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Received: 18 October 2017 Revised: 19 July 2018 Accepted: 23
July 2018
DOI: 10.1002/bin.1641
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The effects of errorless compliance training on
children in home and school settings
Hannah J. Cavell1 | Keith C. Radley2 | Brad A. Dufrene1 |
Daniel H. Tingstrom1 | Emily A. Ness1 | Ashley N. Murphy1
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1Department of Psychology, University of
Southern Mississippi, Hattiesburg, Mississippi
2Department of Educational Psychology,
University of Utah, Salt Lake City, Utah
Correspondence
Keith C Radley, Department of Educational
Psychology, University of Utah, 1721 Campus
Center Dr. #3225, Salt Lake City, UT 84112.
Email: [email protected]
Behavioral Interventions. 2018;33:391–402. w
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Errorless compliance training (ECT) is a procedure used to
lessen disruptive behavior using a gradual and noncoercive
approach. In this study, parents of three school‐aged chil-
dren who demonstrated high levels of disruptive behavior
in the home and the classroom were trained on the ECT
procedure. ECT consisted of training in effective instruction
delivery and delivery of requests in a hierarchal manner.
ECT sessions took place in the home, with parents deliver-
ing requests to participating children. Baseline data were
used to arrange requests into grouped levels, ranging from
Level 1 (requests of which individual is typically compliant)
to Level 4 (requests in which individual is typically noncom-
pliant). Using the ECT procedure, request levels were faded
over time in a gradual fashion to ensure the highest proba-
bility of compliance. Effects of ECT were hypothesized to
generalize from the home to the school setting. Implemen-
tation of ECT resulted in high levels of compliance in both
the home and school settings across all participants. Impli-
cations and limitations are discussed.
KEYWORDS
compliance, errorless compliance training, generalization, hi‐p
command sequences, single‐case design
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1 | INTRODUCTION
Noncompliance is a frequently targeted childhood behavior
problems (e.g., Forehand & McMahon, 1981). Noncom-
pliance occurs when a child fails to complete a given instruction
(Stephenson & Hanley, 2010). Teachers often cite
behaviors that arise as a result of noncompliance as a reason for
poor academic performance and underdeveloped
peer relationships (Roberts, Tingstrom, Olmi, & Bellipanni,
2008), noncompliance resulting in a disruption of
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educational opportunities (Rhode, Jenson, & Reavis, 1992).
Addressing behavioral issues in the classroom detracts
from instructional time for both the child and his or her peers
(Di‐Martini‐Scully, Bray, & Kehle, 2000). Given the
potential educational and social impact of child noncompliance,
researchers point to early identification and interven-
tion as an essential strategy (Gresham, Lane, &
Beebe‐Frankenberger, 2005).
Compliance has been identified as a keystone behavior, meaning
that improvements in compliant behaviors are
likely to have reductive effects on other problematic behaviors
not directly targeted by an intervention (Barnett,
Bauer, Ehrhardt, Lentz, & Stollar, 1996). For example, being
that compliance and defiance are functionally incompat-
ible (Mace & Belfiore, 1990), an increase in compliant behavior
is likely to lead to decreases in oppositional behavior
and increases in communication skills and on‐task behavior
(Ducharme, Atkinson, & Poulton, 2001). Due to the key-
stone nature of compliance, a variety of procedures have been
implemented to address noncompliance in children.
Antecedent manipulations are frequently implemented to
address child compliance (Radley & Dart, 2016).
Antecedent manipulations describe a class of intervention
strategies that involve the manipulation of environ-
mental stimuli prior to the occurrence of a target behavior
(Cooper, Heron, & Heward, 2007). In a recent review of
antecedent manipulations for noncompliance, Radley and Dart
(2016) identified high‐probability (hi‐p) command
sequences as the most frequently researched strategy. Hi‐p
command sequences describe a procedure in which a
child is presented with a series of requests (i.e., an antecedent
to a behavior) that are likely to be met with compliance
prior to the delivery of a low‐probability request (Rortvedt &
Miltenberger, 1994). As a child engages in hi‐p requests,
momentum is built toward compliance with the low‐probability
request. With each instance of compliance, reinforce-
ment for compliance is provided (e.g., praise and preferred
item), with researchers finding the delivery of reinforce-
ment to be a critical element in hi‐p command sequences
(Lipschultz & Wilder, 2017). Radley and Dart (2016)
identified 14 studies in their review, with support being
provided for children with a range of disabilities and no iden-
tified disability. Further, hi‐p command sequences were found
to result in increased compliance in diverse settings
(e.g., home and school; Lipschultz & Wilder, 2017; Radley &
Dart, 2016).
Researchers have suggested that hi‐p command sequences may
be effective interventions for promoting compli-
ance with requests as they establish behavioral momentum.
More specifically, reinforcement of hi‐p requests has an
influence on the general response class of compliance. Once
reinforcement has been provided to hi‐p requests, suf-
ficient behavioral momentum is developed so as to result in
compliance with lower‐probability requests (Mace et al.,
1998). Alternatively, hi‐p command sequences may be effective
as they promote resistance to extinction. That is,
compliance with hi‐p requests results in increased reinforcement
when particular discriminative stimulus is present
(i.e., person giving the request). This results in a higher
probability that an individual will continue to engage in
responses that result in reinforcement in the presence of this
same discriminative stimulus (Nevin & Grace, 2000).
Errorless compliance training (ECT; Ducharme & Popynick,
1993) is a compliance training procedure that is sim-
ilar to hi‐p command sequences, as commands are provided in a
specified order beginning with hi‐p commands. ECT
differs from hi‐p command sequences in that hi‐p command
sequences utilize a short interinstruction interval (i.e.,
requests are presented in close temporal proximity to each
other), whereas this is not required in ECT. Further,
ECT differs in that potential commands are divided into four
levels of compliance probability. Initially, only commands
from hi‐p levels are provided to a child. Further differences
between ECT and hi‐p command sequences are also
noted in that, similar to demand fading (e.g., Piazza, Moes, &
Fischer, 1996), low‐probability commands are gradually
introduced once a general repertoire of compliance has been
established. This ensures that the child maintains a high
level of compliance throughout the intervention and contacts a
frequent positive reinforcement for compliant behav-
ior. This establishment of a pattern of compliance in a particular
context or in the presence of a particular discrimi-
native stimulus may play a critical role in ECT.
In one of the first studies of ECT, compliance to maternal
requests was addressed in four children with develop-
mental disabilities (Ducharme & Popynick, 1993). After
completing a probability questionnaire of child compliance,
parent participants were then video recorded delivering
commands to their children. Requests were then arranged
into levels according to compliance data. Ten requests were
selected for baseline data analysis, followed by four
intervention phases. Seven requests were presented for each
level of ECT, with Level 1 representing requests that
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the child was most likely to comply with and Level 4
representing requests that the child was least likely to comply
with, with two sessions occurring each week. Transition
sessions occurred between phase sessions for increased
gradual introduction of low‐probability requests, with transition
sessions including requests from both the previous
and next level. Generalization data were collected for all four
levels of ECT, using requests to which the child had
not yet been exposed. Follow‐up data were collected using
requests from each of the four levels.
Whereas baseline data indicated low levels of compliance across
participants, introduction of ECT resulted in
immediate increases in compliance. Further, high levels of
compliance were noted as the intervention progressed
from Level 1 requests to Level 4. Follow‐up data indicated
maintained improvements in compliance for up to
3 months. Additionally, participants' improvements in compliant
behavior were found to generalize to novel requests
provided by parents. Although generalization was observed, the
researchers noted that criterion levels of generaliza-
tion were observed only following implementation of ECT for
level 4 requests.
Subsequent evaluations of ECT have demonstrated
improvements in compliance in home, clinic, and school set-
tings for typically developing children and children with
developmental disabilities and have replicated findings of
generalization across requests (e.g., Drain, 2012; Ducharme &
DiAdamo, 2005; Ducharme & Drain, 2004; Ducharme
& Ng, 2012; Rames‐LaPointe, Hixon, Niec, & Rhymer, 2014).
Generalization has also been documented across types
of requests, with generalization indicated from academic
requests to general requests (Ducharme & Drain, 2004).
Despite the burgeoning support for ECT as an effective means
of promoting compliance, the literature base is limited
in assessing generalization across persons and settings.
Although one study has assessed changes in compliance in
both school and home settings, the study involved concurrent
implementation of the intervention in both settings.
