On Expanding the Definition and Use of Procedural Fidelity

Although our field has made significant progress in the measurement of procedural fidelity in research studies, we argue for a more nuanced and expansive perspective on procedural fidelity. Specifically, we review the status quo of procedural fidelity measurement in intervention research along with specific suggestions for increasing both precision and focused research on the levels of procedural fidelity that are needed to maximize outcomes for individual participants. Second, we offer an expanded example of procedural fidelity by examining the data on the influence of typical peers, particularly on how the data influence a broad range of skills for individuals with severe disabilities. Finally, we examine the need for multiple layers of procedural fidelity assessment if we are to fully understand the vast array of contextual variables that can influence both procedural fidelity and child outcomes, particularly in a progression of research from initial efficacy assessment through scale-up and replication. We utilize the program-wide implementation of the Pyramid Model for illustrative purposes.

Improving Outcomes of Behavioral Intervention Plans

According to federal mandates, if a student’s behavior impedes their learning or the learning of others, the individualized education program team is required to address this with a functional behavioral assessment (FBA). The intent of the FBA is to determine the function, or reason, of the impeding behavior for the development of a behavioral intervention plan (BIP). The BIP process is a team-based approach that includes goals and interventions that result in positive behavior change. Procedural fidelity, or compliance with the plan, is of utmost importance to success of this process. Unfortunately, such integrity is often lacking, particularly when teachers carry the responsibility of implementing BIPs in the classroom. Therefore, capacity building within the school team is imperative to increase implementation fidelity of BIPs. This article provides practitioners with the tools to organize the monitoring and implementation of BIPs in classroom settings.

Therapist Characteristics Predict Discrete Trial Teaching Procedural Fidelity

Early intensive behavioral intervention is generally effective for children with autism spectrum disorder but is associated with variability in treatment outcome and quality of treatment delivery may contribute to this. This study examined the relationship between therapist personality, attitude toward individuals with a disability, and perceived relationship between therapist and child on procedural fidelity. Discrete Trial Teaching (DTT) was provided at a preschool for children with intellectual disabilities. Seventy DTT sessions between 22 therapists and 35 children were videotaped and analyzed. Data on therapist's attitude toward individuals with a disability, therapist's personality traits, and perceived relationship between therapist and child were also collected. Procedural fidelity was high and significantly related to therapist's attitude toward individuals with a disability, therapist's openness to experience, and perceived relationship between therapist and child. Therapists with high procedural fidelity tended to have a more positive attitude toward individuals with disabilities on the cognitive dimension, a more negative attitude toward individuals with disabilities on the affect dimension, lower levels of openness to experience, and perceived the relationship between themselves and the child as less positive.