Effects of outcome performance feedback on maintenance of client and staff behavior in a residential setting

This study examined effects of outcome performance feedback on maintenance of client and direct care staff behavior in a group home for four clients with severe/profound intellectual disability. Following baseline observations, 8 staff were instructed to prompt and praise interclient interactions and game activity during leisure sessions. Staff training comprised written instructions, in situ modeling and rehearsal, and performance feedback. This was followed by a 17-week maintenance period, during which staff received outcome performance feedback based on independent and self-recorded observations. Results showed that client gains were maintained, but did not stabilize. It was concluded that process feedback should have accompanied outcome feedback until staff behavior levels suitable for durable maintenance were obtained. In addition, successful use of performance feedback as a maintenance tool is highly dependent on which outcome behaviors are selected, and whether these are eventually naturally reinforced.