Carr et al. (2013) An Assessment-Based Solution to Human-Service Employee Performance PDF

An Assessment-based Solution to a Human-Service Employee Performance Problem An Initial Evaluation of the Performance Diagnostic Checklist – Human Services James E. Carr Behavior Analyst Certification Board David A. Wilder, Lina Majdalany, and David Mathisen Florida In...

An Assessment-based Solution to a Human-Service Employee Performance Problem An Initial Evaluation of the Performance Diagnostic Checklist – Human Services James E. Carr Behavior Analyst Certification Board David A. Wilder, Lina Majdalany, and David Mathisen Florida Institute of Technology and the Scott Center for Autism Treatment and Research Leigh Ann Strain Little Tree Preschool Practice points The Performance Diagnostic Checklist (PDC) has been used in a number of investigations to assess the environmental determinants of poor employee performance. The PDC was revised to explicitly assess the performance of employees in human-service settings who are responsible for providing care to others: the Performance Diagnostic Checklist – Human Services (PDC-HS). The PDC-HS was implemented at a center-based autism treatment facility to identify the variables contributing to employees’ poor cleaning of treatment rooms. Keywords: functional assessment, performance assessment, performance management, staff management 16 PERFORMANCE DIAGNOSTIC CHECKLIST – HUMAN SERVICES Behavior Analysis in Practice, 6(1), 16-32  The PDC-HS implicated a lack of proper training on participant duties and a lack of performance feedback as contributors to the performance problems. As a result, an intervention targeting training on participant duties and performance feedback was implemented across eight treatment rooms; the intervention increased performance in all rooms. This preliminary validation study suggests the PDC-HS may prove useful in solving performance problems in human-service settings. Functional assessment has become the standard of mance Diagnostic Checklist (PDC; Austin, 2000) is an care for identifying the function of problem behavior in informant assessment that is used to identify variables clinical and educational environments (Hanley, Iwata, that may impact poor performance. The PDC is com- & McCord, 2003). An approach akin to functional as- prised of 20 items and is typically conducted by inter- sessment has existed in organizational settings for years. viewing managers and supervisors about factors in four Often termed performance analysis or performance diag- domains: antecedents and information, equipment and nostics (Austin, 2000), this approach is used to identify processes, knowledge and skills, and consequences. Mul- the variables that influence an employee’s substandard tiple deficits in a specific area generally lead to subse- job performance. These influences can include insuf- quent prescribed intervention. ficient task training, insufficient consequences for task A number of recent empirical investigations have performance, and competing contingencies, among employed the PDC to help solve employee performance others. As with functional assessment, performance problems. For example, Rodriguez et al. (2005) stud- analysis is conducted in order to develop a more precise ied restaurant workers who did not offer promotional intervention that is conceptually linked to the variables stamps to customers on a frequent basis. The PDC responsible for the performance problem. For example, identified insufficient consequences for the task and a retraining would not be the optimal solution for an subsequent treatment package employee’s poor performance if said performance was largely a function of poorly designed work materi- als, as opposed to a skill deficit (for which retraining would be functionally matched). Operant models for conducting performance analysis have been proposed since the 1970s (e.g., Daniels, 1989; Gilbert, 1978; Mager & Pipe, 1970) and they all share the behavior-analytic character- istics of operationalizing skill deficits or excesses, considering environmental antecedents and con- sequences, and, ostensibly, linking treatment to assessment results. However, these models have resulted in very little research in the organizational behavior management (OBM) literature (Aus- tin, Carr, & Agnew, 1999). By contrast, a more recent performance analysis tool has influenced a number of empirical investigations. The Perfor- , 16-32 PERFORMANCE DIAGNOSTIC CHECKLIST – HUMAN SERVICES 17 that included feedback produced large improvements the recent performance analysis literature, its contribu- in the target behavior. Austin, Weatherly, and Gravina tion to human-service performance problems warrants (2005) studied restaurant workers who did not suf- investigation. ficiently perform closing tasks. The PDC identified a The PDC was designed primarily for business and “knowledge” deficit and a subsequent treatment package industry; thus, there are a number of items that are that included task clarification and feedback produced not directly relevant to human-service