Turning Point 5 - A Call for Research on Quality Assurance in ABA Autism Service Settings: A Five-Part Series. Part 5 of 5
- Bryant Silbaugh
- Jan 18
- 10 min read
Turning Point Continued...The Final Step is to Start Validating Processes that Reinforce Control Over Behavioral Intervention Quality
Experimental quality control or improvement evaluations for behavioral processes within an ABA autism services organization must start somewhere. But where? Sosine and Cox (2023) wrote about the essential components of service quality. In other words, those characteristics of services that most positively impact clinical outcomes. They said that such characteristics must be identified so that, “stakeholders internal and external to ABA companies can manage the appropriate contingencies to improve service quality”.
But experimental research on the essential components of service quality is lacking. On the topic of promoting quality, Sulzer-Azaroff (2003) suggested applying “Pareto’s Law: A ‘law’ described by Vilfredo Pareto, commonly called in the business world the 80:20 law” (p. 6). As she explains, “It refers to the fact that, in life, 80 per cent (results) often is achieved by a 20 per cent investment of resources” (p. 6). As we await much needed research on the crucial components of service quality (Sosine & Cox, 2023), in this post it is suggested that quality assurance really boils down to the question of whether we deliver evidence-based behavioral interventions as planned and if data are really representative of changes in client behavior.
To the extent that an organization can say yes to those questions, they stand a better chance of improving the quality of their patient’s lives in ways that are verifiably attributable to their interventions. Thus, behavioral intervention quality is worth spending at least part of an organization’s initial 20 percent investment in quality assurance as the best first step in the development of a total performance system that delivers high-quality services with the management of behavioral intervention quality.
Behavioral Intervention Quality and Some Implications
Behavioral intervention quality can be defined as a combination of treatment integrity (sometimes referred to as procedural integrity) and interobserver agreement (Silbaugh, 2023). Peer-reviewed journals usually reject manuscripts of treatment evaluations unless they report adequate levels of interobserver agreement because the data lack evidence to support believability.