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LITERATURE REVIEW
Abstract
Background Services employing staff to support people with disability usually provide training in a range of areas including
communication and managing challenging behaviour. Given that such training can be costly and time-consuming, it is
important to evaluate the evidence presented in support of such programs. Efficacy in clinical practice is measured using
evidence-based practice. However, there is currently no model that is widely used to compare and evaluate training programs
despite the large number of training programs reported each year.
Method Six studies published in the last decade that reported the outcomes of communication-based training and six that
reported on the outcomes of challenging behaviour training were evaluated using the 4-level Kirkpatrick model.
Results Comparison of the levels of evidence is made for these 12 studies.
Conclusion The Kirkpatrick model provides one technique for appraisal of the evidence for any reported training program
For personal use only.
and could be used to evaluate whether a training program is likely to meet the needs and requirements of both the
organisation implementing the training and the staff who will participate.
*This manuscript was accepted under the Guest Editorship of Deb Keen.
Correspondence: Dr Andy Smidt, Discipline of Speech Pathology, University of Sydney, Cumberland Campus, PO Box 170, 75 East Street, Lidcombe, NSW
1825, Australia. E-mail: andy@eye.com.au
ISSN 1366-8250 print/ISSN 1469-9532 online ª 2009 Australasian Society for the Study of Intellectual Disability Inc.
DOI: 10.1080/13668250903093125
Evaluation of training 267
by the support they receive from staff (Mansell, Richman, Riordan, Reiss, Pyles, & Bailey,
1995). In recent years, researchers have considered 1988).
the role of paid care staff in the management of . A combination of the above (Reid et al., 2003).
challenging behaviour (see Ager & O’May, 2001, for
a review) and have attempted to determine the most Despite this focus on training, the efficacy of such
effective method of training and supporting carers training is rarely examined. Even though staff may
(both paid and unpaid) (e.g., Chatterton, 1998; report that training is useful, there is no guarantee
Dobson, Upadhyaya, & Stanley, 2002; Gentry, that the training will impact on their knowledge
Iceton, & Milne, 2001; Golden & Reese, 1996; levels or behaviour (Ziarnik & Bernstein, 1984).
Purcell, McConkey, & Morris, 2000).
Evaluating training programs
Staff training programs
When considering the impact of any particular
Given the research findings detailing the limited study or training program it is necessary to evaluate
number of interactions that typically occur between the evidence presented in support of the program.
J Intellect Dev Dis Downloaded from informahealthcare.com by University of New South Wales
staff and residents in residential services (Felce, One approach to the measurement of the impact of
Lowe, & Blackman, 1995; Felce & Perry, 1995; training is that developed by Kirkpatrick (1996),
Hundert, Walton-Allen, Vasdev, Cope, & Summers, who presented a 4-level model to evaluate training
2003; Markova, Jahoda, Cattermole, & Woodward, comprising reaction (1), learning (2), behaviour (3),
1992), it is not surprising to find a body of recent and results (4). The first level of evaluation,
research that is dedicated to changing and improving reaction, typically involves trainees completing a
interactions between residents and the staff who post-course evaluation of their impressions of the
support them. These studies include staff training program. Such evaluation does not measure what
programs (Chatterton, 1999; Dobson et al., 2002; participants have learned, but gauges the interest,
McLeod, Houston, & Seyfort, 1996; Money, 1997), motivation, and attention levels of participants. The
For personal use only.
activity scheduling, direct skill teaching to residents second level, learning, involves measuring what
(Sigafoos et al., 2004), and staff management pro- participants have learned in terms of both knowl-
cedures (Seys & Duker, 1993; Suda & Miltenberger, edge and/or skills. Learning evaluation can include
1993). trainees participating in written assessments or
In recent years, research and intervention with role-plays to demonstrate their skills. This level of
people with intellectual disability has shifted towards evaluation allows participants to demonstrate their
focusing not only on the person with the disability understanding of specific skills and/or knowledge
but also on the skills of communicative partners and within the learning program. The third level is
modification of their interactions with those indivi- behaviour or performance. This involves assessment
duals (Butterfield & Arthur, 1995; Light & Binger, of the trainees’ ability to use their newly learned
1998; McConkey, Morris, & Purcell, 1999; knowledge or skills in the workplace. This level of
McNaughton & Light, 1989; Purcell et al., 2000; evaluation attempts to determine whether partici-
Purcell, Morris, & McConkey, 1999; Seys, Kersten, pants (who may already have demonstrated acquisi-
& Duker, 1990). The most common approach to tion of specific skills and/or knowledge) use their
changing the interaction skills of the communication new skills when they return to the work environ-
partner is via a training program. There have been a ment. The fourth level, described as results, is a
range of types of training programs offered (Jahr, measure of the impact that the training has had
1998), including instructional procedures (e.g., overall, including financial or morale impacts. This
lectures, discussions, reading material) and one or might include improvement in, for example, staff–
more of the following: resident interaction, decreased incidents of challen-
ging behaviour, and staff turnover.