environments. reliable performance increases across two employee For example, the PDC’s section on “Equipment and classes. Eikenhout and Austin (2005) used the PDC to Processes” includes the following questions: “If equip- develop an intervention to ment is required, is it improve customer service reliable?”; “Is it in good by department store work- We developed a version of the working order?”; and “Is ers. The PDC identified it ergonomically correct?” insufficient consequences PDC to explicitly assess the Although equipment for the task and a subse- performance of employees in is sometimes used in quent treatment package human-service settings, that included feedback and human-service settings who are the presence of irrelevant praise produced reliable items or items that need performance improve- responsible for providing care to be translated into more ments. In a final example, to others: the Performance contextually relevant Pampino, Heering, Wilder, terms might diminish the Barton, and Burson (2003) Diagnostic Checklist – instrument’s utility. Thus, used the PDC to develop Human Services (PDC-HS). we developed a version an intervention to increase of the PDC to explicitly maintenance tasks per- assess the performance of formed by workers in a coffee shop. The PDC identified employees in human-service settings who are responsi- insufficient prompts and consequences for the tasks and ble for providing care to others: the Performance Di- a treatment package containing task clarification and a agnostic Checklist – Human Services (PDC-HS). The staff lottery produced large performance improvements. development process is described later. Although the PDC has been helpful in the devel- The PDC-HS, like the PDC, was designed to be opment of performance interventions for workers in used by practitioners to help identify environmental private industry, it has not yet been applied to the determinants that might contribute to employee perfor- performance of workers in human-service settings. mance problems. The daily activities of many practic- Organizational behavior management has long been ing behavior analysts frequently involve the oversight demonstrated as a successful approach to training and of staff responsible for behavior plan implementation. maintaining the repertoires of staff who deliver educa- Although the behavioral literature contains successful tional and therapeutic services (Reid & Parsons, 2000). demonstrations of staff management procedures (e.g., However, maintenance of performance in such settings Burgio et al., 1990), many of these involve default has been problematic, perhaps as a result of task dif- procedures such as feedback that are not necessarily ficulty and low educational requirements for many of matched to the determinants of the performance prob- these jobs. Poor performance in a human-service agency lem. The PDC-HS may be useful to practicing behavior can negatively impact the health and rate of improve- analysts by (a) helping them understand performance ment of those who are served, in addition to the agen- problems that do not respond to simple and quick solu- cy’s financial health. To the extent that the PDC has tions, and (b) by helping them develop a more sensitive, been causally related to the improvements reported in targeted intervention for those performance problems. 18 PERFORMANCE DIAGNOSTIC CHECKLIST – HUMAN SERVICES  The purpose of the present study was to evaluate the utility of the PDC-HS in the selection of treatments Method for human-service performance problems. The context Setting, Participants, and Materials for the evaluation was an early and intensive behav- ioral intervention (EIBI) center serving children with The present study was conducted at a university- autism. The present study also extended the existing based autism treatment center in the southeastern PDC literature by evaluating the instrument’s predictive United States. The center provided EIBI services to validity. Although the PDC has influenced a number of children between 3 and 7 years of age. Eight treatment recent studies, none of them included a nonfunction- rooms were used for the evaluation, each of which was based treatment comparison. That is, all of the studies approximately 3 m by 3 m in size. Therapists assigned evaluated a treatment (or treatment package) that was to work with children were responsible for cleaning and influenced by PDC results, but none evaluated a treat- arranging their treatment rooms at the end of each 1.5 ment that was not suggested by the PDC. Such an hr treatment session. We selected specific rooms that approach has been used to assess the predictive validity were not kept clean as targets during the study. of functional analysis procedures in the treatment of Participants included 15 staff members who were problem behavior in clinical environments (e.g., Iwata, graduate-student employees at the treatment center. All Pace, Cowdery, & Miltenberger, 1994). An assessment participants were female, between the ages of 23 and of predictive validity is particularly