As such, it is unknown whether implementation of ECT in one
setting (e.g., home) would result in concurrent
improvements in settings in which the intervention has not been
utilized (e.g., school). This study seeks to address
this limitation through evaluation of the generalized effects of
ECT on compliance in a nontraining setting (i.e., gen-
eralization from home to school settings). Specifically, the
current study sought to determine whether implementa-
tion of ECT in the home setting resulted in increased
compliance with parental requests at home, as well as
generalized improvements to teacher requests at school. Finally,
the current study sought to evaluate the effect of
ECT on parent‐reported stress.
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2 | METHOD
2.1 | Participants
Participants consisted of two elementary school‐aged children
enrolled in general education classrooms, and one
eighth‐grade student enrolled at a specialized school for
children with disabilities. Participants were recruited from
a university‐based clinic. Inclusionary criteria included both
teacher and parent reports of noncompliance, with non-
compliance demonstrated in both home and school settings.
Parental and teacher consent, as well as child assent,
was obtained prior to participation in the study. Permission
from a university Institutional Review Board was received
prior to initiation of the study.
Taylor was a 7‐year‐old African American male attending first
grade in a general education classroom. Taylor has
no psychological diagnoses and had never received academic or
behavioral services prior to inclusion in this study. As
he frequently exhibited noncompliant behavior after school at a
daycare facility, ECT was implemented at his daycare
rather than in his school classroom. Taylor's instructor was an
African American male who worked as an after‐school
daycare program instructor. All home procedures were
implemented by Taylor's mother.
Samuel was a 12‐year‐old male enrolled in a school for students
with developmental disabilities. Assessment
data indicated a full‐scale IQ score of 60, as well as
impairments in adaptive functioning across multiple domains.
Samuel had previously been diagnosed with autism spectrum
disorder and an intellectual disability by a licensed psy-
chologist. Samuel's mother expressed interest in compliance
training due to pervasive noncompliant behavior in
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multiple settings (i.e., clinic and school). Samuel's teacher was
a female with a Bachelor's degree in History. She was
currently in her eighth year of teaching. All home procedures
were implemented by Samuel's mother.
Francis was a 6‐year‐old male attending kindergarten in a
general education classroom. He received weekly
school‐based math and reading intervention services as a result
of being retained. However, Francis did not receive
special education services and had no diagnoses. As frequent
noncompliance impacted his academic performance, he
was referred to the university‐based clinic for compliance
training. Francis' mother had received some compliance
training assistance as part of routine clinic services but had
never been exposed to ECT. Francis' teacher was a
35‐year‐old female with a Master's degree in Education. She
was currently in her twelfth year of teaching. All home
procedures were implemented by Francis' mother.
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2.2 | Settings and materials
Parent training workshops were conducted at the university
clinic for both Francis and Samuel, and at a daycare
facility for Taylor. Collection of baseline, treatment, and
follow‐up compliance data took place at each child's home
with a parent delivering requests to their child. Generalized
effects of compliance training were assessed in each
child's school classroom. For assessments for generalization,
teachers of participants delivered requests and child
compliance was recorded via direct observation in the child's
classroom. iPods were used to collect ECT data in
the home. Parents used iPods to video record ETC sessions with
their child by placing the iPod in an unobtrusive
location.
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2.3 | Dependent variables
2.3.1 | Child compliance
The primary dependent variable of the current study was child
compliance with target adult requests. Child compli-
ance was defined as initiating and completing an indicated
response within 5 s of request issuance by the adult. If a
child failed to initiate and complete a response within 5 s, the
child's behavior was recorded as noncompliant. To
assess child compliance, 12 requests were given by parents
during each session (e.g., go to the [area of house] and
pick up your [item]), with 10 requests being given by teachers
during each session. Compliant behavior in the home
setting was assessed through parents' video recorded compliance
sessions. To assess generalization, compliant
behavior was assessed through direct observation of compliance
with commands delivered by the child's teacher
in the classroom. Classroom commands were related to school
behavior (e.g., draw a picture and cut out the shape)
and differed from requests given in the home setting. For both
home and classroom settings, compliance with any
request outside those indicated was not considered. A graduate
student trained in behavioral observations observed
all ECT generalization sessions in the school.
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2.3.2 | Parenting Stress Index Short Form
As increases in compliance were expected to be associated with
decreased parent stress, the Parenting Stress Index
Short Form (PSI‐SF; Abidin, 1995) was administered as a
measure of social validity of intervention procedures. The
PSI‐SF is composed of 36 questions and addresses the following
three domains: Parental Distress (e.g., general
feelings of stress), Child Difficulty (e.g., child characteristics
that contribute to parent stress), and Parent–Child
Dysfunctional Interactions (e.g., beliefs regarding whether
children meet expectations). Normative data indicate an
alpha of .85, suggesting acceptable internal validity. The
PSI‐SF has been shown to not produce differences in
responding based on gender (Baker et al., 2003). Parent
participants completed the PSI both before engaging in
ECT procedures and following the completion of the study.
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2.4 | Data analysis
The effects of ECT on child compliance were assessed through
visual analysis, more specifically, changes in trend,
level, variability, immediacy of effect, overlap, and consistency
across similar phases. Visual analysis of data was sup-
plemented through statistical analysis usingTau‐U (Parker,
Vannest, Davis, & Sauber, 2011). Tau‐U is a nonparametric
measure of overlap across phases. Tau‐U has several advantages
over other nonoverlap statistics, particularly in its
ability to control for baseline trend. Tau‐U scores were
interpreted using guidelines provided by Vannest and Ninci
(2015). Specifically, a score of 0.20 or less was considered a
small change, scores from 0.20 to 0.60 were considered
to be moderate changes, scores from 0.60 to 0.80 were
considered large changes, and scores above 0.80 were con-
sidered large to very large changes.
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2.5 | Interobserver agreement, procedural integrity, and
treatment integrity
Using videos recorded via iPod, trained graduate students
watched videos and recorded child compliance. The num-
ber of occurrences in which both observers recorded compliance
was divided by the total number of agreements and
disagreements, and then multiplied by 100. IOA data were
collected for at least 30% of baseline, treatment, and gen-
eralization observations for all participants. Baseline and
generalization observations yielded 100% agreement, and
treatment observations yielded an average 98% agreement.
Procedural integrity data were collected during every parent
training session, with integrity calculated by dividing
the number of steps completed by the total number of steps and
multiplying by 100. Procedural integrity for parent
training sessions was 100% across all trainings for all parents.
IOA for procedural integrity was assessed during 100%
of training sessions, with IOA for procedural integrity being
100%. Treatment integrity was assessed by reviewing all
video recordings of baseline data collection and ECT sessions.
If parent integrity fell below 85%, retraining was to be
implemented prior to the next observation. Treatment integrity
of implementation of ECT procedures was 100% for
Francis' mother. Both Samuel's (M = 99%; range, 80–100%) and
Taylor's (M = 98%; range, 80–100%) mothers had
two retraining sessions each, as implementation of ECT fell
below the 85% criterion.
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2.6 | Design
A concurrent multiple baseline design across participants was
used to assess the effects of ECT. Phase changes
occurred following a compliance level equal to or greater than
75% for three or more days within a phase. Phase
changes were followed by transition sessions, in which
commands from the previous and subsequent phase were
both delivered. A minimum of five data points were collected
for each phase (Kratochwill et al., 2010).
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2.7 | Procedures
ECT procedures utilized in the current study were consistent
with those from prior evaluations of the intervention
(e.g., Drain, 2012). More specifically, elements of the current
study included parent orientation and training meetings,
baseline, four levels of ECT that corresponded with the
development of a request hierarchy, and three transition
phases.
2.7.1 | Baseline
The baseline phase consisted of multiple elements. Namely, an
initial parent orientation, baseline data collection,
request hierarchy development, and training in ECT.
Initial parent orientation
Parent training began with an overview of ECT procedures and
completion of the PSI‐SF. Data collection procedures
were presented didactically and modeled for parents. Instruction
and modeling was also provided regarding steps for
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recording videos via the iPod. Parents were then trained on the
definition of compliant behavior and were then
required to identify researcher‐modeled instances of compliant
and noncompliant behavior with 100% accuracy.