. Role-playing (i.e., where participants act out In this paper we will consider the effectiveness of a
the part of the staff member and the client) range of staff training programs for staff working with
(Gentry et al., 2001; Schepis, Reid, Ownbey, & adults with intellectual disability as evaluated using
Parsons, 2001). the Kirkpatrick model (Kirkpatrick, 1996). Given
. Direct feedback (e.g., on tasks learned during that those needing the highest level of support often
training) (Reid & Parsons, 1996). include people with severe communication impair-
. Self-management (such as self-recording, self- ments and those with challenging behaviour, our
evaluation, and self-administered consequen- focus is on two types of training: (a) training to
ces) (Embregts, 2000; Morris & Ellis, 1997; improve staff–resident interaction, and (b) training
268 A. Smidt et al.
to improve staffs’ management of challenging beha- ‘‘knowledge about communication and its break-
viour. What follows is a critical overview of current down,’’ and to apply this to a resident with whom
knowledge in staff training in these two areas to they were familiar. This study involved evaluations
determine which types of training are most effective at a range of levels including use of a questionnaire
at modifying staff behaviour and, in turn, resident (Level 1 and 2), interview (Level 1), analysis of
behaviour. interactions (coded as social or functional), and
duration of interactions (Level 3) before and after
Training to improve staff–resident interaction training (a total of 11 weeks). The training resulted
in no significant difference in the duration of staff-
Studies reporting communication-based training initiated interactions. However, there was a sig-
were selected from a search of the PsychINFO and nificant increase in the immediacy of staff members’
ERIC databases using the terms ‘‘staff training,’’ responses to clients and a significant increase in
‘‘disabilities,’’ and ‘‘communication.’’ Six studies staff members’ use of nonverbal communication to
that evaluated the effectiveness of this training were support interactions. The analysis of the question-
identified. The methods of evaluating each reported naire pre- and post-training indicated a significant
J Intellect Dev Dis Downloaded from informahealthcare.com by University of New South Wales
across-group design, which involved measurements specific recommendations on some changes staff
of the behaviours of staff groups prior to and after might make in their interactions; namely, less use of
training. The results reported the percentage of closed questions, more use of open questions, more
intervals of staff behaviour. No statistical analysis responses, more nonverbal acts, more use of com-
was performed; however, the authors discussed the ments, and more use of facial expressions. Fre-
graphs and compared them to a control group who quency counts of these behaviours indicated that all
received no intervention. Results indicated that staff made at least one positive change and staff
staff participants made some increases in positive reported that they felt that they had benefited from
verbal behaviours and slight improvements in posi- the training. Analysis of the data, however, revealed
tive nonverbal behaviour after training. Concurrent no significant change.
improvements in resident behaviours were not Dobson et al. (2002) described a multidisciplin-
observed. ary focus approach used to train staff to alter their
Money (1997) compared the effectiveness of communication with adults with profound intellec-
three different approaches to the delivery of speech tual disability. The study examined a training pro-
and language therapy; namely (a) direct individual gram for nine care staff in a day centre in the UK.
therapy given to the client and his/her communica- The training centred around video recordings of
tion partner; (b) attendance by communication staff interacting with one service-user for each staff
partner at a training program; and (c) a combination member trained. The researchers analysed videos
of approaches where the communication partner for the amount of language used and the type of
attended training and received individual therapy communication acts involved (Level 3). Data were
input. Money’s training program did not result in collected before and immediately after training and
any significant changes in the quantity of interactions; then again 6 months after training. Results in-
there was, however, a reported change in staff initia- dicated a significant increase in the number of
tions where staff used more open questions and utterances used by staff, especially those utterances
fewer statements. Statistically significant changes that were praise, acknowledgements, and requests
only occurred in the combination approach where for information. These changes were not sustained
both direct therapy and staff training were given. when measured 6 months after training. There was
Chatterton (1998) investigated the impact of a little difference in the language level or structure
2-day communication workshop, which the author used. The authors commented that the lack of
states was designed to increase staff participants’ change observed was due to the staff being an
J Intellect Dev Dis Downloaded from informahealthcare.com by University of New South Wales
For personal use only.
