Graduation Date

Spring 5-4-2024

Document Type


Degree Name

Doctor of Philosophy (PhD)


Medical Sciences Interdepartmental Area

First Advisor

Regina Carroll


Previous research has shown low treatment integrity can lead to decreased effectiveness and efficiency of skill acquisition during discrete-trial instruction (DTI; Carroll et al., 2013). Pantermuehl and Lechago (2015) found that during covert observations, treatment integrity ranged from 18.6 to 76% whereas during overt observations, integrity was as high as 100%. This shows reactivity is an obstacle within DTI service delivery. It is important to investigate how reactivity affects staff performance and identify ways to increase and maintain high integrity. Finding a socially acceptable, effective, and efficient method to increase and maintain high levels of staff treatment integrity during covert observations is critical in the clinic setting. The purpose of the current study was to examine the effectiveness of video self-monitoring in increasing and maintaining high treatment integrity for staff implementing DTI during covert and overt observations. Participants included four staff working one-on-one with children with autism spectrum disorder (ASD) implementing DTI with less than 90% integrity during covert or overt observations. Results show video self-monitoring was effective at increasing staff treatment integrity and maintaining high integrity over time.


2024 Copyright, the authors

Available for download on Monday, October 14, 2024