relevant to the PDC 27, and enrolled in a master’s degree program in applied because the majority of intervention components (e.g., behavior analysis. More than one participant worked in task clarification, feedback) evaluated in this line of re- some rooms, but no participant worked in more than search have often been demonstrated as effective in the one room. Participants worked as one-on-one therapists absence of performance analysis (e.g., Nolan, Jarema, & providing EIBI services to young children with autism. Austin, 1999). Thus, the ultimate contribution of the Upon hire, approximately 1 month before the current information obtained from the PDC to the reported study began, all participants were trained to perform all treatment outcomes is largely unknown. The present of the therapy room-cleaning duties listed in Appendix study included a nonfunction-based treatment com- A. This training included taking them into the room, parison to assess the predictive validity of the describing all of the tasks, and showing them PDC-HS. where the necessary materials were located. Materials included a checklist (Appendix A) describing items that the participants were responsible for cleaning (tailored to each room), a graph that was posted on the wall in each target room for delivery of daily feedback during the intervention phase, the PDC-HS (see Appendix B), and a video camera. Additional materials included items that were specified on the checklist: disin- fectant wipes, gloves, tissues, and a fully stocked first aid kit. The PDC-HS Development. The PDC-HS was developed to assess the environmental determinants of human-service staff PERFORMANCE DIAGNOSTIC CHECKLIST – HUMAN SERVICES 19 performance problems. The development process began which multiple items are endorsed. Interventions may with questions from the original PDC (Austin, 2000) be implemented concurrently or consecutively, with the being applied to the following common human-service latter option being preferred for settings in which staff performance problems: poor treatment implementation, resources are limited. Sample interventions and illustra- inaccurate data collection, inadequate development of tive literature citations for each area are provided at the program materials, poor attendance/tardiness, failure to end of the assessment. report problems to supervisors, and poor graph con- Data Collection and Interobserver Agreement struction. This process identified numerous areas for revision. The PDC’s section titles, section order, ques- The dependent measure was the percentage of tasks tion wording, and question order were then revised to correctly completed on the treatment room cleanli- better match human-service contexts and problems. ness checklist (Appendix A). Checklists differed slightly Besides the authors of this article, 11 behavior analysts depending on the arrangement of the room. Observers then provided input into the wording of the questions indicated that items were completed correctly by writing after being asked to review a plus sign next to the item; and pilot test the assess- incorrect or lack of com- ment. These professionals pletion of the item was had an average of 12 years Common human-service indicated by a negative (range, 4 to 35) working sign. Correct completion in human-service settings. performance problems include: of an item was defined as Nine of them held doc- poor treatment implementation, fully completing the item toral degrees and 10 of as listed on the checklist. them were Board Certi- inaccurate data collection, For example, one checklist fied Behavior Analysts® item was to have a box of (BCBAs®). After the final inadequate development gloves present and at least revisions were made, the half full. In order to count PDC-HS was evaluated in of program materials, poor as correctly completed, the present study. the box must have been Administration. The attendance/tardiness, failure to at least half full; the mere PDC-HS consists of 20 presence of the box was questions organized into report problems to supervisors, insufficient. Observers the following four sec- and poor graph construction. collected data 10–15 min tions: (a) Training; (b) after each session ended. Task Clarification & Participants were out of Prompting; (c) Resources, the room at this time and Materials, & Processes; and (d) Performance Conse- did not see the observers collecting data. quences, Effort, and Competition. Each of the four sec- A second independent observer collected data along tions includes 4 to 6 questions about task performance. with, but independent of, the primary data collector. The assessment is designed to be used by a behavior Interobserver agreement (IOA) data were obtained by analyst during an interview with the employee’s direct comparing observers’ data for each item on the checklist supervisor or manager. Thirteen of the questions may on an item-by-item basis. Point-by-point agreement be answered based on informant report and 7 should was calculated by dividing the number of agreements by be answered via direct