Error correction was delivered as necessary throughout the
session, and modeling was repeated until all parents cor-
rectly identified compliant and noncompliant behavior across
three consecutive models. Parents were then given a
baseline data collection sheet and were instructed to deliver
each of the 12 commands on a daily basis.
Data collection
Parents were instructed to begin collecting baseline data
immediately following the first parent‐training workshop.
During the baseline phase, parents delivered 12 requests each
day using typical compliance strategies. The 12
requests were selected from the Compliance Probability
Questionnaire (e.g., Drain, 2012). The 12 requests selected
from the Compliance Probability Questionnaire were selected as
they could be completed in a relatively short period
of time, did not require the presence of someone else (e.g.,
asking someone to play), and did not require the recording
of private activities (e.g., putting on pajamas). Using the
checklist, parents scored compliance with each command
with either a check for compliance or a minus sign for
noncompliance. Parents were instructed to respond to com-
pliance and noncompliant behavior as usual. Parents video
recorded the delivery of all requests via iPod. Video
recordings of requests were collected from participants and
scored to verify accuracy. Baseline data collection was
terminated when participants demonstrated stable or decreasing
levels of compliance with the 12 requests delivered
by parents.
Baseline assessment of child compliance in the school setting
was completed through teacher delivery of com-
pliance probes in the child's classroom. Untrained teachers
delivered 10 commands to participants to assess child
compliance rates. All data were collected via direct observation
by a trained researcher.
Hierarchy development
Following collection of baseline data, the probability of
compliance with each request was calculated by dividing
the number of times the child was compliant for each request by
the total number of instances of the request,
and the multiplied by 100. After calculations, the commands
were arranged from highest to lowest probability
(Rames‐LaPointe et al., 2014), and then divided equally into
four levels. Each level contained three commands.
An individualized data sheet with each child's compliance
hierarchy was then constructed for collection of
intervention data.
Training in ECT
Consistent with prior evaluations of ECT, parents were taught
presented with strategies for effectively delivering
requests (e.g., Ducharme & Drain, 2004). Parents received
didactic instruction on elements of effective request deliv-
ery. Specifically, training discussed the importance of making
and maintaining eye contact when delivering a request,
delivering only one request at a time, and issuing requests in the
imperative. Following didactic training, the facilitator
presented three models of request delivery. Parents were then
provided the opportunity to role‐play effective
request delivery with the facilitator. Each parent role‐played
request delivery until they demonstrated 100% of skill
steps during a role‐play scenario with the facilitator.
Following training in request delivery, parents were then taught
ECT procedures. Training in ECT consisted of
reviewing the developed request hierarchies and instruction to
only deliver requests that coincided with the current
phase of ECT. After reviewing the request hierarchies, the
facilitator discussed strategies for avoiding requests from
subsequent levels of ECT that were discussed (e.g., breaking up
tasks; Drain, 2012).
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2.7.2 | Intervention
During intervention, participants were exposed to multiple
phases. Specifically, participants experienced four levels
of requests (i.e., Phases 1 through 4) and three transition
sessions (Transitions 1 through 3).
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Treatment, Phase 1
During Phase 1, only requests from Level 1 were delivered by
parents. This consisted of the three requests identified
as resulting in the highest level of compliance during baseline,
each delivered 4 times per day. Compliance with
requests was met with praise, whereas noncompliance resulted
in no response from the parent. Parents were
instructed to collect data 5 days per week, and data were
recorded on the intervention data sheet and recorded
via iPod.
Transition sessions (Transitions 1–3)
Transition sessions served as bridges across levels of ECT.
Requests delivered during transition phases consisted of
one request from the previous phase and one from the
subsequent phase. Transition sessions were initiated once a
participant had reached a compliance rate equal to or greater
than 75% for three or more days for a specific phase.
Two transition sessions were conducted prior to introducing the
next level of the compliance hierarchy.
Treatment, Phases 2–4
Procedures indicated for Phase 1 were used in Phases 2–4, with
the exception of requests issued. Phase 2 only
included Level 2 commands. Further, Phases 3 and 4 only
included commands from their respective levels. During
each of these levels, the three requests that corresponded with
each level were delivered four times per day. During
Phases 2–4, parents were able to deliver requests from previous
phases (e.g., parents in Phase 3 were able to deliver
requests from Level 1), but delivery and compliance with these
requests was not systematically controlled or tracked.
Postintervention follow‐up
During the third parent training session, parents completed a
postintervention PSI‐SF. ECT was discussed once more,
and parents were informed they could continue to utilize the
intervention procedures despite the termination of the
study.
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2.8 | Generalization probes
Generalization probes were conducted in each child's classroom
to determine the generalized effects of ECT in the
home on compliance in the school setting. Assessment of
generalized compliance was assessed twice weekly
throughout the intervention. During assessment of generalized
effects, teachers of child participants delivered 10
requests. Requests delivered were adapted from ECT skills in
coordination with the child's current level in ECT. If
compliance fell below 70% during intervention phases, the
child's teacher was to be trained on ECT procedures, sim-
ilar to parent training (i.e., sequential modification; Stokes &
Baer, 1977). Every participant exhibited compliance
behavior above 70% during intervention. As such, teacher
training did not occur as part of the study.
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3 | RESULTS
In general, rapid improvements in level of compliance were
observed for each participant following the introduction
of ECT (Figure 1). Across all participants, calculation of Tau‐U
indicated a very large effect (Tau‐U = 0.87).
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3.1 | Taylor
Compliance with parental requests was stable during baseline
(M = 38%, range = 33–42%), as were generalization
baseline (M = 56%, range 50–60%). The implementation of ECT
procedures resulted in an immediate change in level
for Taylor in home (M = 99%, range = 90–100%) and
generalization sessions (M = 100%). Additionally, results were
maintained during all four phases of ECT while maintaining
high stability as lower probability requests were gradually
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FIGURE 1 Child compliance graph across participants across
phases. Note. Open squares represent data collected
in the home setting. Closed squares represent data collected in
the school setting. BL = baseline; P = phase;
T = transition
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introduced. Calculation of Tau‐U for parental requests in the
home indicated a very large effect for Taylor (Tau‐
U = 1.00). Similarly, calculation of Tau‐U for generalization
data indicated a very large effect (Tau‐U = 1.00).
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3.2 | Samuel
Compliance with parental requests was variable during baseline
(M = 49%, range = 8–67%) and demonstrating a
decreasing trend throughout the phase. Generalization baseline
compliance data were also variable (M = 33%, range
10–80%). Introduction of ECT resulted in an increase in level,
despite initial variability (M = 79%, range 33–100%).
Generalization data indicated an immediate increase in level
and reduction in variability (M = 99%, range
90–100%), with high levels of compliance being maintained
throughout all intervention phases. Tau‐U produced a
moderate effect (Tau‐U = 0.62). When calculating Tau‐U for
generalization data, a very large intervention effect
was indicated (Tau‐U = 1.00).
are governed by the applicable C
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3.3 | Francis
Compliance with parental requests was variable during baseline
(M = 46%, range = 17–67%) and demonstrated a
decreasing trend. Generalization setting baseline compliance
data were also variable (M = 43%, range 10–60%). Fol-
lowing implementation of ECT, an immediate change in level
and decrease in variability was apparent for in both the
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1099078x, 2018, 4, D
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home setting (M = 100%) and generalization setting (M =
100%). These levels were maintained throughout all
intervention phases of ECT. Calculation of Tau‐U indicated a
very large effect in the home and generalization setting
(Tau‐U = 1.00).
https://onlinelibrary.w
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3.4 | Parenting Stress Index
The PSI‐SF (Abidin, 1995) was administered to participants
before engaging in ECT procedures and following the
completion of the study. Prior to intervention, Taylor's mother
rated her Total Stress level at 115, a score at the
99th percentile (Table 1). Upon completion of ECT, Taylor's
mother's Total Stress index was 104, at the 95th percen-
tile. A decrease in percentile was also observed for the Parental
Distress and Parent–Child Dysfunctional Interaction
subscales. Prior to intervention, Samuel's mother rated her
Parental Distress as 104, at the 95th percentile. At post-
intervention, Samuel's mother'sTotal Stress index increased to a
score of 113, at the 99th percentile. With the excep-
tion of the percentile on the Difficult Child subscale increasing,
all other scores remained stable. Prior to intervention,
Francis' mother's Total Stress score was 56, at the 20th
percentile. Following ECT, Francis' mother had aTotal Stress
score of 54, falling in at 15th percentile. All subscale scores
were stable from preintervention to postintervention.
ion, W
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erm
s and C
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s-and-conditions) on W
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ibrary for rule
4 | DISCUSSION
The purpose of this study was to assess the effect of ECT on
compliance with parental requests in a home setting and
generalization to a school setting in which ECT was not in
place. Following implementation of ECT procedures in the
home, all three participants exhibited increased compliance to
directives given at home, as well as generalization to
the school setting in which no compliance training procedures
were implemented.
