Effects of a mindfulness training program on behaviour intervention procedural fidelity
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Abstract
Autism Spectrum Disorder (ASD) is a lifelong developmental disability that is characterized by challenges with social communication and social interaction as well as repetitive behaviours, interests, or activities (American Psychiatric Association, 2013). An effective and well documented instructional approach for children with ASD is Discrete Trials Teaching (DTT). Since procedural fidelity is related to client outcomes (e.g., Noell, Gresham, & Gansle, 2002; Rhymer, Evans-Hampton, McCurdy, & Watson, 2002; Wilder, Atwell, & Wine, 2006), it is important to evaluate the accuracy with which staff conduct DTT sessions. Mindfulness training has been applied to improve attention, reflection, and skillful responding (Bishop et al., 2004) and has been proposed as a method to improve patient safety through adherence to prescribed procedures (Epstein, 1999; Pezzolesi, Ghaleb, Kostrzewski, & Dhillon, 2013). This study measured the effect of a brief mindfulness training program on procedural fidelity of staff conducting DTT with children with ASD. Three autism tutors from St.Amant Autism Programs participated. In a multiple-baseline design across participants, the principal investigator and a trained research assistant directly observed the accuracy with which tutors delivered prescribed DTT steps. DTT procedural fidelity increased during training for all participants. Specifically, during the baseline phase, procedural fidelity for Participants 1, 2, and 3 averaged 81%, 69%, and 70%, respectively. During the training phase, procedural fidelity increased to 86%, 83%, and 82%, respectively. Procedural fidelity was maintained at a high level for 2 of the 3 participants who were available at Follow-up.