Golden & Reese (1996) To train 12 staff to rate the Slight increases in staff positive Consumer satisfaction questionnaire. Level 1 – reaction
interaction between themselves and interaction behaviours. Little or Measurement of change in staff– Level 3 – behaviour
12 residents. inconsistent change in resident resident interaction levels using
behaviours. counts of pre-determined
behaviours.
Money (1997) To train 20 staff members in one of 3 All approaches resulted in limited Measurement of pre- and post- Level 3 – behaviour
models of speech therapy service changes in staff initiations, resident intervention levels of types of staffs’
delivery: responses, and modality of initiations of communication,
(1) direct therapy alone communication. Significant changes staffs’ modality of communication,
(2) staff training were found for staff in the and residents’ modality of
(3) combined direct therapy and combination approach. communication by coding of
staff training. videotapes.
Chatterton (1998) To train 12 staff in a one-day Staff increased their use of nonverbal A questionnaire. Level 1 – reaction
workshop to improve their communication, responded more Level 2 – knowledge
communication with 7 residents. quickly to resident communication, An interview between each staff Level 1 – reaction
and engaged in longer interactions. member and a researcher about
their perception of the
communication skills of the
individual with whom they worked.
Analysis of functional and social Level 3 – behaviour
interactions between staff and
resident.
Measurement of the duration of Level 3 – behaviour
interactions.
Purcell, McConkey, & To train 24 self-selected staff during a No significant changes in staff Analysis of videos of staff–resident Level 3 – behaviour
Morris (2000) 2-day training session to improve behaviour. Some increased interaction.
their communication with one responsiveness from staff. Clients
selected resident for each staff became more active communicators.
member.
Evaluation of training
Dobson, Upadhyaya, & To train 9 staff in a multidisciplinary Staff improved their verbal Analysis of the amount of language Level 3 – behaviour
Stanley (2002) approach to improve communication with clients as well as used and the type of
communication between staff and 9 gaze monitoring and position during communication acts involved using
selected clients with profound interactions. Changes were videos of staff–client interactions.
intellectual disability. maintained for at least 6 months.
Smidt, Balandin, Reed, & To train 18 staff members in a 4-week Staff increased their use of AAC and Staff reaction using questionnaires. Level 1 – reaction
Sigafoos (2007) program to identify praise with residents. Staff decreased Measured staff–resident interactions. Level 3 – behaviour
communication goals for their use of inappropriate language. Measured resident challenging Level 4 – results
themselves with one resident. Some limited decrease in client behaviour.
challenging behaviour.
269
270 A. Smidt et al.
established team with appropriate language skills it involves showing that training had an impact on
prior to the training. They noted that the purpose of more general outcomes such as the quality of life of
the training with this staff group was to recognise the client. This is partly due to the difficulty in
their own existing skills and to encourage them to demonstrating that any changes in client quality of
use these skills more often, rather than to teach life have resulted from the training rather than from
skills that the staff did not have. The researchers did any number of other factors including a change in
use a Level 3 analysis of staff behaviour in the staff or physical conditions.
workplace (analysis of videos of staff and resident
communicative acts), but the study involved small Training to improve staff management of challenging
numbers of staff who were all trained behaviour
simultaneously.
Smidt, Balandin, Reed, and Sigafoos (2007) Six studies reporting the effectiveness of challenging
reported on a training program that supported behaviour training were identified from the Psy-
residential care staff to analyse the communicative chINFO and ERIC databases using the terms ‘‘staff
interactions between themselves and clients. The training,’’ ‘‘disabilities,’’ and ‘‘behaviour.’’ The
J Intellect Dev Dis Downloaded from informahealthcare.com by University of New South Wales
staff worked collaboratively to formulate consensus methods used to evaluate training programs that
communication guidelines. The researchers used aimed to teach staff to manage challenging behaviour
analyses at Levels 1, 3, and 4 to evaluate not only are presented in Table 2.
changes in staff–resident interaction but also levels of Allen, McDonald, Dunn, and Doyle (1997)
residents’ challenging behaviour. In a multiple base- conducted a training program that focused on teach-
line study, participants demonstrated an increased ing staff to understand aggressive incidents, primary
use of praise, decreased use of inappropriate prevention, secondary prevention, and reactive stra-
language, and increased use of augmentative and tegies based on Positive Behaviour Support (PBS) in
alternative communication (AAC). There was some a residential behavioural treatment unit. Evaluation
decrease in challenging behaviour, but this was not included measurements at Kirkpatrick’s Level 4
For personal use only.