Findings of increased compliance to parental requests are
unsurprising given previous studies, which have eval-
uated changes in compliance in one setting following
implementation of ECT in that same setting (e.g., Ducharme
et al., 2001; Ducharme & Ng, 2012). Whereas, the current study
served as a replication of prior findings with primar-
ily young, typically developing, African American males.
Despite the importance of this replication, future researchers
must consider evaluating the procedures described in this study
with participants of other ages, races, and varying
disability status to determine generalizability of results.
An increase in compliance behavior in the training setting (i.e.,
home) may be attributed resistance to extinction.
The hi‐p commands that are used in the beginning of ECT
resulted in frequent contact with reinforcement under a
particular set of stimuli (i.e., in the home, parental request). As
lower probability requests were gradually introduced,
participants may have continued to comply as these stimuli
served as discriminative stimuli for reinforcement
contingent upon compliance. Increases in compliant behavior
may have also establishing a learning history, with
reinforcement for compliance serving as an abolishing operation
for future noncompliant behavior (e.g., Bullock &
Normand, 2006).
Previous studies have assessed the generalization of trained to
untrained requests using ECT (e.g., Ducharme &
Drain, 2004; Ducharme & Popynick, 1993), finding ECT to
result in generalization across requests. Similar to these
TABLE 1 Preintervention and postintervention Parenting Stress
Index Short Form percentiles
Taylor Samuel Francis
Pre Post Pre Post Pre Post
Parental Distress 95th 80th 25th 25th 10th 10th
Parent–Child Dysfunctional Interaction 99th 95th 99th 99th
35th 35th
Difficult Child 95th 95th 95th 99th 35th 35th
Total Stress 99th 95th 95th 99th 20th 15th
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erm
s and C
onditions (https://onlinelibrary.w
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/term
s-and-conditions) on W
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studies, the current study documented generalized effects to
untrained requests for all three participants. How-
ever, this study was unique in that generalization across persons
(i.e., teachers), settings (i.e., school), and requests
(i.e., academic tasks) was also assessed. Results of the study
indicated generalization of effects across requests,
persons, and settings for all participants. The documented
generalization may be attributed to several factors.
The training of multiple exemplars likely contributed to
generalization of compliance behavior. The 12 directives
used in the home setting allowed the child participants access to
multiple stimuli in the training setting. This
increased the participants' likelihood of responding to
unfamiliar stimuli, such as the directives used in the school
setting (Stokes & Baer, 1977). The frequency with which
participants contacted reinforcement for requests in the
home setting likely contributed to generalized effects, as
compliance may have become a generalized operant
behavior. Following compliance in the school setting,
participants contacted a reinforcer (i.e., praise). Although
teachers were not trained to praise participants for compliance
behavior, all teacher participants chose to praise
child participants.
Concerning the third research question, minor reductions in
total parental stress were evidenced in two out of
three participants' parents. Samuel's mother reported an elevated
level of total parenting stress, whereas the other
two mothers exhibited minor reductions in parental stress. It is
possible that the variability of responding evidenced
in Samuel's data contributed to high parenting stress levels
during implementation of ECT. Although Samuel's data
indicate a response to ECT, his data are substantially more
variable than the other two participants. Taylor's and
Francis' mothers both reported some decrease in parental stress
following ECT. The keystone nature of compliance
(Barnett et al., 1996) allows for the alteration of other variables
when noncompliance is targeted in intervention, such
as parental stress. It is possible that increases in child
compliance in both the home and school settings influenced
these mothers' reports of lessened parental stress.
It is important to note that in the current study, as with all
previous evaluations of ECT, parents were taught gen-
eral compliance strategies as part of the ECT package (e.g.
Ducharme & Drain, 2004). Although compliance increased
following introduction of the ECT package, no component
analysis was conducted for the components of ECT. As
such, it is unknown if and the extent to which the training of
general compliance strategies resulted in direct
increases in child compliant behavior. Prior research (Everett,
Olmi, Edwards, & Tingstrom, 2005) supports the use
of eye contact and contingent praise as components that lead to
increased child compliant behavior. Future research
should assess which these general compliance strategies lead to
increased child compliant behavior within the con-
text of ECT.
In order to collect data from a naturalistic setting in an
unobtrusive manner, all sessions were video recorded and
only parents were present at the time of the recording of data.
Although this was associated with several advantages,
this made it impossible to control for anything that parents may
have done in addition to ECT at times when parent–
child interactions were not being recorded. For example, a
parent may have introduced an additional contingency
(e.g., additional contingency introduced for demonstrating
compliance during probes). Although parents were dis-
couraged from implementing other procedures by the primary
researcher, future researchers may consider methods
for collecting data on the use of other procedures by parents
(e.g., survey at the conclusion of the study asking if
other procedures were used).
In the current study, increases in compliant behavior in the
home generalized to the school setting for all
three participants following introduction of ECT procedures.
This is notable in that this is the first study in which
generalization across settings was assessed for ECT. Due to the
frequent co‐occurrence of noncompliance in
both the home and school settings, noncompliance is often an
issue for both parents and educators alike. Given
the results of this study, school‐based professionals may
consider working with parents to implement
compliance‐promoting procedures in the home setting. As
addressing behavioral issues in the classroom may
be disruptive for both the target child and his or her peers,
home‐based compliance training represents a less
disruptive option for addressing both home and school
noncompliance (Di‐Martini‐Scully et al., 2000). Although
results of this study are promising, additional research is
necessary to replicate these findings with other
populations.
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COMPLIANCE WITH ETHICAL STANDARDS
All authors of the study report no conflicts of interest.
All procedures performed in the current study were in
accordance with the ethical standards of the institution
and the national research committee and with the 1964 Helsinki
declaration and its later amendments.
Informed consent and assent was obtained for all individual
participants included in the study.
