Formal Monitoring and Feedback
There are three major considerations when implementing the formal monitoring and feedback approach to maintain improvements in staff provision of meaningful activities. These include setting a maintenance goal for monitoring, the frequency of monitoring and providing feedback, and scheduling monitoring sessions.
Setting a Maintenance Goal for Monitoring. When formally monitoring to maintain staff performance, several procedural alterations occur relative to monitoring prior to and during the staff training and supervision components discussed previously with the evidence-based protocol. One variation involves providing a comparison of how well staff promote meaningful activity involvement to a maintenance goal established for the staffs’ participant group. The purpose of a maintenance goal is to quantify an agency’s expectation for providing meaningful activities. At least two factors should be considered when setting maintenance goals.
The first factor is the normative data for meaningful activities. It is recommended that the maintenance goal always be above the normative average of approximately 50% meaningful activities described in Chapter 5, Assessing Meaningful Versus Nonmeaningful Task Participation, for center-based programs. The second factor is the skill level of individuals within a given participant group. Goals for meaningful task participation sometimes need to be altered based on the skills and challenges of individual adults with autism. For example, the maintenance goal for individuals with autism who have additional challenges of a highly significant nature (e.g., severe mobility or health impairments) may not be as rigid as the maintenance goal for individuals with less significant disabilities. All things considered, however, a reasonable expectation for most participant groups is that between 80% and 100% of the observed activities should be meaningful.
Frequency of Monitoring During Maintenance. A second way that monitoring varies during maintenance is that it occurs less frequently than during the initial training and supervision phases. This variation is due to practical concerns. Initial interventions to change staff performance—such as intervening to change the types of participant activities provided—can be relatively time-consuming. Expecting supervisors to continue that same amount of time investment for extended periods is unrealistic; supervisors usually do not have the available time in light of all their other expected duties.
For maintaining meaningful activities, the frequency of formal monitoring can usually be reduced initially to every other week. Subsequently, once the data obtained from monitoring indicate that meaningful activity involvement is remaining at or above the maintenance goal then the frequency can be reduced to once per month. The monthly monitoring generally should then continue on a regular basis. Experience has suggested that in most situations, reducing the frequency of formal monitoring to less than monthly will be insufficient for maintaining a satisfactory level of meaningful activities.
Scheduling of Monitoring During Maintenance. Another way that monitoring differs during maintenance pertains to when formal monitoring sessions are scheduled to be conducted. As described previously, when staff are beginning to change to more meaningful activities and are focusing only on specific periods of the day, monitoring should regularly occur during those designated periods. When monitoring occurs in this manner, it becomes a predictable occurrence for staff. Staff come to expect that their participant activities will be routinely observed during the targeted periods.
After staff have initiated changes in meaningful activities across all periods of the day that warranted improvement, monitoring should occur on a less predictable schedule across different time periods of the entire program day. When monitoring is unpredictable, staff tend to realize that they must be ready to have their activities observed at essentially any time. This can prompt staff to focus on meaningful activity involvement of their participant groups throughout each day (i.e., in contrast to only during specific time periods during the day in which they previously expected to have their activities observed).
When monitoring staff performance and providing feedback to maintain provision of meaningful activities for center participants, attention should be given to the maintenance goal for meaningful activity involvement, the frequency of monitoring, and how monitoring sessions are scheduled across times of day.