Allen et al. (1997) To train staff (number unspecified) to Some decrease in behavioural incidents for Measurements were made of the behaviour Level 4 – results
understand aggressive incidents, how to most residents, decrease in use of major levels of clients following training using the
prevent challenging behaviour by reactive strategy use, and decrease in level Adaptive Behavior Scale.
modifying the environment, how to of staff and resident injury.
recognise the start of challenging behaviour
and respond safely, and how to react if
behaviours did occur.
McDonnell (1997) To train 21 care staff in a 3-day training Knowledge scores and confidence scores (1) A multiple choice knowledge test. Level 2 – knowledge
course to understand the causes of increased. (2) Managing Challenging Behaviour Level 2 – knowledge
challenging behaviour, to use verbal and Confidence Scale.
physical skills to diffuse incidents, to use (3) A Restraint Role-Play Test. Level 2 – knowledge
non-violent physical restraint, and to
increase the confidence of staff in
managing challenging behaviour.
Baker (1998) To train staff (number not specified) to carry Functional assessments and behaviour Measurement of whether staff completed a Level 3 – behaviour
out a functional assessment of problem support plans were written for all residents. behaviour support plan.
behaviours, to write a behaviour Frequency of problem behaviour Evaluation of the content of the behaviour Level 2 – knowledge
intervention plan, and to teach new skills to decreased. plan (i.e., staff knowledge).
a resident using appropriate teaching An audit of incident reports was made to Level 4 – results
strategies. measure levels of challenging behaviour.
Allen & Tynan (2000) To train 109 staff to prevent and manage Participants were more confident in Confidence in Coping with Patient Level 1 – reaction
challenging behaviour, including managing challenging behaviour and more Aggression Instrument.
preventative strategies and use of physical confident in applying reactive strategies. Reactive strategies questionnaire. Level 1 – reaction
interventions. Participants were then
taught physical intervention strategies in a
practical session.
Gentry et al. (2001) To train 101 staff using a program based on Staff increased knowledge about challenging Completion of a questionnaire at the start Level 2 – knowledge
‘‘Interactive Staff Training.’’ Staff were behaviour and were able to demonstrate and end of the 3-day course.
taught appropriate management use of management techniques in a role- Role-play exercises. Level 2 – knowledge
techniques for challenging behaviour, play situation. Staff expressed improved Attitudes were measured using participant Level 1 – reaction
including breakaway techniques and confidence in managing challenging evaluation forms.
restraint techniques. behaviour.
McKenzie et al. (2000) To train 59 care staff about the definitions of Staff improved their knowledge about all Participants completed a questionnaire Level 2 – knowledge
disability, challenging behaviour, and staff factors except those important in managing before and after training.
responsibilities. Staff were taught to define challenging behaviour. Participants described how they would Level 2 – knowledge
and record challenging behaviour, reactive respond to two scenarios.
strategies, and positive programming
Evaluation of training
approaches.
271
272 A. Smidt et al.
confident in managing challenging behaviour than the larger size of participant groups in the behaviour
the untrained group. The researchers then trained management studies and the consequent time and
the untrained group and found significant improve- cost to monitor the behaviour of such a large group
ments in their confidence following training. of staff. Although two studies (Allen et al., 1997;
Gentry et al. (2001) developed a training program Baker, 1998) attempted to measure change in
based on ‘‘Interactive Staff Training’’ (Corrigan & resident behaviour following training, the study by
McCracken, 1997), a staff training package for staff Allen et al. (1997) noted that there were methodo-
working in psychiatric rehabilitation settings. Gentry logical problems with pre-training data that limited
et al. modified the training package and included the usefulness of these measures. It is interesting to
some additional features based on ‘‘best practice’’ note that only two of the six behaviour management
For personal use only.
