition of skills needed to provide effective treatment to the children in the institution. While many training programs only incorporate the components aimed at ensuring acquisition, well-developed programs should also incorporate the components aimed at the maintenance of the skills.

New staff members who are working with children are evaluated approximately twice a week by either trainers or staff. Each trainee is aware of each performance component on which he or she is being evaluated. Evaluations are in the form of a checklist with five performance ratings, ranging from “poor” to “outstanding.” In addition to the checklist, evaluators supplement their evaluation with additional comments. Evaluations are equally distributed across the children each trainee works with to ensure the maintenance of skill proficiency with each child’s program. That is, if a trainee is evaluated twice a week and is assigned to two children, each evaluation for that week will be divided between the two children. Evaluations are also provided by different trainers and staff so that each trainee is provided with feedback by an array of personnel.

One of the most vital components to the training program is the continuation of acquisition throughout employment. A large majority of the trainees become temporary employees, therefore they attend class once a week with a curriculum based on a well-known behavioral modification text that focuses on the behavior analytic principles crucial to their experience. These trainees must prove comprehension of the material by passing weekly exams with a grade of 80% or higher. Trainees are given three opportunities to achieve the 80% mastery criterion. If they do not achieve this goal, they are not hired, but can make another attempt the following year. Once trainees have been hired, they are required to attend weekly staff meetings, annual conferences, conventions and in-services provided by the institution. Additionally, the programs are written in such detail that only someone with adequate comprehension of applied behavior analytic skills would be able to run them.

This training program focuses on both the core essentials of training (i.e.,, performance modeling, practice and feedback, and written and verbal instruction) in addition to incorporating a maintenance component. In doing so, the institution takes a multifaceted approach to providing, maintaining and promoting the skills needed to effectively serve the children. Behavior analytic principles are used not only to control the behavior of the children, but also of the staff. By employing such an approach, the institution is maximizing its contribution to both the children being served and, its employees.

References

Dyer, K., Schwartz, I. S., & Luce, S. C. (1984). A supervision program for increasing functional activities for severely handicapped students in a residential setting. Journal of Applied Behavior Analysis, 17, 249-259.

Parsons, M. B., Schepis, M. M., & Reid, D. H. (1987). Expanding the impact of behavioral staff management: A large-scale, long-term application in schools serving severely handicapped students. Journal of Applied Behavior Analysis, 20, 139-150.

Reid, D.H., & Parsons, M.B. (2000). Organizational behavior management in human service settings. In J. Austin & J. Carr (Ed.) Handbook of Applied Behavior Analysis. (pp. 275-293). Reno, NV: Context Press.