Treatment integrity refers to the degree to which intervention procedures are implemented as planned, designed, or intended. Research has shown that high treatment integrity is associated with positive therapeutic outcomes. Unfortunately, and despite receiving pre-service training, many practitioners do not maintain acceptable treat- ment integrity over time. With regard to clinical practice, it is not possible to properly evaluate the effectiveness of intervention plans if practitioners apply procedures inaccurately. Furthermore,
replication of successful plans may fail if intervention integ- rity is not closely monitored.
Assessing treatment integrity entails direct observa- tion of practitioners implementing procedures with the people in their care. Typically, observers use a recording form with steps that correspond to procedures that are listed on a written instructional or behavior support plan. The form allows the observer to document wheth- er a practitioner implemented each procedure properly or deviated from expected criteria. A common training strategy is to follow direct observation with verbal per- formance feedback in which the observer praises accu- rately implemented procedures and corrects procedures that were misapplied. Performance feedback may also include written correspondence, graphic display of inter- vention integrity data, and in vivo practice sessions.