ORCID
Keith C. Radley http://orcid.org/0000-0001-6155-9666
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Received 18 October 2017 Revised 19 July 2018 Accepted 23 J.docx

  • 1. Received: 18 October 2017 Revised: 19 July 2018 Accepted: 23 July 2018 DOI: 10.1002/bin.1641 1099078x, 2018, 4, D ow nlo ad R E S E A R CH AR T I C L E ed f rom https://onlinelibrary.w iley.com /doi/10.1002/bin.1641 by B The effects of errorless compliance training on children in home and school settings Hannah J. Cavell1 | Keith C. Radley2 | Brad A. Dufrene1 |
  • 2. Daniel H. Tingstrom1 | Emily A. Ness1 | Ashley N. Murphy1 ehavior A nalyst C ertification, W iley O nline L ibrary on [14/1 1Department of Psychology, University of Southern Mississippi, Hattiesburg, Mississippi 2Department of Educational Psychology, University of Utah, Salt Lake City, Utah Correspondence Keith C Radley, Department of Educational Psychology, University of Utah, 1721 Campus Center Dr. #3225, Salt Lake City, UT 84112. Email: [email protected] Behavioral Interventions. 2018;33:391–402. w 1/2022]. See the T erm s and C onditions (https://onlinelibrary.w iley.com
  • 3. /term s-and-conditions) on W iley O nline L ibrary for rules of use Errorless compliance training (ECT) is a procedure used to lessen disruptive behavior using a gradual and noncoercive approach. In this study, parents of three school‐aged chil- dren who demonstrated high levels of disruptive behavior in the home and the classroom were trained on the ECT procedure. ECT consisted of training in effective instruction delivery and delivery of requests in a hierarchal manner. ECT sessions took place in the home, with parents deliver- ing requests to participating children. Baseline data were used to arrange requests into grouped levels, ranging from Level 1 (requests of which individual is typically compliant) to Level 4 (requests in which individual is typically noncom- pliant). Using the ECT procedure, request levels were faded over time in a gradual fashion to ensure the highest proba- bility of compliance. Effects of ECT were hypothesized to
  • 4. generalize from the home to the school setting. Implemen- tation of ECT resulted in high levels of compliance in both the home and school settings across all participants. Impli- cations and limitations are discussed. KEYWORDS compliance, errorless compliance training, generalization, hi‐p command sequences, single‐case design ; O A articles are governed by the applicable C reative C 1 | INTRODUCTION Noncompliance is a frequently targeted childhood behavior problems (e.g., Forehand & McMahon, 1981). Noncom- pliance occurs when a child fails to complete a given instruction (Stephenson & Hanley, 2010). Teachers often cite behaviors that arise as a result of noncompliance as a reason for poor academic performance and underdeveloped peer relationships (Roberts, Tingstrom, Olmi, & Bellipanni, 2008), noncompliance resulting in a disruption of © 2018 John Wiley & Sons, Ltd.ileyonlinelibrary.com/journal/bin 391 om
  • 5. m ons L icense http://orcid.org/0000-0001-6155-9666 mailto:[email protected] https://doi.org/10.1002/bin.1641 http://wileyonlinelibrary.com/journal/bin http://crossmark.crossref.org/dialog/?doi=10.1002%2Fbin.1641 &domain=pdf&date_stamp=2018-08-14 392 CAVELL ET AL. 1099078x, 2018, 4, D ow nloaded from https://onlinelibrary.w iley.com /doi/10.1002/bin.1641 by B ehavior A nalyst C ertification, W iley O nline L ibrary on [14/11/2022]. See the T erm s and C
  • 6. onditions (https://onlinelibrary.w iley.com /term s-and-conditions) on W iley O nline L ibrary for rules of use; O A articles are governed by the applicable C reative C o educational opportunities (Rhode, Jenson, & Reavis, 1992). Addressing behavioral issues in the classroom detracts from instructional time for both the child and his or her peers (Di‐Martini‐Scully, Bray, & Kehle, 2000). Given the potential educational and social impact of child noncompliance, researchers point to early identification and interven- tion as an essential strategy (Gresham, Lane, & Beebe‐Frankenberger, 2005). Compliance has been identified as a keystone behavior, meaning that improvements in compliant behaviors are likely to have reductive effects on other problematic behaviors not directly targeted by an intervention (Barnett, Bauer, Ehrhardt, Lentz, & Stollar, 1996). For example, being that compliance and defiance are functionally incompat-
  • 7. ible (Mace & Belfiore, 1990), an increase in compliant behavior is likely to lead to decreases in oppositional behavior and increases in communication skills and on‐task behavior (Ducharme, Atkinson, & Poulton, 2001). Due to the key- stone nature of compliance, a variety of procedures have been implemented to address noncompliance in children. Antecedent manipulations are frequently implemented to address child compliance (Radley & Dart, 2016). Antecedent manipulations describe a class of intervention strategies that involve the manipulation of environ- mental stimuli prior to the occurrence of a target behavior (Cooper, Heron, & Heward, 2007). In a recent review of antecedent manipulations for noncompliance, Radley and Dart (2016) identified high‐probability (hi‐p) command sequences as the most frequently researched strategy. Hi‐p command sequences describe a procedure in which a child is presented with a series of requests (i.e., an antecedent to a behavior) that are likely to be met with compliance prior to the delivery of a low‐probability request (Rortvedt & Miltenberger, 1994). As a child engages in hi‐p requests, momentum is built toward compliance with the low‐probability request. With each instance of compliance, reinforce- ment for compliance is provided (e.g., praise and preferred item), with researchers finding the delivery of reinforce-
  • 8. ment to be a critical element in hi‐p command sequences (Lipschultz & Wilder, 2017). Radley and Dart (2016) identified 14 studies in their review, with support being provided for children with a range of disabilities and no iden- tified disability. Further, hi‐p command sequences were found to result in increased compliance in diverse settings (e.g., home and school; Lipschultz & Wilder, 2017; Radley & Dart, 2016). Researchers have suggested that hi‐p command sequences may be effective interventions for promoting compli- ance with requests as they establish behavioral momentum. More specifically, reinforcement of hi‐p requests has an influence on the general response class of compliance. Once reinforcement has been provided to hi‐p requests, suf- ficient behavioral momentum is developed so as to result in compliance with lower‐probability requests (Mace et al., 1998). Alternatively, hi‐p command sequences may be effective as they promote resistance to extinction. That is, compliance with hi‐p requests results in increased reinforcement when particular discriminative stimulus is present (i.e., person giving the request). This results in a higher probability that an individual will continue to engage in responses that result in reinforcement in the presence of this same discriminative stimulus (Nevin & Grace, 2000).
  • 9. Errorless compliance training (ECT; Ducharme & Popynick, 1993) is a compliance training procedure that is sim- ilar to hi‐p command sequences, as commands are provided in a specified order beginning with hi‐p commands. ECT differs from hi‐p command sequences in that hi‐p command sequences utilize a short interinstruction interval (i.e., requests are presented in close temporal proximity to each other), whereas this is not required in ECT. Further, ECT differs in that potential commands are divided into four levels of compliance probability. Initially, only commands from hi‐p levels are provided to a child. Further differences between ECT and hi‐p command sequences are also noted in that, similar to demand fading (e.g., Piazza, Moes, & Fischer, 1996), low‐probability commands are gradually introduced once a general repertoire of compliance has been established. This ensures that the child maintains a high level of compliance throughout the intervention and contacts a frequent positive reinforcement for compliant behav- ior. This establishment of a pattern of compliance in a particular context or in the presence of a particular discrimi- native stimulus may play a critical role in ECT. In one of the first studies of ECT, compliance to maternal requests was addressed in four children with develop-
  • 10. mental disabilities (Ducharme & Popynick, 1993). After completing a probability questionnaire of child compliance, parent participants were then video recorded delivering commands to their children. Requests were then arranged into levels according to compliance data. Ten requests were selected for baseline data analysis, followed by four intervention phases. Seven requests were presented for each level of ECT, with Level 1 representing requests that m m ons L icense CAVELL ET AL. 393 1099078x, 2018, 4, D ow nloaded from https://onlinelibrary.w iley.com /doi/10.1002/bin.1641 by B ehavior A nalyst C ertification, W iley O
  • 11. nline L ibrary on [14/11/2022]. See the T erm s and C onditions (h the child was most likely to comply with and Level 4 representing requests that the child was least likely to comply with, with two sessions occurring each week. Transition sessions occurred between phase sessions for increased gradual introduction of low‐probability requests, with transition sessions including requests from both the previous and next level. Generalization data were collected for all four levels of ECT, using requests to which the child had not yet been exposed. Follow‐up data were collected using requests from each of the four levels. Whereas baseline data indicated low levels of compliance across participants, introduction of ECT resulted in immediate increases in compliance. Further, high levels of compliance were noted as the intervention progressed from Level 1 requests to Level 4. Follow‐up data indicated maintained improvements in compliance for up to 3 months. Additionally, participants' improvements in compliant behavior were found to generalize to novel requests provided by parents. Although generalization was observed, the researchers noted that criterion levels of generaliza-
