A descriptive analysis of client outcomes associated with staff interventions in developmental disabilities

Abstract

Although a large body of research supports the use of behavioral staff management interventions in developmental disabilities, the nature of client outcomes associated with such interventions has not been systematically assessed. We reviewed 59 staff management studies published over 20 years (1971-1990) in order to determine the generality or scope of the research (i.e., range of settings, types and levels of clients' disabilities, clients' ages), the frequency of inclusion of client outcome measures, the types of measures and levels of analysis selected (i.e., individual groups, combination), and the effects of the interventions on client behavior. Results indicated that: (a) over two-third of the studies were conducted in institutional settings; (b) more than one-half involved clients with profound to severe mental retardation; (c) clients of various ages were served; (d) assessment of client outcomes increased progressively over the period; (e) engagement and skill acquisition were the most frequently used measures; (0 group data were presented twice as frequently as either individual or a combination of group and individual data; and (g) staff interventions were associated with either positive or mixed client outcomes in 80% or more of the cases, although maladaptive behavior went unchanged in one-fifth of the studies in which they were reported. Based on these findings, suggestions are made for how researchers might extend the generality of staff management research, improve client outcome assessment practices, and produce even more consistently positive results.

Feedback for improving staff training and performance in behavioral treatment programs

“…Measuring both staff and client target behaviors is necessary for defining feedback content and evaluating behavior change (see Fellner & Sulzer-Azaroff, 1984). Many studies now report both staff and client behaviors, as opposed to reporting only the former, and those that do, more convincingly demonstrate beneficial outcomes and effective staff training (see Fleming & Reile, 1993;Repp et al, 1987). Of course, staff training programs can demonstrate changes in staff performance without evidence of benefit for clients, but such programs raise concerns about client outcome efficacy, cost, and validity.…”

Supporting People with Developmental Disabilities in Their Homes in the Community

“…As a rcsult o f these conccrns, providing services to individuals with developmental disabilities in smallcr, highly individualized community-bascd settings presents unique challenges to organizations. For examplc, Fleming and Reile (1993) reviewed 20 years of OBM research in developmental disabilities (1971)(1972)(1973)(1974)(1975)(1976)(1977)(1978)(1979)(1980)(1981)(1982)(1983)(1984)(1985)(1986)(1987)(1988)(1989)(1990) published in 11 behavioral journals. They identified a total of59 research articles o f which only 5% (i.e., 3 studies) examined OBM procedures in community living settings.…”

A Systematic Review of Interventions for Improving the Work Performance of Direct Support Staff

“…Intervention effectiveness was characterised according to one of the five categories described by Fleming and Reile (1993). Where participant data were aggregated and presented as a single group or number of groups, intervention effectiveness was assessed at the group level.…”