observation. Each item scored as the total number of checklist items, and converting the No on the PDC-HS should be considered as an oppor- ratio to a percentage. Agreement was assessed for at least tunity for intervention, with priority given to areas in 40% of sessions (range, 40% to 71%) in eight treatment 20 PERFORMANCE DIAGNOSTIC CHECKLIST – HUMAN SERVICES rooms. Means and ranges for IOA data were as follows: Training and graphed feedback. Based on the Room A, 96% (range, 78% to 100%); Room B, 97% results of the PDC-HS, training and graphed feedback (range, 82% to 100%); Room C, 96% (range, 81% to were introduced. The experimenter entered before the 100%); Room D, 96% (range, 81% to 100%); Room session and described each item on the checklist to the E, 95% (range, 75% to 100%); Room F, 93% (range, participant to ensure she understood the tasks she was 78% to 100%); Room G, 93% (range, 80% to 100%); to complete at the end of the session. The checklist was and Room H, 91% (range, 78% to 100%). posted to a wall of the room and available for partici- pants to review during this phase, but participants were Procedure not given a copy of the checklist to take with them. In We first began collecting baseline data on task com- addition, the experimenter informed the participants pletion of cleaning duties using the room cleanliness that graphed data would be posted regularly, and where checklist. After baseline data were collected, the third to find the materials needed to complete the tasks, but author (a master’s-level BCBA) used the PDC-HS to in- the materials were not placed in one salient location in dividually interview three supervisors (the respondents) the room. After the training was complete, the experi- who oversaw all center operations about the problems menter asked the participant not to mention the check- they were having with treatment room cleanliness. The list to anyone else to help preserve the integrity of the interviewer also conducted all direct observation com- multiple-baseline design. After this training, the experi- ponents of the PDC-HS. All supervisors were masters- menter had no additional contact with the participants, and doctoral-level BCBAs with 3 to 10 years of experi- except when a participant asked a question, to which ence in the field. After we completed the interviews, we the experiment replied, “I can’t answer that.” Within 5 reviewed the results, identified two interventions based minutes after each session, the experimenter graphed on the results, and began implementing the interven- the data for the room and posted it on a wall next to the tions. We used a (concurrent) multiple-baseline design checklist. The participants were not in the room when across treatment rooms to evaluate intervention effects. the data were posted. The updated data were available The first intervention consisted of training and post- for the participants to view when they entered the room ed, graphed feedback. These interventions were based again, which was typically immediately before their next on the results of the PDC-HS, especially the Training session. and Performance Consequences sections. A second Task clarification and increased availability of intervention was introduced for two of the rooms (G, materials. Task clarification and increased availabil- H). The second intervention consisted of task clarifica- ity of materials were introduced for rooms G and H. tion and more convenient placement of the materials Task clarification consisted of posting the checklist in a necessary for task completion. These two intervention salient location in the room (directly in front of them components were based on the Task Clarification and upon entry); however, the experimenter did not speak Prompting and Resources, Materials, and Processes about the checklist with the participants working in the sections, which were not identified as being problematic rooms. In addition, all the materials necessary to com- based on the results of the PDC-HS. The purpose of plete the tasks on the checklist were placed in a salient the second intervention was to examine the effects of a location in the room (near the checklist), but no infor- nonindicated intervention on task completion. mation on what to do with these materials was provided Baseline. During baseline, we evaluated each room and no feedback on performance was delivered. After using the cleanliness checklist after the participants had the training was complete, the experimenter asked the completed their treatment session and left. Observers participant not to mention the checklist to anyone else made no contact with participants and no feedback was to ensure independence between rooms. After this train- provided on room cleanliness. ing, the experimenter had no additional contact with the participants. PERFORMANCE DIAGNOSTIC CHECKLIST – HUMAN SERVICES 21  mance problems for all 3 of the BCBA respondents Results interviewed. For respondents 1 and 2, 75% and 80% of the questions on the Training section and the Conse- PDC-HS quences, Effort, and Competition section, respectively, Figure 1 depicts the results of the PDC-HS. The suggested a problem. For respondent 3, 75% of the PDC-HS identified a lack of proper training on par- questions on the Training section and 60% of the ques- ticipant duties and a lack of feedback on performance tions on the Consequences, Effort, and Competition as potentially being responsible for participant perfor- section suggested a problem. For all respondents, the Figure 1. Results from the PDC-HS across BCBA respondents. 