  • 12. tion were observed only following implementation of ECT for level 4 requests. Subsequent evaluations of ECT have demonstrated improvements in compliance in home, clinic, and school set- tings for typically developing children and children with developmental disabilities and have replicated findings of generalization across requests (e.g., Drain, 2012; Ducharme & DiAdamo, 2005; Ducharme & Drain, 2004; Ducharme & Ng, 2012; Rames‐LaPointe, Hixon, Niec, & Rhymer, 2014). Generalization has also been documented across types of requests, with generalization indicated from academic requests to general requests (Ducharme & Drain, 2004). Despite the burgeoning support for ECT as an effective means of promoting compliance, the literature base is limited in assessing generalization across persons and settings. Although one study has assessed changes in compliance in both school and home settings, the study involved concurrent implementation of the intervention in both settings. As such, it is unknown whether implementation of ECT in one setting (e.g., home) would result in concurrent improvements in settings in which the intervention has not been utilized (e.g., school). This study seeks to address this limitation through evaluation of the generalized effects of ECT on compliance in a nontraining setting (i.e., gen-
  • 13. eralization from home to school settings). Specifically, the current study sought to determine whether implementa- tion of ECT in the home setting resulted in increased compliance with parental requests at home, as well as generalized improvements to teacher requests at school. Finally, the current study sought to evaluate the effect of ECT on parent‐reported stress. ttps://onlinelibrary.w iley.com /term s-and-conditions) on W iley O nline L ibrary for rules of use; O A articles are governed by the applicable C reative C o 2 | METHOD 2.1 | Participants Participants consisted of two elementary school‐aged children enrolled in general education classrooms, and one eighth‐grade student enrolled at a specialized school for children with disabilities. Participants were recruited from
  • 14. a university‐based clinic. Inclusionary criteria included both teacher and parent reports of noncompliance, with non- compliance demonstrated in both home and school settings. Parental and teacher consent, as well as child assent, was obtained prior to participation in the study. Permission from a university Institutional Review Board was received prior to initiation of the study. Taylor was a 7‐year‐old African American male attending first grade in a general education classroom. Taylor has no psychological diagnoses and had never received academic or behavioral services prior to inclusion in this study. As he frequently exhibited noncompliant behavior after school at a daycare facility, ECT was implemented at his daycare rather than in his school classroom. Taylor's instructor was an African American male who worked as an after‐school daycare program instructor. All home procedures were implemented by Taylor's mother. Samuel was a 12‐year‐old male enrolled in a school for students with developmental disabilities. Assessment data indicated a full‐scale IQ score of 60, as well as impairments in adaptive functioning across multiple domains. Samuel had previously been diagnosed with autism spectrum disorder and an intellectual disability by a licensed psy-
  • 15. chologist. Samuel's mother expressed interest in compliance training due to pervasive noncompliant behavior in m m ons L icense 394 CAVELL ET AL. 1099078x, 2018, 4, D ow nloaded from https://onlinelibrary.w iley.com /doi/10.10 multiple settings (i.e., clinic and school). Samuel's teacher was a female with a Bachelor's degree in History. She was currently in her eighth year of teaching. All home procedures were implemented by Samuel's mother. Francis was a 6‐year‐old male attending kindergarten in a general education classroom. He received weekly school‐based math and reading intervention services as a result of being retained. However, Francis did not receive special education services and had no diagnoses. As frequent noncompliance impacted his academic performance, he was referred to the university‐based clinic for compliance
  • 16. training. Francis' mother had received some compliance training assistance as part of routine clinic services but had never been exposed to ECT. Francis' teacher was a 35‐year‐old female with a Master's degree in Education. She was currently in her twelfth year of teaching. All home procedures were implemented by Francis' mother. 02/bin.1641 by B ehavior A nalyst C ertification, W iley O nline L ibrary on [14/ 2.2 | Settings and materials Parent training workshops were conducted at the university clinic for both Francis and Samuel, and at a daycare facility for Taylor. Collection of baseline, treatment, and follow‐up compliance data took place at each child's home with a parent delivering requests to their child. Generalized effects of compliance training were assessed in each child's school classroom. For assessments for generalization, teachers of participants delivered requests and child compliance was recorded via direct observation in the child's classroom. iPods were used to collect ECT data in
  • 17. the home. Parents used iPods to video record ETC sessions with their child by placing the iPod in an unobtrusive location. 11/2022]. See the T erm s and C onditions (https://onlinelibrary.w iley.com /term s-and-conditions) on W iley O nline L 2.3 | Dependent variables 2.3.1 | Child compliance The primary dependent variable of the current study was child compliance with target adult requests. Child compli- ance was defined as initiating and completing an indicated response within 5 s of request issuance by the adult. If a child failed to initiate and complete a response within 5 s, the child's behavior was recorded as noncompliant. To assess child compliance, 12 requests were given by parents during each session (e.g., go to the [area of house] and pick up your [item]), with 10 requests being given by teachers during each session. Compliant behavior in the home
  • 18. setting was assessed through parents' video recorded compliance sessions. To assess generalization, compliant behavior was assessed through direct observation of compliance with commands delivered by the child's teacher in the classroom. Classroom commands were related to school behavior (e.g., draw a picture and cut out the shape) and differed from requests given in the home setting. For both home and classroom settings, compliance with any request outside those indicated was not considered. A graduate student trained in behavioral observations observed all ECT generalization sessions in the school. ibrary for rules of use; O A articles are governed by the applicable C reative C o 2.3.2 | Parenting Stress Index Short Form As increases in compliance were expected to be associated with decreased parent stress, the Parenting Stress Index Short Form (PSI‐SF; Abidin, 1995) was administered as a measure of social validity of intervention procedures. The PSI‐SF is composed of 36 questions and addresses the following three domains: Parental Distress (e.g., general feelings of stress), Child Difficulty (e.g., child characteristics that contribute to parent stress), and Parent–Child
  • 19. Dysfunctional Interactions (e.g., beliefs regarding whether children meet expectations). Normative data indicate an alpha of .85, suggesting acceptable internal validity. The PSI‐SF has been shown to not produce differences in responding based on gender (Baker et al., 2003). Parent participants completed the PSI both before engaging in ECT procedures and following the completion of the study. m m ons L icense CAVELL ET AL. 395 1099078x, 2018, 4, D ow nloaded from https://onlinelibrary.w iley.com /doi/10.1002/ 2.4 | Data analysis The effects of ECT on child compliance were assessed through visual analysis, more specifically, changes in trend, level, variability, immediacy of effect, overlap, and consistency across similar phases. Visual analysis of data was sup-
  • 20. plemented through statistical analysis usingTau‐U (Parker, Vannest, Davis, & Sauber, 2011). Tau‐U is a nonparametric measure of overlap across phases. Tau‐U has several advantages over other nonoverlap statistics, particularly in its ability to control for baseline trend. Tau‐U scores were interpreted using guidelines provided by Vannest and Ninci (2015). Specifically, a score of 0.20 or less was considered a small change, scores from 0.20 to 0.60 were considered to be moderate changes, scores from 0.60 to 0.80 were considered large changes, and scores above 0.80 were con- sidered large to very large changes. bin.1641 by B ehavior A nalyst C ertification, W iley O nline L ibrary on [14/11/2022]. See the T erm s and C onditio 2.5 | Interobserver agreement, procedural integrity, and treatment integrity Using videos recorded via iPod, trained graduate students watched videos and recorded child compliance. The num-
  • 21. ber of occurrences in which both observers recorded compliance was divided by the total number of agreements and disagreements, and then multiplied by 100. IOA data were collected for at least 30% of baseline, treatment, and gen- eralization observations for all participants. Baseline and generalization observations yielded 100% agreement, and treatment observations yielded an average 98% agreement. Procedural integrity data were collected during every parent training session, with integrity calculated by dividing the number of steps completed by the total number of steps and multiplying by 100. Procedural integrity for parent training sessions was 100% across all trainings for all parents. IOA for procedural integrity was assessed during 100% of training sessions, with IOA for procedural integrity being 100%. Treatment integrity was assessed by reviewing all video recordings of baseline data collection and ECT sessions. If parent integrity fell below 85%, retraining was to be implemented prior to the next observation. Treatment integrity of implementation of ECT procedures was 100% for Francis' mother. Both Samuel's (M = 99%; range, 80–100%) and Taylor's (M = 98%; range, 80–100%) mothers had two retraining sessions each, as implementation of ECT fell below the 85% criterion. ns (https://onlinelibrary.w