principles of training. They conducted the training at studies measured staff satisfaction (Level 1), which
the group home venue, enlisted support from super- may indicate that staff are expected to participate in
visory staff, and included the staff as ‘‘partners in the challenging behaviour training as a requirement of
training venture’’ (p. 144). The modified ‘‘inter- their employment rather than communication train-
active staff training’’ was provided to a total of 101 ing, which may be based on staff interest rather than
staff in a program lasting 3 days. Evaluation was staff and resident safety.
made at Level 2 of the Kirkpatrick model. Results In summary, of the six behaviour management
indicated a highly significant improvement in parti- studies that attempted to teach care staff knowledge
cipants’ knowledge (Level 2) as measured by a and skills for working with individuals with intellec-
questionnaire administered before and after training. tual disability, the majority used no measures of
Measurements were made of participants’ skills and changes in staff behaviour in the workplace (Level 3).
attitudes during a role-play; however, these results Some researchers demonstrated a significant change
were not subjected to statistical analysis. Question- in knowledge or skills immediately after the training
naires at the end of the training indicated that the (Level 2) (e.g., Baker, 1998; Gentry et al., 2001;
participants found the course to be enjoyable and McDonnell, 1997; McKenzie et al., 2000), but there
useful (Level 1). was little evidence that this increased knowledge
McKenzie, Paxton, Patrick, Matheson, and impacted on staff behaviour in the workplace or if
Murray (2000) conducted a one-day training course there was any change in the levels of residents’
with the aim of improving the knowledge of staff challenging behaviour.
about the characteristics of intellectual disability,
definition and management of challenging beha-
Conclusion
viour, client choice, and duty of care. A total of 59
staff were trained. Evaluation of the training was Many staff training programs related to individuals
made via completion of a questionnaire before and with disability are conducted each year. These pro-
after training, and by participants describing how grams consume organisational time and resources.
they would respond to two scenarios (Level 2 in Under these circumstances, it is important that
Kirkpatrick’s model). Participants had significantly managers selecting a particular training program
better understanding about the definition of intellec- are able to determine with some degree of certainty
tual disability and their duty of care; however, they the likely impact of the training on staff and resident
did not show a significant change in their outcomes. If the efficacy of training in terms of
Evaluation of training 273
practical outcomes is not established, staff may be Dobson, S., Upadhyaya, S., & Stanley, B. (2002). Using an
inappropriately blamed for not ‘‘following through,’’ interdisciplinary approach to training to develop the quality of
communication with adults with profound learning disabilities
the behaviour of residents may be considered by care staff. International Journal of Language & Communica-
intractable, and resources may be wasted. tion Disorders, 37, 41–57.
To date, the evidence in support of the benefits Doerner, M., Miltenberger, R. G., & Bakken, J. (1989). The
of disability-related staff training is equivocal. effects of staff self-management on positive social interactions
in a group home setting. Behavioral Residential Treatment, 4,
Few studies have provided strong evidence that
313–330.
training significantly improves outcomes for people Embregts, P. J. C. M. (2000). Effectiveness of video feedback and
with disability. Reports of training need to be self-management on inappropriate social behavior of youth
appraised according to an appropriate standard. The with mild mental retardation. Research in Developmental
Kirkpatrick model provides one technique for apprai- Disabilities, 21, 409–423.
sal of the evidence for any reported training program. Felce, D. (1994). Costs, quality and staffing in services for people
with severe learning disabilities. Journal of Mental Health, 3,
Moreover, the model can be used to determine 495–506.
whether a favourable outcome is limited to self- Felce, D., Lowe, K., & Blackman, D. (1995). Resident behaviour
reported staff attitudes and practices, or whether there and staff interaction with people with intellectual disabilities
J Intellect Dev Dis Downloaded from informahealthcare.com by University of New South Wales
are improvements to relevant knowledge acquisition and seriously challenging behaviour in residential services.
and application, and even positive impacts on operat- Mental Handicap Research, 8, 272–295.
Felce, D., & Perry, J. (1995). The extent of support for ordinary
ing costs. The ultimate goal is a training program that living provided in staffed housing: The relationship between
will meet the needs of both the staff who will staffing levels, resident characteristics, staff:resident interac-
participate and the clients with disability for whom it tions and resident activity patterns. Social Science & Medicine,
is intended; but also one that is likely to be 40, 799–810.
