School & Classroom

The Impact of Integrated Support and Context on Treatment Implementation and Child Outcomes Following Behavioral Consultation.

Noell et al. (2022) · Behavior modification 2022
★ The Verdict

Three cheap add-ons—social influence, planning, and performance feedback—turn post-consultation follow-up into strong teacher implementation and better student outcomes.

✓ Read this if BCBAs who consult with teachers in any school setting
✗ Skip if Clinicians who only provide 1:1 therapy in homes or clinics

01Research in Context

01

What this study did

Noell et al. (2022) split teachers into two groups after the same behavior-consultation meeting.

One group got weekly check-ins. The other got the same check-ins plus three boosts: social influence, planning sheets, and performance feedback.

The team then tracked how well each teacher used the behavior plan and how the kids did.

02

What they found

Teachers who got the extra boosts used the plan far more often than the check-in-only group.

Their students also showed bigger gains in classroom behavior and learning.

03

How this fits with other research

Staff et al. (2022) showed that two short teacher-training sessions can cut ADHD symptoms. George adds that layering social influence, planning, and feedback on top of those sessions keeps the gains coming.

van Vonderen et al. (2010) found that video feedback alone lifts staff accuracy. George widens the lens: combine feedback with peer influence and a clear plan and you lift both accuracy and child outcomes.

Nitz et al. (2023) reviewed 40 studies and say multi-tiered systems work. George gives a micro-view of one tier—post-consultation—and shows which ingredients make that tier stick.

04

Why it matters

You already run consults. Instead of ending with "Let me know how it goes," hand the teacher a one-page plan, name two respected peers who use the plan, and set a five-minute weekly data review. George proves these three cheap steps turn advice into action and action into better student behavior. Try it next week.

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→ Action — try this Monday

After your next consult, give the teacher a short plan, two peer names, and a five-minute weekly data check-in.

02At a glance

Intervention
not applicable
Design
randomized controlled trial
Sample size
48
Population
not specified
Finding
positive

03Original abstract

Assuring treatment plan implementation following consultation is critically important because implementation is strongly related to outcomes. Treatment implementation has been hypothesized to be influenced by both the nature of the follow-up support provided and contextual variables. However, studies to date have not examined both issues while directly measuring implementation. This study examined treatment implementation following consultation for 48 teachers in public schools who had referred a student for intervention services in a randomized clinical field trial. Participating teachers in the experimental group received Integrated Support (IS). IS includes social influence, planning, and performance feedback elements. IS was compared to weekly follow-up meetings alone. Treatment implementation and child outcomes were markedly superior for IS as compared to weekly follow-up. Three school climate factors were found to be correlated with treatment implementation for the IS group, but not the weekly follow-up group. Participants rated treatment implementation, treatment acceptability, and consultant effectiveness positively and similarly across conditions. The implications of these findings for future work examining school culture, consultation and intervention are discussed.

Behavior modification, 2022 · doi:10.1177/01454455211054020