  • 22. iley.com /term s-and-co 2.6 | Design A concurrent multiple baseline design across participants was used to assess the effects of ECT. Phase changes occurred following a compliance level equal to or greater than 75% for three or more days within a phase. Phase changes were followed by transition sessions, in which commands from the previous and subsequent phase were both delivered. A minimum of five data points were collected for each phase (Kratochwill et al., 2010). nditions) on W iley O nline L ibrary for rules of use; O A articles are governed by the applicable C reative C o 2.7 | Procedures ECT procedures utilized in the current study were consistent with those from prior evaluations of the intervention (e.g., Drain, 2012). More specifically, elements of the current study included parent orientation and training meetings,
  • 23. baseline, four levels of ECT that corresponded with the development of a request hierarchy, and three transition phases. 2.7.1 | Baseline The baseline phase consisted of multiple elements. Namely, an initial parent orientation, baseline data collection, request hierarchy development, and training in ECT. Initial parent orientation Parent training began with an overview of ECT procedures and completion of the PSI‐SF. Data collection procedures were presented didactically and modeled for parents. Instruction and modeling was also provided regarding steps for m m ons L icense 396 CAVELL ET AL. 1099078x, 2018, 4, D ow nloaded from https://onlinelibrary.w iley.com
  • 24. /doi/10.1002/bin.1641 by B ehavior A nalyst C ertification, W iley O nline L ibrary on [14/11/2022]. See the T erm s and C onditions (https://onlinelibrary.w iley.com /term s-and-conditions) on W iley O nline L ibrary for rules of use; O A articles are gov recording videos via the iPod. Parents were then trained on the definition of compliant behavior and were then required to identify researcher‐modeled instances of compliant and noncompliant behavior with 100% accuracy. Error correction was delivered as necessary throughout the session, and modeling was repeated until all parents cor-
  • 25. rectly identified compliant and noncompliant behavior across three consecutive models. Parents were then given a baseline data collection sheet and were instructed to deliver each of the 12 commands on a daily basis. Data collection Parents were instructed to begin collecting baseline data immediately following the first parent‐training workshop. During the baseline phase, parents delivered 12 requests each day using typical compliance strategies. The 12 requests were selected from the Compliance Probability Questionnaire (e.g., Drain, 2012). The 12 requests selected from the Compliance Probability Questionnaire were selected as they could be completed in a relatively short period of time, did not require the presence of someone else (e.g., asking someone to play), and did not require the recording of private activities (e.g., putting on pajamas). Using the checklist, parents scored compliance with each command with either a check for compliance or a minus sign for noncompliance. Parents were instructed to respond to com- pliance and noncompliant behavior as usual. Parents video recorded the delivery of all requests via iPod. Video recordings of requests were collected from participants and scored to verify accuracy. Baseline data collection was terminated when participants demonstrated stable or decreasing
  • 26. levels of compliance with the 12 requests delivered by parents. Baseline assessment of child compliance in the school setting was completed through teacher delivery of com- pliance probes in the child's classroom. Untrained teachers delivered 10 commands to participants to assess child compliance rates. All data were collected via direct observation by a trained researcher. Hierarchy development Following collection of baseline data, the probability of compliance with each request was calculated by dividing the number of times the child was compliant for each request by the total number of instances of the request, and the multiplied by 100. After calculations, the commands were arranged from highest to lowest probability (Rames‐LaPointe et al., 2014), and then divided equally into four levels. Each level contained three commands. An individualized data sheet with each child's compliance hierarchy was then constructed for collection of intervention data. Training in ECT Consistent with prior evaluations of ECT, parents were taught presented with strategies for effectively delivering
  • 27. requests (e.g., Ducharme & Drain, 2004). Parents received didactic instruction on elements of effective request deliv- ery. Specifically, training discussed the importance of making and maintaining eye contact when delivering a request, delivering only one request at a time, and issuing requests in the imperative. Following didactic training, the facilitator presented three models of request delivery. Parents were then provided the opportunity to role‐play effective request delivery with the facilitator. Each parent role‐played request delivery until they demonstrated 100% of skill steps during a role‐play scenario with the facilitator. Following training in request delivery, parents were then taught ECT procedures. Training in ECT consisted of reviewing the developed request hierarchies and instruction to only deliver requests that coincided with the current phase of ECT. After reviewing the request hierarchies, the facilitator discussed strategies for avoiding requests from subsequent levels of ECT that were discussed (e.g., breaking up tasks; Drain, 2012). erned by the applicable C reative C o 2.7.2 | Intervention During intervention, participants were exposed to multiple
  • 28. phases. Specifically, participants experienced four levels of requests (i.e., Phases 1 through 4) and three transition sessions (Transitions 1 through 3). m m ons L icense CAVELL ET AL. 397 1099078x, 2018, 4, D ow nloaded from https://onlinelibrary.w iley.com /doi/10.1002/bin.1641 by B ehavior A nalyst C ertification, W iley O nline L ibrary on [14/11/2022]. See the T erm s and Treatment, Phase 1
  • 29. During Phase 1, only requests from Level 1 were delivered by parents. This consisted of the three requests identified as resulting in the highest level of compliance during baseline, each delivered 4 times per day. Compliance with requests was met with praise, whereas noncompliance resulted in no response from the parent. Parents were instructed to collect data 5 days per week, and data were recorded on the intervention data sheet and recorded via iPod. Transition sessions (Transitions 1–3) Transition sessions served as bridges across levels of ECT. Requests delivered during transition phases consisted of one request from the previous phase and one from the subsequent phase. Transition sessions were initiated once a participant had reached a compliance rate equal to or greater than 75% for three or more days for a specific phase. Two transition sessions were conducted prior to introducing the next level of the compliance hierarchy. Treatment, Phases 2–4 Procedures indicated for Phase 1 were used in Phases 2–4, with the exception of requests issued. Phase 2 only included Level 2 commands. Further, Phases 3 and 4 only included commands from their respective levels. During
  • 30. each of these levels, the three requests that corresponded with each level were delivered four times per day. During Phases 2–4, parents were able to deliver requests from previous phases (e.g., parents in Phase 3 were able to deliver requests from Level 1), but delivery and compliance with these requests was not systematically controlled or tracked. Postintervention follow‐up During the third parent training session, parents completed a postintervention PSI‐SF. ECT was discussed once more, and parents were informed they could continue to utilize the intervention procedures despite the termination of the study. C onditions (https://onlinelibrary.w iley.com /term s-and-conditions) on W 2.8 | Generalization probes Generalization probes were conducted in each child's classroom to determine the generalized effects of ECT in the home on compliance in the school setting. Assessment of generalized compliance was assessed twice weekly throughout the intervention. During assessment of generalized effects, teachers of child participants delivered 10
  • 31. requests. Requests delivered were adapted from ECT skills in coordination with the child's current level in ECT. If compliance fell below 70% during intervention phases, the child's teacher was to be trained on ECT procedures, sim- ilar to parent training (i.e., sequential modification; Stokes & Baer, 1977). Every participant exhibited compliance behavior above 70% during intervention. As such, teacher training did not occur as part of the study. iley O nline L ibrary for rules of use; O A 3 | RESULTS In general, rapid improvements in level of compliance were observed for each participant following the introduction of ECT (Figure 1). Across all participants, calculation of Tau‐U indicated a very large effect (Tau‐U = 0.87). articles are governed by the applicable C reative C o 3.1 | Taylor Compliance with parental requests was stable during baseline (M = 38%, range = 33–42%), as were generalization baseline (M = 56%, range 50–60%). The implementation of ECT procedures resulted in an immediate change in level
  • 32. for Taylor in home (M = 99%, range = 90–100%) and generalization sessions (M = 100%). Additionally, results were maintained during all four phases of ECT while maintaining high stability as lower probability requests were gradually m m ons L icense FIGURE 1 Child compliance graph across participants across phases. Note. Open squares represent data collected in the home setting. Closed squares represent data collected in the school setting. BL = baseline; P = phase; T = transition 398 CAVELL ET AL. 1099078x, 2018, 4, D ow nloaded from https://onlinelibrary.w iley.com /doi/10.1002/bin.1641 by B ehavior A nalyst C ertification, W iley O
  • 33. nline L ibrary on [14/11/2022]. See the T erm s and C onditions (https://onlinelibrary.w iley.com /term s introduced. Calculation of Tau‐U for parental requests in the home indicated a very large effect for Taylor (Tau‐ U = 1.00). Similarly, calculation of Tau‐U for generalization data indicated a very large effect (Tau‐U = 1.00). -and-conditions) on W iley O nline L ibrary for rules of use; O A articles 3.2 | Samuel Compliance with parental requests was variable during baseline (M = 49%, range = 8–67%) and demonstrating a decreasing trend throughout the phase. Generalization baseline compliance data were also variable (M = 33%, range 10–80%). Introduction of ECT resulted in an increase in level, despite initial variability (M = 79%, range 33–100%).
