Generalization and Sustainability in Positive Behavior Support

Using Fidelity of Implementation to Monitor Sustainability

Keeping track of how well the interventions are being implemented can help teams monitor effectiveness over time. When challenges start to increase, a review of intervention fidelity is an activity that can be added to the implementation plan.

The review of intervention fidelity may show that staff tend to skip certain steps involved in an intervention. This may occur when the intervention takes a lot of work to implement, when there aren't enough resources to maintain the intervention, or when additional training is needed for family members or staff. These issues are all related to how well a plan fits the child or adult and others involved in implementation.

Andy’s Intervention Fidelity Checklist

Check if/when observed OR indicate N/A. if Not Applicable

1. Practice showing Andy how to initiate a request to talk or spend time with someone using the visual card

2. Staff prompts Andy to use the social invitation card as soon as he arrives home from work.

3. Andy’s staff and roommate respond immediately any time Andy requests attention.

4. Remind Andy’s roommate that it is important to let Andy spend time with him if he hands him the social invitation card.

5. When Andy has been playing on his alone for an hour but no challenges have occurred, remind him that he can use the social invitation card.

Total Checkmarks for Replacement Behavior Interventions =

Replacement Behavior Intervention Fidelity =

(Total checkmarks/Total # interventions to be observed) X 100 =

  • Build the fidelity tool based on a task analysis of steps involved in the intervention
  • Teach family and staff members to fade prompts over time
  • Observe people implementing the interventions to see if all the steps are included
  • Count how many steps were actually implemented and document across days
  • Calculate the actual number of steps taken divided by total steps possible for a percentage
  • Create a graph and observe whether fidelity is being maintained or whether there are patterns indicating a review of the intervention is needed