22 PERFORMANCE DIAGNOSTIC CHECKLIST – HUMAN SERVICES Task Clarification and Prompting and the Resources, clarification and increased availability of materials) Materials, and Processes sections included fewer ques- was also implemented across two of the same rooms. tions indicating a problem. Both implementations of the alterative intervention were ineffective. These data suggest that the PDC-HS Intervention Evaluation streamlined the treatment process by helping to iden- Figure 2 depicts the results of the intervention evalu- tify relevant factors and disregard irrelevant factors in ation. The intervention was first implemented in rooms treatment selection. This strategy of assessing predic- A and B. The baseline mean for Room A was 47% tive validity—comparing indicated and nonindicated complete; training and feedback increased performance interventions—had not yet been employed in the PDC to a mean of 97% complete. For Room B, the baseline or OBM literatures, but it is consistent with behavior- mean was 26% complete. The mean during training analytic research in other areas (e.g., Iwata et al., 1994). and feedback was 98% complete. Next, the interven- Although social validity was not formally assessed tion was implemented for rooms C and D. For Room in the current investigation, anecdotal reports from the C, the baseline mean was 38% complete; training and staff members who participated in both the PDC-HS feedback increased the mean to 96% complete. For interviews and the intervention evaluation suggest that Room D, the baseline mean was 41% complete; train- they found the PDC-HS and the resulting intervention ing and feedback increased the mean to 97% complete. to be useful. For example, one staff member reported For Room E, the baseline mean was 27% complete. The that the PDC-HS would enable her to “quickly and mean during the training and feedback phase was 92% easily assess what needs to be done to help employees complete. For Room F, the baseline mean was 31% to do their job.” Further, the center-based program has complete; training and feedback increased the mean to continued to use the intervention long after the conclu- 92% complete. For Room G, the baseline mean was sion of the study. 25% complete. The mean during the task clarification The results of the present validation study should be and increased material availability phase was 36% com- evaluated in the context of several considerations. First, plete. The mean during the training and feedback phase we assessed only a limited range of the content of the was 100% complete. For Room H, the baseline mean PDC-HS. Specifically, we assessed interventions de- was 18% complete. The mean during task clarification signed to address problems with training and feedback. and increased availability of materials was 12% com- Interventions designed to address identified problems plete. The mean during the training and feedback phase with prompting and the availability of materials were was 80% complete. not examined. Systematic replications exploring these other areas would be useful in future research. Discussion Second, it is possible that other nonindicated in- Three BCBAs at a center-based autism treatment terventions may have been equally effective to increase facility were interviewed using the PDC-HS to identify performance. We only assessed the efficacy of training, the variables contributing to poor cleaning of treatment feedback, task clarification, and increased availability rooms by therapist employees. The PDC-HS implicated of materials. Intervention components unrelated to a lack of proper training on participant duties and a lack PDC-HS results, such as goal setting or the presence of of performance feedback as contributors to the perfor- a manager, may have been equally effective to increase mance problems. An intervention (training and graphed participant performance. That said, it would have been feedback) targeting these variables was implemented impractical to assess all nonindicated interventions. across eight treatment rooms; the intervention increased Furthermore, the interventions that were evaluated were participant performance in all rooms. In addition, an logically related to the problem (increased availability of alternative intervention that included components not materials) or commonly studied in the empirical litera- identified as being problematic by the PDC-HS (task ture (e.g., task clarification; Austin et al., 2005). Thus, PERFORMANCE DIAGNOSTIC CHECKLIST – HUMAN SERVICES 23  Figure 2. Percentage of completed tasks in each treatment room during the following conditions: baseline, training + graphed feedback, and task clarification + increased availability of materials (TC + Materials). 