Improving Day‐treatment Services for Adults With Severe Disabilities: A Norm‐referenced Application of Outcome Management

Abstract

We evaluated an outcome management program for working with staff to improve the performance of adults with severe disabilities in a congregate day-treatment setting. Initially, observations were conducted of student task involvement and staff distribution of teaching interactions across students in four program sites. Using recent normative data to establish objective goals for student performance, management intervention was warranted in two of the sites. A six-step outcome management program was then implemented in the two sites. The program involved defining desired student and staff outcomes, systematic monitoring of the outcomes, staff training, and supportive and corrective feedback. The outcome management program was accompanied by increases in student on-task behavior and staff distribution of teaching interactions in both sites. The increases brought the levels of on-task behavior above the normative average; on-task behavior was maintained above the baseline average for over 1 year in both sites. These results are discussed in terms of the benefits of relying on normative data for objectively evaluating and improving service delivery systems. Discussion of future research needs focuses on applying the outcome management program to other settings and services for people with disabilities.

Effects of Reactivity to Observations on Staff Performance

“…analysis of reactivity to observations of staff performance is warranted. We observed reactivity in the present study even though one of the standard controls for reactivity-frequent presence of the observer in the work area (Parsons et al, 2004)-was in place. The job coordinator who conducted observations spent time in the work-break areas every day.…”

“…Despite concerns over reactivity, as well as experimental evidence indicating that it can be an obstacle when evaluating staff behavior (Reid, Parsons, Green, & Schepis, 1991), little attention has been directed to reactivity as a dependent variable. Although some studies have attempted to include controls for reactivity (Fleming & Sulzer-Azaroff, 1992;Parsons, Rollyson, & Reid, 2004;Shore et al, 1995), the extent to which such procedures actually affect staff reactivity has not been examined experimentally in typical staff training and management research. The purpose of this study was to document and then decrease reactivity during observations of staff performance following completion of a staff-training program.…”

“…This condition represented a maintenance phase following a staff-training program during which observations of job-coach performance were conducted. Using an outcome management approach (Parsons et al, 2004), we trained each coach to conduct work breaks by prompting the worker to complete the steps and refraining from completing steps for the worker. The observations conducted by the coordinator were conspicuous in that she made recordings on a sheet after each step in the break routine in close visual and physical proximity to the job coach who was being observed.…”

Initiation of activities and alertness in individuals with profound intellectual and multiple disabilities

“…; Arthur ; Parsons et al . ). As a consequence, DSPs may target their own behaviour more appropriately.…”

Changing Less-Preferred Duties to More-Preferred: A Potential Strategy for Improving Supervisor Work Enjoyment

“…One area has been training human services staff with relevant work skills (Jahr, 1998). The second area has been managing or improving day-to-day work performance, generally involving situations in which staff have the necessary work skills, but routine performance does not reflect acceptable application of those skills (e.g., Harchik, Sherman, Sheldon, & Strouse, 1992;Parsons, Rollyson, & Reid, 2004).…”