Factors Influencing Quality of Behavior Intervention Plans for Children and Adolescents with Autism Spectrum Disorder
Objectives: 1) Evaluate the quality of BIPs developed for children and adolescents with ASD at an autism clinic. 2) Determine factors associated with high-quality BIPs.
Methods: BIPs (n=60) written for children with ASD evaluated at a community autism clinic were randomly selected from low, medium, and high SES groups in Connecticut (n=20 per group). The Behavior Support Plan Quality Evaluation Guide-II (BSP-QEII) was used to assess BIP quality, as its items correspond to the most highly recommended elements for inclusion in BIPs. Two raters rated the BIPs, resulting in a BSP-QEII total score that fell into the following categories: weak, underdeveloped, good, or superior, as specified by the BSP-QEII. Raters also noted whether the BIP author was a board-certified behavior analyst (BCBA) and whether an FBA was conducted to inform the development of each BIP.
Results: The two raters had good interrater reliability (r=.697, p<.01); therefore, their BSP-QEII scores were averaged for subsequent analyses. 31% of BIP scores fell into categories of superior or good while 69% were classified as underdeveloped or weak. An FBA was conducted prior to BIP development in 70% of the sample. BIP total scores written by BCBAs (M=16.30, SD=5.071) were significantly higher than those written by non-BCBAs, (M=9.60, SD=5.144), t(51)=4.639, p<.001. BIP total scores in which an FBA was conducted prior to BIP development (M=14.60, SD=4.02) were significantly higher than when an FBA was not conducted prior to BIP development (M=11.42, SD=5.04), t(58)=2.60, p=.01. A one-way ANOVA revealed no differences in BSP-QEII scores across the three SES groups (ps>.148).
Conclusions: Findings suggest that many BIPs written for children and adolescents with ASD may be weak or underdeveloped and fail to consider FBA input. BCBAs were more likely to write higher quality BIPs than other professionals, and the BIPs based on an FBA were more likely to have higher quality ratings. School district SES does not appear to be associated with BIP quality, suggesting the need for further training in BIP development is a requirement regardless of the potential resources available to the school district.