Fidelity Drift on a New Technician With Two Supervision Hours a Month
A QBA supervises 11 behavior technicians across three homes under a contract providing 6 supervision hours per month total, with 2 hours currently allocated to "Renee." Renee runs a DRA with a 5-second prompt delay and differential reinforcement of a mand for "break." Across four fidelity checks: correct SD delivery 100%; prompt delay adherence 40% (she prompts at 1-2 seconds); reinforcer delivered following problem behavior on 3 of 5 opportunities; and she sometimes omits the mand prompt entirely when the client is "already upset." Renee says she "knows the protocol" and has watched the training video twice. The family reports aggression is unchanged and asks that Renee not be replaced.
1. Prioritize the three fidelity errors and justify the ranking.
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Rank by threat to the client, not by how easy the error is to fix.
- Reinforcer delivered after problem behavior (3 of 5). This directly strengthens the behavior the plan exists to reduce and sets up a concurrent reinforcement contingency for aggression. It is not a fidelity lapse so much as the wrong plan being implemented.
- Omitting the mand prompt when the client is upset. This is a strategic departure made exactly at the moments of highest EO and highest aggression probability - FCT is abandoned precisely when it matters most.
- Prompt delay at 1-2 s instead of 5 s. Functionally this is near-immediate prompting: the mand stays prompt-bound, never contacts the contingency independently, and control does not transfer to the EO.
Note the pattern: the family's report that aggression is unchanged is consistent with the fidelity data and should not be interpreted as "the plan doesn't work." That inference must be stated explicitly, because the common next move - redesigning an adequate plan - would be an error.
2. Design the supervision within the 2 hours per month using behavioral skills training.
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BST sequence: instructions (protocol plus the rationale for the 5-s delay) → modeling (QBA or a proficient technician models the trial) → rehearsal (role-play to criterion: three consecutive correct trials of the 5-s delay and mand prompt) → feedback (immediate, specific, one positive and one corrective). Repeat rehearsal until criterion. Then in-vivo coaching during live sessions.
Budgeting the 2 hours:
- Session 1 (30 min): BST on the two highest-priority steps.
- Session 2 (30 min): rehearsal to criterion; do not schedule the technician unsupervised until criterion is met.
- Sessions 3-5 (20 min each, spread across weeks): live observation with the checklist, feedback immediately after.
- Reserve ~10 minutes for data review and documentation.
Use a task-analysis checklist with the critical steps flagged; graph fidelity by step, not as a single percentage, so drift in one component is visible. A single 80% composite score can conceal a 0% on the step that matters most.
Tiered model for the other 10 technicians: senior technicians conduct maintenance checks and the QBA reviews their data weekly, so the 2-hour allocation does not starve the rest of the caseload.
3. The family asks that Renee not be replaced and Renee says she already knows the protocol. What do you do and say?
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Separate what the family is asking (continuity, a relationship they value) from what they are not asking (that fidelity be ignored). These are compatible.
First move is not reassignment. Removing her punishes a trainee and builds no competence.
With the family: Renee is staying and receiving additional coaching on specific steps; you are monitoring with data; you will tell them if anything changes. Plain language, no jargon.
With Renee: "You know the protocol" is not the disputed claim - the data are. Name the gap concretely using her own records ("the break followed aggression on 3 of 5 opportunities"), avoid a global competence judgment, and set a behavioral criterion for success. Defense is much less likely when the feedback is a number she produced rather than a trait attributed to her.
Document: the supervision provided, the retraining, the criterion, and the dates.
Escalation rule stated in advance: if fidelity remains below criterion on the critical steps after targeted BST and a reasonable number of sessions, reassign with the family informed. Access to effective treatment outranks staffing preference, and the supervision record must show the sequence that led there.