  • 34. Generalization data indicated an immediate increase in level and reduction in variability (M = 99%, range 90–100%), with high levels of compliance being maintained throughout all intervention phases. Tau‐U produced a moderate effect (Tau‐U = 0.62). When calculating Tau‐U for generalization data, a very large intervention effect was indicated (Tau‐U = 1.00). are governed by the applicable C reative C o 3.3 | Francis Compliance with parental requests was variable during baseline (M = 46%, range = 17–67%) and demonstrated a decreasing trend. Generalization setting baseline compliance data were also variable (M = 43%, range 10–60%). Fol- lowing implementation of ECT, an immediate change in level and decrease in variability was apparent for in both the m m ons L icense CAVELL ET AL. 399 1099078x, 2018, 4, D ow
  • 35. nloaded from home setting (M = 100%) and generalization setting (M = 100%). These levels were maintained throughout all intervention phases of ECT. Calculation of Tau‐U indicated a very large effect in the home and generalization setting (Tau‐U = 1.00). https://onlinelibrary.w iley.com /doi/10.1002/bin.1641 by B ehavior A nalyst C ertificat 3.4 | Parenting Stress Index The PSI‐SF (Abidin, 1995) was administered to participants before engaging in ECT procedures and following the completion of the study. Prior to intervention, Taylor's mother rated her Total Stress level at 115, a score at the 99th percentile (Table 1). Upon completion of ECT, Taylor's mother's Total Stress index was 104, at the 95th percen- tile. A decrease in percentile was also observed for the Parental Distress and Parent–Child Dysfunctional Interaction subscales. Prior to intervention, Samuel's mother rated her Parental Distress as 104, at the 95th percentile. At post- intervention, Samuel's mother'sTotal Stress index increased to a score of 113, at the 99th percentile. With the excep-
  • 36. tion of the percentile on the Difficult Child subscale increasing, all other scores remained stable. Prior to intervention, Francis' mother's Total Stress score was 56, at the 20th percentile. Following ECT, Francis' mother had aTotal Stress score of 54, falling in at 15th percentile. All subscale scores were stable from preintervention to postintervention. ion, W iley O nline L ibrary on [14/11/2022]. See the T erm s and C onditions (https://onlinelibrary.w iley.com /term s-and-conditions) on W iley O nline L ibrary for rule 4 | DISCUSSION The purpose of this study was to assess the effect of ECT on compliance with parental requests in a home setting and generalization to a school setting in which ECT was not in place. Following implementation of ECT procedures in the
  • 37. home, all three participants exhibited increased compliance to directives given at home, as well as generalization to the school setting in which no compliance training procedures were implemented. Findings of increased compliance to parental requests are unsurprising given previous studies, which have eval- uated changes in compliance in one setting following implementation of ECT in that same setting (e.g., Ducharme et al., 2001; Ducharme & Ng, 2012). Whereas, the current study served as a replication of prior findings with primar- ily young, typically developing, African American males. Despite the importance of this replication, future researchers must consider evaluating the procedures described in this study with participants of other ages, races, and varying disability status to determine generalizability of results. An increase in compliance behavior in the training setting (i.e., home) may be attributed resistance to extinction. The hi‐p commands that are used in the beginning of ECT resulted in frequent contact with reinforcement under a particular set of stimuli (i.e., in the home, parental request). As lower probability requests were gradually introduced, participants may have continued to comply as these stimuli served as discriminative stimuli for reinforcement contingent upon compliance. Increases in compliant behavior
  • 38. may have also establishing a learning history, with reinforcement for compliance serving as an abolishing operation for future noncompliant behavior (e.g., Bullock & Normand, 2006). Previous studies have assessed the generalization of trained to untrained requests using ECT (e.g., Ducharme & Drain, 2004; Ducharme & Popynick, 1993), finding ECT to result in generalization across requests. Similar to these TABLE 1 Preintervention and postintervention Parenting Stress Index Short Form percentiles Taylor Samuel Francis Pre Post Pre Post Pre Post Parental Distress 95th 80th 25th 25th 10th 10th Parent–Child Dysfunctional Interaction 99th 95th 99th 99th 35th 35th Difficult Child 95th 95th 95th 99th 35th 35th Total Stress 99th 95th 95th 99th 20th 15th s of use; O A articles are governed by the applicable C reative C om m
  • 39. ons L icense 400 CAVELL ET AL. 1099078x, 2018, 4, D ow nloaded from https://onlinelibrary.w iley.com /doi/10.1002/bin.1641 by B ehavior A nalyst C ertification, W iley O nline L ibrary on [14/11/2022]. See the T erm s and C onditions (https://onlinelibrary.w iley.com /term s-and-conditions) on W iley O
  • 40. nline L ibrary for rules of use; O A articles are governed by the applicable C reative C o studies, the current study documented generalized effects to untrained requests for all three participants. How- ever, this study was unique in that generalization across persons (i.e., teachers), settings (i.e., school), and requests (i.e., academic tasks) was also assessed. Results of the study indicated generalization of effects across requests, persons, and settings for all participants. The documented generalization may be attributed to several factors. The training of multiple exemplars likely contributed to generalization of compliance behavior. The 12 directives used in the home setting allowed the child participants access to multiple stimuli in the training setting. This increased the participants' likelihood of responding to unfamiliar stimuli, such as the directives used in the school setting (Stokes & Baer, 1977). The frequency with which participants contacted reinforcement for requests in the home setting likely contributed to generalized effects, as compliance may have become a generalized operant
  • 41. behavior. Following compliance in the school setting, participants contacted a reinforcer (i.e., praise). Although teachers were not trained to praise participants for compliance behavior, all teacher participants chose to praise child participants. Concerning the third research question, minor reductions in total parental stress were evidenced in two out of three participants' parents. Samuel's mother reported an elevated level of total parenting stress, whereas the other two mothers exhibited minor reductions in parental stress. It is possible that the variability of responding evidenced in Samuel's data contributed to high parenting stress levels during implementation of ECT. Although Samuel's data indicate a response to ECT, his data are substantially more variable than the other two participants. Taylor's and Francis' mothers both reported some decrease in parental stress following ECT. The keystone nature of compliance (Barnett et al., 1996) allows for the alteration of other variables when noncompliance is targeted in intervention, such as parental stress. It is possible that increases in child compliance in both the home and school settings influenced these mothers' reports of lessened parental stress. It is important to note that in the current study, as with all previous evaluations of ECT, parents were taught gen-
  • 42. eral compliance strategies as part of the ECT package (e.g. Ducharme & Drain, 2004). Although compliance increased following introduction of the ECT package, no component analysis was conducted for the components of ECT. As such, it is unknown if and the extent to which the training of general compliance strategies resulted in direct increases in child compliant behavior. Prior research (Everett, Olmi, Edwards, & Tingstrom, 2005) supports the use of eye contact and contingent praise as components that lead to increased child compliant behavior. Future research should assess which these general compliance strategies lead to increased child compliant behavior within the con- text of ECT. In order to collect data from a naturalistic setting in an unobtrusive manner, all sessions were video recorded and only parents were present at the time of the recording of data. Although this was associated with several advantages, this made it impossible to control for anything that parents may have done in addition to ECT at times when parent– child interactions were not being recorded. For example, a parent may have introduced an additional contingency (e.g., additional contingency introduced for demonstrating compliance during probes). Although parents were dis-
  • 43. couraged from implementing other procedures by the primary researcher, future researchers may consider methods for collecting data on the use of other procedures by parents (e.g., survey at the conclusion of the study asking if other procedures were used). In the current study, increases in compliant behavior in the home generalized to the school setting for all three participants following introduction of ECT procedures. This is notable in that this is the first study in which generalization across settings was assessed for ECT. Due to the frequent co‐occurrence of noncompliance in both the home and school settings, noncompliance is often an issue for both parents and educators alike. Given the results of this study, school‐based professionals may consider working with parents to implement compliance‐promoting procedures in the home setting. As addressing behavioral issues in the classroom may be disruptive for both the target child and his or her peers, home‐based compliance training represents a less disruptive option for addressing both home and school noncompliance (Di‐Martini‐Scully et al., 2000). Although results of this study are promising, additional research is necessary to replicate these findings with other populations.
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  • 45. iley O nline L ibrary for rules of use; O A articles are governed by the applicable C reative C o COMPLIANCE WITH ETHICAL STANDARDS All authors of the study report no conflicts of interest. All procedures performed in the current study were in accordance with the ethical standards of the institution and the national research committee and with the 1964 Helsinki declaration and its later amendments. Informed consent and assent was obtained for all individual participants included in the study. ORCID Keith C. Radley http://orcid.org/0000-0001-6155-9666 REFERENCES Abidin, R. R. (1995). Parenting Stress Index, Third Edition: Professional manual. Odessa, FL: Psychological Assessment Resources, Inc. Baker, B. L., McIntyre, L. L., Blacher, J., Crnic, K., Edlebrock, C., & Low, C. (2003). Pre‐school children with and without
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