Treatment Integrity Problem Solving

Strategies designed to increase treatment integrity fall into two categories: antecedent-based strategies and consequence-based strategies.

A summary of the available studies accumulated over the past 40 years on a key education driver, teacher competencies offers practical strategies, practices, and rules to guide teachers in ways to improve instruction that improves student performance and the quality of the work experience.

This article examines the evidence-based practice decision-making heuristic in the broader context of clinical decision making.

The usual approach to determining if an intervention is effective for a student is to review student outcome data; however, this is only part of the task. Student data can only be understood if we know something about how well the intervention was implemented. Student data without treatment integrity data are largely meaningless because without knowing how well an intervention has been implemented, no judgments can be made about the effectiveness of the intervention. Poor outcomes can be a function of an ineffective intervention or poor implementation of the intervention. Without treatment integrity data, the is a risk that an intervention will be judged as ineffective when, in fact, the quality of implementation was so inadequate that it would be unreasonable to expect positive outcomes.

Student achievement scores in the United States remain stagnant despite repeated attempts to reform the education system. New initiatives promising hope arise, only to disappoint after being adopted, implemented, and quickly found wanting. The cycle of reform followed by failure has had a demoralizing effect on schools, making new reform efforts problematic. These efforts frequently fail because implementing new practices is far more challenging than expected and require that greater attention be paid to how initiatives are implemented. Treatment integrity is increasingly recognized as an essential component of effective implementation in an evidence-based education model that produces results, and inattention to treatment integrity is seen as a primary reason new initiatives fail. The question remains, what strategies can educators employ to increase the likelihood that practices are implemented as designed? The Wing Institute overview on the topic of Treatment Integrity Strategies examines the essential practice elements indispensable for maximizing treatment integrity.

To produce better outcomes for students two things are necessary: (1) effective, scientifically supported interventions (2) those interventions implemented with high integrity.  Typically, much greater attention has been given to identifying effective practices.  This review focuses on features of high quality implementation.