Gentry, M., Iceton, J., & Milne, D. (2001). Managing challenging
implemented by the responsible organisation.
behaviour in the community: Methods and results of interactive
staff training. Health and Social Care in the Community, 9, 143–150.
Golden, J., & Reese, M. (1996). Focus on communication:
Improving interaction between staff and residents who have
For personal use only.
References
severe or profound mental retardation. Research in Develop-
Ager, A., & O’May, F. (2001). Issues in the definition and mental Disabilities, 17, 363–382.
implementation of ‘‘best practice’’ for staff delivery of Grey, I. M., & Hastings, R. P. (2005). Evidence-based practices in
interventions for challenging behaviour. Journal of Intellectual intellectual disability and behaviour disorders. Current Opinion
& Developmental Disability, 26, 243–256. in Psychiatry, 18, 469–475.
Allen, D., McDonald, L., Dunn, C., & Doyle, T. (1997). Hundert, J., Walton-Allen, N., Vasdev, S., Cope, K., & Summers,
Changing care staff approaches to the prevention and manage- J. (2003). A comparison of staff-resident interactions with
ment of aggressive behaviour in a residential treatment unit for adults with developmental disabilities moving from institu-
persons with mental retardation and challenging behaviour. tional to community living. Journal on Developmental Disabil-
Research in Developmental Disabilities, 18, 101–112. ities, 10, 93–112.
Allen, D., & Tynan, H. (2000). Responding to aggressive Jahr, E. (1998). Current issues in staff training. Research in
behavior: Impact of training on staff members’ knowledge Developmental Disabilities, 19, 73–87.
and confidence. Mental Retardation, 38, 97–104. Jenkins, R., Rose, J., & Lovell, C. (1997). Psychological well-being
Baker, D. J. (1998). Outcomes of behavior support training to an of staff working with people who have challenging behaviour.
agency providing residential and vocational support to persons Journal of Intellectual Disability Research, 41, 502–511.
with developmental disabilities. Journal of the Association for Kirkpatrick, D. (1996). Great ideas revisited. Techniques for
Persons with Severe Handicaps, 23, 144–148. evaluating training programs. Revisiting Kirkpatrick’s four-
Baker, D. J., & Feil, E. G. (2000). A self-evaluation by agencies level model. Training and Development, 50, 54–59.
providing residential support regarding capacity to support Light, J. C., & Binger, C. (1998). Building communicative
persons with disabilities and challenging behaviours. International competence with individuals who use augmentative and alternative
Journal of Disability, Development and Education, 47, 171–181. communication. Baltimore: Paul H. Brookes.
Butterfield, N., & Arthur, M. (1995). Shifting the focus: Emerging Mansell, J. (1995). Staffing and staff performance in services for
priorities in communication programming for students with a people with severe or profound learning disability and serious
severe intellectual disability. Education & Training in Mental challenging behaviour. Journal of Intellectual Disability Research,
Retardation, 30, 41–50. 39, 3–14.
Chatterton, S. (1998). An investigation of speech and language Markova, I., Jahoda, A., Cattermole, M., & Woodward, D.
therapy to improve the communication environment of people (1992). Living in hospital and hostel: The pattern of
with severe learning disabilities who have communication interactions of people with learning difficulties. Journal of
difficulties and behaviours that challenge services. Journal of Intellectual Disability Research, 36, 115–127.
Learning Disabilities for Nursing, Health and Social Care, 2, 203– McConkey, R., Morris, I., & Purcell, M. (1999). Communications
211. between staff and adults with intellectual disabilities in naturally
Chatterton, S. (1999). Learning disabilities. Communication skills occurring settings. Journal of Intellectual Disability Research, 43,
workshops in learning disability nursing. British Journal of 194–205.
Nursing, 8, 94–96. McDonnell, A. (1997). Training care staff to manage challenging
Corrigan, P. W., & McCracken, S. G. (1997). Interactive staff behaviour: An evaluation of a three day training course. British
training: Rehabilitation teams that work. New York: Plenum. Journal of Developmental Disabilities, 43, 156–162.
