Define Treatment-Integrity Components and Opportunities

To define treatment integrity components and opportunities, translate the procedure into observable steps and state exactly when each step is due. Include sequence, timing, accepted variation, required supports, and invalid conditions. Separate an implementer error from a missing opportunity, inaccessible communication, client withdrawal, or a clinician-authorized adaptation. Pilot the definitions with more than one observer before using scores for decisions.

Write one observable component per line

State who acts, what counts, when it is due, and the accepted range. Replace labels such as supportive or calm with actions an observer can score.

Include the cue, actor, response, timing, allowed materials or prompts, partner outcome, and valid adaptation. Separate combined statements when one part could occur without the other. Use language that trained observers and implementers can apply without guessing intent. Link every component to the current approved procedure version so later revisions do not silently alter the scoring dictionary.

Define the eligible opportunity

Specify the cue, setting, required people and materials, time window, and exclusions. An opportunity exists only when the component could legitimately occur.

Distinguish opportunities planned, available, offered, declined, invalid, and completed. A partner cannot score an available-choice response when the choice was never accessible, and a missing communication device may invalidate the opportunity rather than create a client error. Record conditional cues and which system condition prevented an opportunity. The denominator should reflect the actual question being measured.

Preserve sequence and timing

A step can occur yet miss the clinically relevant order or window. Score occurrence, sequence, and timing separately when those distinctions affect interpretation.

Define the relevant interval in observable terms, such as before a demand, within a stated response window, or after a recognizable request. Avoid millisecond precision unless the procedure and observation method justify it. Record out-of-sequence and late performance distinctly from total omission. This lets coaching or plan review target the aspect that may affect the proposed mechanism.

Pilot disagreement

Have two trained observers score the same examples and explain disagreements. Revise ambiguous wording before using the dictionary to judge implementation.

Test common cases, edge cases, valid adaptations, missing supports, client withdrawal, and events that should be excluded. Require independent scoring before discussion and document whether disagreement concerns opportunity detection, component occurrence, timing, or calculation. Repeat the pilot after revisions. Preserve unresolved items and limit the measure's use until the rule can support consistent, fair observation.

Publish the final dictionary with its version, approver, effective date, examples, and relationship to the clinical procedure. Train implementers and observers on the same governing definitions while keeping their roles distinct. Monitor which states are used unexpectedly often. A surge in invalid or unresolved opportunities can reveal a poorly written rule or plan-context mismatch that needs review.

Put the component and opportunity definitions into practice

Benicio's dictionary defines when the bus-preparation cue occurs, when AAC and the visual schedule must be available, which partner responses are due, and when the routine ends. A cancelled bus, unavailable AAC, and an agreed pause receive distinct states instead of becoming zeros or disappearing from the denominator.

Compare measurement options for Benicio

Benicio's team compares direct observation, component scoring, opportunity sampling, duration, permanent product, structured interview, system record, and direct client feedback only when each option can answer the component and opportunity dictionary's decision. Record validity, visibility, reactivity, effort, privacy, access, timeliness, and what each source cannot establish.

Pilot Benicio's component and opportunity dictionary

Test the definition, form, observer instructions, technology, access, timing, missing-data states, and review workflow in representative conditions. Ask Benicio and the implementer whether the process changes the routine or adds burden. Revise the measurement system before using it for coaching, treatment change, supervision, or performance decisions.

Protect access and clinical responsibility for Benicio

Benicio's review keeps AAC, interpreters, mobility, food, water, bathroom use, prescribed care, health support, rest, relationships, and emergency help available. Obtain required consent and assent when applicable and follow the governing response to withdrawal or distress. A qualified clinician retains responsibility for clinical interpretation and treatment decisions; a fidelity score does not transfer that responsibility.

Keep procedure versions and evidence states separate

For Benicio, record the active procedure version, date, author, authorized adaptations, temporary responses, observed deviations, missing evidence, and unresolved classifications. Preserve the original record. Add a dated explanation whenever a correction or later review changes the procedure version used to judge an observation.

Ask six integrity questions for Benicio

Use these questions in the component and opportunity dictionary:

Which decision, procedure version, component, cue, and eligible opportunity apply?
Which client, implementer, setting, time, and observation conditions were sampled?
Which access, safety, health, consent, assent, and communication supports were present?
Which integrity, exposure, outcome, experience, adverse-effect, and agreement series stay separate?
Which missing evidence, adaptation, drift, burden, reactivity, or concurrent change limits interpretation?
Which owner, repair, stop rule, next evidence step, and review date follow?

Keep every unresolved item visible with a state, owner, age, and next action.

A fictional integrity example for Benicio

Benicio is fictional and involved in a morning bus-preparation routine using a visual schedule and AAC. Reviewers freeze 29 cue, component, sequence, timing, opportunity, access, invalid-state, observer, and version fields and complete 21 of 29 by the checkpoint. Every missing, unobservable, inapplicable, adapted, drifted, failed, or pending field keeps its defined state.

The component and opportunity dictionary measures evidence completeness. It does not establish effectiveness, safety, acceptability, medical necessity, authorization, payment, compliance, generalization, maintenance, or causation. Report the applicable raw counts and conditions before a percentage.

Use current sources within their scope for Benicio

For Benicio's component and opportunity dictionary, the CASP public summary supplies high-level individualized assessment, implementation, and evaluation scope for ABA treatment of autistic people. The BACB Ethics Code addresses competence, client involvement, consent and assent when applicable, risk, documentation, supervision, and evaluation for covered behavior analysts. The BCBA Test Content Outline includes procedural fidelity as examination content; it is not a case protocol or universal threshold.

For Benicio's component and opportunity dictionary, the Ferguson practitioner guide supports observable component and eligible-opportunity design. The Essig, Rotta, and Poling review supports caution about the consistency and interpretation of fidelity reporting in the literature it examined. ASHA's AAC guidance says AAC users should always have access to their communication tools or devices. None of these sources makes one sampling rate, percentage, or repair rule valid for every case.

Close Benicio's review

Ask Benicio and each implementer to review the component and opportunity dictionary through accessible communication. Record the selected decision, raw evidence, procedure version, direct feedback, limitations, responsible role, repair, next observation, and review date. Reopen the analysis when the goal, procedure, client preference, access, health, setting, implementer, risk, or outcome changes.

How to Define Treatment-Integrity Components and Opportunities