Ongoing Positive and Corrective Feedback
The final component of the staff training and supervision process for changing activities is for the clinician (and/or supervisor) to provide feedback to the staff in a face-to-face manner. Although providing feedback is referred to as the final component, it actually should occur throughout the training and supervision process as just indicated. Feedback should be provided routinely as staff are observed to make desired changes in activities during the prompting visits and after formal observations have been resumed.
There are a number of ways to provide feedback to staff. However, one particularly effective way is to give what is considered diagnostic feedback using a 7-step behavioral protocol (Reid et al., 2012, Chapter 6). This feedback protocol has repeatedly been shown to be effective in shaping and otherwise improving a variety of staff skills in settings serving individuals with disabilities, including promotion of participant involvement in meaningful tasks (Reid et al., in press). Feedback provided in accordance with the protocol is likewise usually well received by staff.
Using the feedback protocol, the clinician begins by setting a positive tone for the feedback by providing a positive, encouraging, or supportive statement (Step 1). Next, aspects of staff performance that have been completed correctly are specified (Step 2). The clinician then identifies any aspects of performance that have been performed incorrectly (Step 3) and how the actions should have been performed (Step 4). Once the positive and corrective feedback have been given, the clinician prompts questions from the staff person to ensure that the information presented was clear and understood by the staff member (Step 5).
Subsequently, the clinician describes when the next feedback session will occur (Step 6) and lastly, ends the feedback session with a positive statement about the staff performance or efforts (Step 7). An example of using the seven steps of the feedback protocol in regard to promoting involvement of adults with autism in meaningful tasks is provided in the following case illustration.
Example of Feedback Provided Using the 7-Step Protocol
Step 1: “You guys have made a lot of great changes with the activities in this group.”
Step 2: “I particularly like the way you are teaching Joe to write his name. Previously you were asking him to write his name three times on a piece of notebook paper but now you are asking Joe to write his name by signing in and out when he enters and exits the work area. Signing in and out of the work area is an activity that many adults without disabilities are expected to do at work and should give Joe lots of practice writing his name.”
Step 3: “One area of concern I noted though is that the materials you are using for the leisure activity of bean bag toss look like they were designed for young children.”
Step 4: “Let’s get a larger, sturdier set from the sporting goods store painted with the colors and logo from the university. Then, it will be the same type of activity commonly observed among adults during recreational get togethers such as at tailgate parties at football games.”
Step 5: “Do you see how changing the materials will make the activity more age-appropriate? Do you have any questions or concerns about the activity changes you are planning?”
Step 6: “I am looking forward to visiting with your group again sometime in the next week.”
Step 7: “Again, your activity changes are really coming along nicely. Well done!”
Feedback should be provided very frequently as staff are in the beginning stages of changing activities. In particular, feedback should occur almost daily for the first 1—2 weeks after the date (set at the follow-up meeting) for having new activities in place. As direct support staff become more skillful at designing meaningful activities, observations followed by feedback can occur less frequently. However, it is unlikely that feedback concerning meaningful versus nonmeaningful activities can ever be totally discontinued. Without ongoing monitoring and feedback, nonmeaningful activities tend to creep back into the routines of center-based programs.
Diagnostic feedback provided following the protocol just noted seems to be the best format for giving feedback in the early stages of the training and supervision process as staff learn to differentiate between meaningful and nonmeaningful activities. As time goes on, positive feedback can take forms other than just the spoken feedback to staff. For example, written positive feedback can be provided to a staff member by sending a hand-written note or email about an activity the clinician thought was particularly well done.
Feedback can likewise be provided to a group of staff. To illustrate, one agency posted a certificate of commendation in the agency’s conference room recognizing all of the day program staff when formal observations indicated that all participant groups in the agency were consistently at or above the normative average (see chapter: Assessing Meaningful Versus Nonmeaningful Task Participation) for meaningful activities. Finding new and different ways to provide feedback to focus and motivate staff efforts in providing meaningful activities is essential for maintaining staff performance over time (see discussion in chapter: Maintaining Meaningful Activity Participation).