How to Administer the Performance Diagnostic Checklist-Human Services

The Performance Diagnostic Checklist-Human Services (PDC-HS) is a performance analysis tool used to identify barriers to performance in human-service settings. Multiple published studies have used the PDC-HS to determine effective interventions (Wilder et al. Journal of Applied Behavior Analysis 53(2), 1170-1176, 2020). However, in a recent discussion article proposing guidelines for administering the PDC-HS, Brand et al. Behavior Analysis in Practice, 1-7 (2022) noted that procedural descriptions provided for administering the PDC-HS are somewhat ambiguous in the published literature. The purpose of the current systematic review was to compare methods used to administer the PDC-HS. Fifteen articles met inclusion criteria and were coded to evaluate commonalities among PDC-HS components. Authors generally agreed on how the outcomes of the PDC-HS were depicted and discussed but varied in their descriptions of methods used to administer the PDC-HS. Results are discussed in terms of the importance of technological descriptions and directions for future research towards the development of a more standardized tool.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40617-023-00848-3.

Caregiver involvement in applied behavior-analytic research: A scoping review and discussion

We conducted a scoping review to characterize the role of caregiver involvement in behavior-analytic research. We reviewed eight behavioral-learning journals from 2011-2022 for works that included children or caregivers as participants and characterized caregiver involvement as passive (implications for caregivers, input, social validity) and active (implementation, caregiver behavior, training, caregiver-collected data). The review identified 228 studies, and almost all (96.1%; n = 219) involved caregivers in some capacity; 94.3% (n = 215) had passive involvement (26.8% had only passive involvement; n = 61), 69.3% (n = 158) had active involvement (1.8% had only active involvement; n = 4), and 3.9% (n = 9) had neither passive nor active involvement. Involvement generally increased over publication years. The most common types of involvement were implications for caregivers, implementation, and input; caregiver-collected data were rare. We propose considerations when engaging caregivers in research and suggest new avenues of inquiry related to caregivers' treatment objectives and social validity, treatment implementers, and caregiver-collected data.

Assessment and treatment of tracheostomy tube manipulation: Effects of competing stimuli and protective equipment

Functional analyses (FA) are widely used in the assessment and treatment of problem behavior. However, with limited exceptions, the procedures are rarely applied to potentially dangerous behaviors involving medical equipment. The current study replicated and extended procedures previously used by Kurtz and Chin (2004) to assess and treat tracheostomy tube manipulation in a 5-year-old boy diagnosed with extensive medical and developmental conditions. FA results indicated that tracheostomy tube manipulation (i.e., touching, pulling, occluding) was automatically maintained. An augmented competing stimulus assessment was conducted to identify stimuli associated with low levels of tracheostomy tube manipulation and elevated levels of item engagement. A treatment package consisting of noncontingent access to competing stimuli with prompting and continuous application of protective equipment produced significant reductions in tracheostomy tube manipulation, as well as significant increases in toy engagement.

Utilizing Group-Based Contingencies to Increase Hand Washing in a Large Human Service Setting

Hand washing is the most important preventative measure for the reduction of contagious disease. Although hand washing is easy to perform, non-adherence is a ubiquitous problem. Several studies have demonstrated the effectiveness of multi-component intervention packages to improve hand washing among employees; however, interventions are limited to acute settings, are often implemented for a short period of time, and rarely, if ever, include information on long-term effectiveness. The purpose of the current study was to utilize a behavior analytic approach to determine the stimulus conditions under which hand washing should occur, and to assess and then implement a long-term monitoring system among direct care workers in a large, non-acute inpatient unit. A single-case repeated measures reversal design was used to evaluate the effectiveness of two interventions aimed at improving hand washing adherence. A lottery was found to be effective in increasing hand hygiene for 2-years with 170 staff.

Effects of specified performance criterion and performance feedback on staff behavior: a component analysis

The present study isolated the effects of frequently used staff training intervention components to increase communication between direct care staff and clinicians working on an inpatient behavioral unit. Written "protocol review" quizzes developed by clinicians were designed to assess knowledge about a patient's behavioral protocols. Direct care staff completed these at the beginning of each day and evening shift. Clinicians were required to score and discuss these protocol reviews with direct care staff for at least 75% of shifts over a 2-week period. During baseline, only 21% of clinicians met this requirement. Completing and scoring of protocol reviews did not improve following additional in-service training (M = 15%) or following an intervention aimed at decreasing response effort combined with prompting (M = 28%). After implementing an intervention involving specified performance criterion and performance feedback, 86% of clinicians reached the established goal. Results of a component analysis suggested that the presentation of both the specified performance criterion and supporting contingencies was necessary to maintain acceptable levels of performance.

Assessment and treatment of excessive straightening and destructive behavior in an adolescent diagnosed with autism

Repetitive behaviors such as excessive straightening are commonly observed among individuals with autism. Attempts to prevent these behaviors may increase the likelihood of other problem behaviors. The present study was designed to assess and treat the excessive straightening and associated destructive behaviors of a 16-year-old boy who had been diagnosed with autism and moderate mental retardation. Following a series of functional analyses, an intervention that incorporated functional communication, extinction of destructive behavior, and blocking of repetitive straightening was demonstrated to be effective in reducing straightening and destructive behavior.

Further evaluation of antecedent social events during functional analysis

The value of a reinforcer may change based on antecedent events, specifically the behavior of others (Bruzek & Thompson, 2007). In the current study, we examined the effects of manipulating the behavior of the therapist on problem behavior while all dimensions of reinforcement were held constant. Both participants' levels of problem behaviors increased as a function of the altered behavior of the therapist without direct manipulation of states of satiation or deprivation.