The Effect of a Teacher Report on the Sustainability of an Intervention to Facilitate Engagement by a Child with Developmental Delays

Abstract

Abstract This case study reports the effect of teachers completing and posting an Engagement Report on maintaining their use of a behavioral intervention designed to facilitate the engagement of a pre-school child with developmental delays. The Engagement Report recorded instances of child engagement during the day. Teachers posted the Report where the parent could read it when picking up her child. After establishing a baseline estimate of the efficacy of the Engagement Report (Condition B), a withdrawal-reversal phase (Condition A) was implemented under naturalistic conditions designed to simulate the absence of the researcher from the setting. Results indicated that teacher's use of the behavioral intervention to facilitate child engagement was higher during the Report condition (B) compared to the No Report condition (A). The facilitation intervention plus the Engagement Report was turned over to the teachers upon completion of the experiment. Unobtrusive observation confirmed sustained use of both components after departure of the researcher at follow up. The results suggest two strategies that may help bridge the gap between research and practice. First, involving consumers such as the parent may contribute to the sustainability of behavioral interventions. Second, simulating naturalistic conditions may permit the experimental analysis of variables that may contribute to sustainability of behavioral interventions. Keywords: sustainability, simulation, program survival, engagement, parent, aberrant. ********** The long-standing gap between research and practice in ... education is a matter of national concern." (Abbott, Greenwood, Tapia, & Walton, 1999). Applied behavior analysis has demonstrated the effectiveness of numerous interventions capable of solving a vast array of behavioral problems. Unfortunately these interventions are not widely used in applied settings (e.g., Greenwood & Abbot, 2001; Witt, 1986). And, even when used and initial effectiveness demonstrated (Baer, 1989), local providers often do not continue to implement the procedures in the absence of the founding researcher or consultant. One might speculate that if the use of any evidence-based intervention is not readily sustainable after its successful introduction to a setting, it is unlikely that it will be adopted by others in other settings (Baer, 1989). A good place to start to reduce this kind of gap between research and practice may be to better understand and program the factors that promote the sustainability of interventions. Fixsen, Naoom, Blase, Friedman and Wallace (2005) completed a comprehensive review of the literature regarding sustained implementation of evidence-based interventions in non-research settings. They identified 743 articles related to this issue. These articles covered not only interventions in education and human services but also agriculture, business and engineering. They set the goal of developing a science that goes beyond promoting the "adoption" of an intervention to the implementation of that "innovation with fidelity". They reported that only 20 experimental studies were available using rigorious within-subjects or randomized group designs (Fixsen, et al., 2005, p. 20). Each study examined the effect of different practices on the sustained use of an intervention by service providers such as doctors, clinicians and therapists. They concluded, based on a review of these studies that simple dissemination of information alone did not result in sustainable and effective interventions and more broadly that a science of implementing evidence-based interventions "with fidelity and good outcomes for consumers lags far behind" (Fixsen, et al., 2005, p. vi) the initial development of evidence-based practices by researchers. The lag in developing a science of implementation is reflected by several limitations in the existing literature. For example, in a comprehensive review of experiments on teacher use of behavioral interventions in which they were trained, Rose and Church (1998) reported that only 20 out of 49 studies reported follow-up data. …