• The degree to which a treatment plan is implemented as written.
• How the steps of the program are implemented

• People who implement behavior support plans and interventions are crucial to the outcome of the client's success. Their skill level, training, consistency, and natural consequences must be securely in place.
• Intervention's success = Client's success

1. Specify: Clearly specify what staff must do to implement the plan.
2. Train: Train staff on procedures using competency and performance based strategies.
3. Monitor: Routinely monitor staff performance.
4. Reinforce: Reinforce correct performance.

2 Methods:

1. Direct Methods
   • Observation
2. Indirect Methods
   • Self-reports
   • Questionnaires
   • Behavior Rating Scales

1. A precise DESCRIPTION of the skill to be taught
2. A brief WRITTEN description of the skills to be taught. 
   • Reinforces what is to be taught, and acts as permanent product for review.
3. DEMONSTRATION: A trainer to MODEL the skill in the closest approximation of the conditions in which the skill will be utilized.
4. VIDEO MODELS
5. ROLE-PLAY: an opportunity to practice and learn
   • Easy to contrive learning opportunities
6. OBSERVE individual performing the skill in the training & natural settings. 
   • REHEARSAL: observing competency on the job.
7. FEEDBACK: Trainer provides immediate, positively minded input on proficiency, explaining possible improvements. 
8. REPEAT the process until mastery.

• Start with positive empathetic statement
• Identify skills performed correctly
• Identify skills performed incorrectly
• Specify necessary changes to improve performance
• Answer questions
• Describe next steps
• Positive supportive statement

• How supervisors ensure staff is carrying our procedures as intended
• Systematic data collection for objective performance measurement
• Supervisors can determine if plan is working for client

2 Goals of Performance Monitoring:

1. Provides means for evaluating staff performance and program implementation
2. Exhibits program's effect on target behavior

• Knowledge of the target
• How environment is arranged
• Understanding of antecedents
• Use of consequences
• Understanding of behaviors to increase & decrease
• Staff responses to behaviors to increase vs. decrease
• Staff conforming to routines
• Practice of discrete trial training

4 Ways to Effectively Monitor Staff Performance

IF OF

1. Inform staff they are being monitored, and why
2. Be Friendly, polite, and courteous to staff.
3. Monitor staff Overtly, covert monitoring may cause negative feelings
4. Feedback should be given as soon as possible

• A tool given to employees to evaluate if they like how their employers are monitoring and supervising them that involves items tat they must choose between on the same measure. 

Ex: "When your supervisor comes to observe you, do you prefer them supervising you or informing you ahead of time?"

• Use Time Sampling
• Evaluate Their Data Collection
• Use Permanent Products

• Consider reasons for current behavior challenges
  • This will help you get information on the current contingencies of reinforcement
• If your client does NOT possess the skill:
  
  • Design interventions to teach the skill
• If your client does possess the skill, but does not engage in it:
  • Design interventions accordingly to focus on effectively reinforcing the client's use of that skill.

• Evaluation system that uses narrative description, incident reporting, and measurable ratings.
• Scores are based on descriptive information and quantitative measurement → feedback is specific and less judgmental.

• Ideally the person who wrote the plan is involved in overseeing the monitoring of the plan.
  • S/he is most equipped, and understands the rationale and the specific treatment procedures.

Things to Consider When:

Developing a Behavior Support Plan

• Resources: 
  • Write a plan that can be carried out with current resources 
• Staff Deployment:
  • Where are staff located, can they be where they need to be to carry out teh plan?
• Onsite Presence of a Supervisor:
  • Frequent supervision ensures proper implementation
• Staff Absenteeism and turnover:
  • Difficult to control, but must be considered

Ensuring Success and Support When

Conducting a Behavior Support Plan

• Involve guardian and / or supportive staff in the creation of the plan.
  • Will ensure participation and support
  • Consider how they will support the client in skill acquisition 
• Consider how client's new skills will be reinforcing to family members, group home staff etc. 
• Will there be natural reinforcers to maintain the behavior after treatment ends? what are they?
• Determine what skills or behaviors the individual should acquire to contact natural reinforcers
• Consider input from paraprofessionals, as they may have more personal contact with clients.
• Collaborate with other professionals achieve clinical outcomes.

• Ensuring the environment has many meaningful activities may help to reduce challenging behavior.
• It is the BAs responsibility to evaluate and measure how the clients engage in and how staff promote meaningful activities.
• Is challenging behavior occurring in an environment with limited meaningful activities, if so the ENVIRONMENT is the problem.

• Clinical therapeutic component.
• Without functional skills training, challenging behaviors are likely to continue.
• Should be taught systematically and frequently.

1. Involve activities that someone else would have to do  for an individual the individual could not do the activities.
2. The more frequently the individual is likely to perform a skill, the more functional the skill is to teach. 
3. Choose skills for which an individual can be paid to perform as part of a job.
4. Choose skills that allow an individual to get something wanted, or to get out of something unwanted without displaying challenging behavior.

1. Behaviors:
   • Specification of behaviors for increase and behaviors for decrease.
2. Antecedents:
   • These should be clearly identified because they can aid staff in prevention of behavior-evoking antecedents.
3. Consequences:
   • Description of what to do when target behavior occurs.
4. Environmental Set-Up:
   • Setting up the environment to prevent or reduce challenging behavior.
     • What should / should not be in place