274 A. Smidt et al.
McKenzie, K., Paxton, D., Patrick, S., Matheson, E., & Murray, Richman, G. S., Riordan, M. R., Reiss, M. L., Pyles, D. A. M.,
G. C. (2000). An evaluation of the impact of a one-day & Bailey, J. S. (1988). The effects of self-monitoring
challenging behaviour course on the knowledge of health and and supervisor feedback on staff performance in a residential
social care staff working in learning disability services. Journal setting. Journal of Applied Behavior Analysis, 21, 401–409.
of Intellectual Disabilities, 4, 153–165. Schepis, M. M., Reid, D. H., Ownbey, J., & Parsons, M. B.
McLeod, H., Houston, M., & Seyfort, B. (1996). Communicative (2001). Training support staff to embed teaching within
interactive skills training for caregivers of nonspeaking adults natural routines of young children with disabilities in an
with severe disabilities. International Journal of Practical inclusive preschool. Journal of Applied Behavior Analysis, 34,
Approaches to Disability, 19, 5–11. 313–327.
McNaughton, D., & Light, J. (1989). Teaching facilitators to Seys, D. M., & Duker, P. C. (1993). Staff management
support the communication skills of an adult with severe procedures and changes in the distribution of nontargeted
cognitive disabilities: A case study. Augmentative and Alter- activities by residential staff members: A secondary analysis.
native Communication, 5, 35–41. Behavioral Residential Treatment, 8, 21–28.
Money, D. (1997). A comparison of three approaches to delivering Seys, D., Kersten, H., & Duker, P. (1990). Evaluating a ward staff
a speech and language therapy service to people with learning program for increasing spontaneous and varied communicative
disabilities. European Journal of Disorders of Communication, 32, gesturing with individuals who are mentally retarded. Beha-
449–466. vioral Residential Treatment, 5, 247–257.
Morris, J., & Ellis, J. (1997). The effect of verbal and graphic Sigafoos, J., Drasgow, E., Reichle, J., O’Reilly, M., Green, V. A.,
J Intellect Dev Dis Downloaded from informahealthcare.com by University of New South Wales
feedback on the data-recording behavior of direct care trainers. & Tait, K. (2004). Tutorial: Teaching communicative rejecting
Behavioral Interventions, 12, 77–104. to children with severe disabilities. American Journal of Speech-
Parsons, M. B., & Reid, D. H. (1993). Evaluating and improving Language Pathology, 13, 31.
residential treatment during group leisure situations: A Smidt, A., Balandin, S., Reed, V., & Sigafoos, J. (2007). A
program replication and refinement. Research in Developmental communication training programme for residential staff work-
Disabilities, 14, 67–85. ing with adults with challenging behaviour: Pilot data on
Purcell, M., McConkey, R., & Morris, I. (2000). Staff commu- intervention effects. Journal of Applied Research in Intellectual
nication with people with intellectual disabilities: The impact Disabilities, 20, 16–29.
of a work-based training programme. International Journal of Suda, K. T., & Miltenberger, R. G. (1993). Evaluation of
Language & Communication Disorders, 35, 147–158. staff management strategies to increase positive interactions
Purcell, M., Morris, I., & McConkey, R. (1999). Staff perceptions in a vocational setting. Behavioral Residential Treatment, 8,
of the communicative competence of adult persons with 69–88.
For personal use only.
intellectual disabilities. British Journal of Developmental Dis- Vollmer, T. R., Iwata, B. A., Zarcone, J. R., Smith, R. G., &
abilities, 45, 16–25. Mazaleski, J. L. (1993). The role of attention in the
Reid, D. H., & Parsons, M. B. (1996). A comparison of staff treatment of attention-maintained self-injurious behavior:
acceptability of immediate versus delayed verbal feedback in Noncontingent reinforcement and differential reinforce-
staff training. Journal of Organizational Behavior Management, ment of other behavior. Journal of Applied Behavior Analysis,
16, 35–47. 26, 9–21.
Reid, D. H., Rotholz, D. A., Parsons, M. B., Morris, L., Braswell, Ziarnik, J. P., & Bernstein, G. S. (1984). Effecting change in
B. A., Green, C. W., et al. (2003). Training human service community-based facilities: Putting staff training in perspec-
supervisors in aspects of PBS: Evaluation of a statewide, tive. Behavior Therapist, 7, 39–41.
performance-based program. Journal of Positive Behavior
Interventions, 5, 35–46.
Reilly, S. (2004). The challenges in making speech pathology
practice evidence based. Advances in Speech–Language Patho-
logy, 6, 113–124.