24 PERFORMANCE DIAGNOSTIC CHECKLIST – HUMAN SERVICES we contend that, although not exhaustive, the present problems would also be valuable. Common problems treatment comparison was a fair one. such as tardiness and absenteeism, procedural integrity Third, because the intervention that proved suc- failures, and unsafe behavior might be impacted by dif- cessful was a package of two components (training and ferent environmental factors. Thus, studies of different feedback), it is impossible to identify their individual performance problems might also be opportunities to contributions to performance improvement. Future evaluate a fuller range of variables on the PDC-HS. An studies of interventions indicated by the PDC-HS analysis of PDC-HS outcomes for a large staff sample would be better served by single-intervention compo- in a proscribed area (e.g., 50 direct-care staff members nents so that the assessment’s prediction can be better serving adult consumers) would also be important. Such evaluated. an “epidemiological” analysis would enable one to iden- Fourth, unlike some prior training applications, tify common performance problems and the proportion participants were not given a written description of the of different environmental determinants that might tasks in the training and graphed feedback condition lead to the development of improved default training (although a checklist was posted in the room). It is pos- and management procedures. This approach has been sible that this treatment package would have been even successful with client problem behavior (e.g., Iwata et more effective if participants had physical possession al., 1994) and might be similarly useful in organiza- of the checklist. However, in an effort to maintain the tional settings. In addition, as we modified the PDC for functional independence of our multiple baselines, the human-service settings, the instrument could be further decision was made to omit this step during training. modified for other purposes (e.g., skill deficits in aging Fifth, IOA on the administration of the PDC-HS populations). Finally, as a further test of the utility of was not assessed. It is possible that the involvement of the PDC-HS, researchers could compare the effects of other interviewers or informants would have yielded staff-management interventions between behavior ana- different results. Future research on the reliability of the lysts who do or do not use the assessment. It is possible administration of the PDC-HS would be an important that practicing behavior analysts already ask the ap- contribution to this line of research. propriate questions when diagnosing staff performance Finally, the indirect nature of the PDC-HS is an problems and intervene accordingly. Although this has inherent limitation. As mentioned previously, many not been our observation, the premise is certainly test- performance problems are behavioral deficits, not be- able. havioral excesses. Behavioral deficits are not particularly In conclusion, the present article contributes to the well suited for direct-observation assessment such as performance management literature by introducing descriptive assessment or functional analysis. Thus, until the PDC-HS, an assessment that can be used to exam- this barrier is eliminated, indirect assessment such as the ine the variables that contribute to staff performance PDC-HS may prove useful. problems in human-service settings. Given the prolifera- As with the development of any new assessment tion of human-service environments and the ongoing tool, there are a number of opportunities for additional staff management challenges in those environments, research. Among the most pressing research needs are the PDC-HS should be useful, if not in always identify- systematic replications of the PDC-HS with different ing effective interventions, then by getting practicing classes of human-service staff members from different behavior analysts to attend to a wider array of factors care settings. In the present study, all of the staff mem- that can affect supervisee performance and rely less on bers were young, college educated, and committed to common default interventions such as retraining. The careers in behavior analysis. This sample is, admittedly, present study also extends the literature on the PDC by not representative of many human-service staff popu- demonstrating a method for assessing predictive valid- lations for whom the PDC-HS may be differentially ity, a strategy that should be employed to assess newly useful. Systematic replications with other performance developed functional assessment procedures. PERFORMANCE DIAGNOSTIC CHECKLIST – HUMAN SERVICES 25  References Mager, R. F., & Pipe, P. (1970). Analyzing performance problems. Belmont, CA: Fearon Publishers. Austin, J. (2000). Performance analysis and perfor- Nolan, T., Jarema, K., & Austin, J. (1999). An objec- mance diagnostics. In J. Austin & J. E. Carr (Eds.), tive review of Journal of Organizational Behavior Handbook of applied behavior analysis (pp. 321–349). Management: 1986–1997. Journal of Organizational Reno, NV: Context Press. Behavior Management, 19(3), 83–115. Austin, J., Carr, J. E., & Agnew, J. L. (1999). The Pampino, R. N., Heering, P. W., Wilder, D. A., Barton, need for assessment of maintaining variables in C. G., & Burson, L. M. (2003). The use of the Per- OBM. Journal of Organizational Behavior Manage- formance Diagnostic Checklist to guide intervention ment, 19(2), 59–87. selection in an independently owned coffee shop. Austin, J., Weatherly, N. L., & Gravina, N. E. (2005). Journal of Organizational Behavior Management, 23 Using task clarification, graphic feedback, and verbal (2–3), 5–18. feedback to increase closing-task completion in a pri- Reid, D. H., & Parsons, M. B. (2000). Organizational vately owned restaurant. Journal of Applied Behavior behavior management in human service settings. In Analysis, 38, 117–120. J. Austin & J. E. Carr (Eds.), Handbook of applied Burgio, L. D., Engel, B. T., Hawkins, A., McCormick, behavior analysis (pp. 274–294). Reno, NV: Context K., Scheve, A., & Jones, L. T. (1990). A staff Press. management system for maintaining improvements Rodriguez, M., Wilder, D. A., Therrien, K., Wine, B., in continence with elderly nursing home residents. Miranti, R., Daratany, K. Salume, G., Baranovsky, Journal of Applied Behavior Analysis, 23, 111–118. G., & Rodriguez, M. (2005). Use of the Perfor- Daniels, A. C. (1989). Performance management. mance Diagnostic Checklist to select an intervention Tucker, GA: Performance Management Publications. designed to increase the offering of promotional Eikenhout N., & Austin, J. (2005). Using goals, stamps at two sites of a restaurant franchise. Jour- feedback, reinforcement, and a performance matrix nal of Organizational Behavior Management, 25(3), to improve customer service in a large department 17–35. store. Journal of Organizational Behavior Manage- ment, 24(3), 27–64. Gilbert, T. F. (1978). Human competence. New York: Author Notes McGraw-Hill. We thank Ivy Chong and Alison Betz for their assistance Hanley, G. P., Iwata, B. A., & McCord, B. E. (2003). in arranging data collection. The content of this article Functional analysis of problem behavior: A review. does not reflect an official position of the Behavior Ana- Journal of Applied Behavior Analysis, 36, 147–185. lyst Certification Board. Iwata, B. A., Pace, G. M., Cowdery, G. E., & Milten- Address correspondence to James E. Carr, Behavior berger, R. G. (1994). What makes extinction work: Analyst Certification Board, 1929 Buford Blvd., Talla- An analysis of procedural form and function. Jour- hassee, FL 32308; [email protected]. nal of Applied Behavior Analysis, 27, 131–144. 26 PERFORMANCE DIAGNOSTIC CHECKLIST – HUMAN SERVICES  Appendix A Treatment room cleanliness checklist. Treatment room cleanliness checklist. Safety and Sanitation Counter/Cabinet o Is at least one hand sanitizer pump, one box of gloves in each size (S,M,L), and one opened container of Clorox Wipes present, and on the counter? o Is at least one full backup pump of hand sanitizer present, and in the cabinet above the sink? o Is at least one full backup box of each glove size (S,M,L) present, and in the cabinet above the sink? o Is at least one unopened backup container of Clorox Wipes present, and in the cabinet above the sink? o Is a fully stocked first aid kit in the cabinet? (includes Band-Aids, alcohol wipes, and gauze) Panic Button o Is the panic button present, and does it match the room number written on the back of it? o Are the alarms working? Room Organization Are only essential materials on the counter tops (i.e., hand sanitizer, gloves, tissues, Clorox Wipes), otherwise countertops are clear? Is the CD player present and on top of the shelf below the whiteboard that holds Legos? Are the tables in the correct place? (1 U-shaped table in front of sink, straight edge parallel to counter) Are all chairs tucked under the tables? Are the easels (2) set up between the early learner classrooms, with drawing surfaces facing each classroom? Are art supplies cleaned up? (i.e., easels cleaned off, paintbrushes washed, containers closed, and supplies put away in the cabinet above the sink) Are toys in appropriately labeled bin, or in appropriate place if there is no labeled bin? (e.g., a ball is not found in the tub labeled cars, puzzles are neatly stacked on the shelf or placed in stacker) Are bins and large toys neatly along the wall or on a shelf? Are books placed upright on bookshelf in an organized manner? Are cabinet doors and drawers closed? Floors and Tables Is trash thrown away? (i.e., not on floor or table tops) PERFORMANCE DIAGNOSTIC CHECKLIST – HUMAN SERVICES 27  Appendix B 28 PERFORMANCE DIAGNOSTIC CHECKLIST – HUMAN SERVICES PERFORMANCE DIAGNOSTIC CHECKLIST – HUMAN SERVICES 29 30 PERFORMANCE DIAGNOSTIC CHECKLIST – HUMAN SERVICES PERFORMANCE DIAGNOSTIC CHECKLIST – HUMAN SERVICES 31 32 PERFORMANCE DIAGNOSTIC CHECKLIST – HUMAN SERVICES