Transcription

Streamlining Administration, Scoring, Reporting and GoalGeneration with Online ToolsSpeeding Up the VB-MAPP

Abstractperspectives on leveraging onlinetechnology to support administration,scoring, reporting, and goaldevelopment.The VB-MAPP assessment isfrequently used by behavior analystsin their endeavors to teach valuablecommunication skills to childrenwith Autism Spectrum and relateddisorders. Tools as comprehensiveas the VB-MAPP can, however, posechallenges in implementation. Inparticular, the VB-MAPP is noted totake several hours to complete, andnot all of this time is reimbursed. Withonline tools, there are opportunitiesto facilitate the use of assessmentssuch as the VB-MAPP.Our Challenge: An Incredible,but Time-Consuming ToolThe Verbal Behavior - MilestonesAssessment & Placement Plan (VB-MAPP;Sundberg, 2008) is one of the the mostinformative tools on the market for assessingthe verbal behavior skills of children withAutism Spectrum and related disorders(Gould et. al., 2011). Based on Skinner’sVerbal Behavior (1957), the assessmentbuilds upon a solid research base supportingCentralReach, a cloud-basedpractice management and clinicaldocumentation and data softwaresolution, conducted a survey of nearly2000 VB-MAPP users to understandhow they use VB-MAPP today, thechallenges they face, and theirSpeeding up the VB-MAPPthe use of a behavior analytic approach tolanguage as functional communication.Supporting evidence of reliability and validitycan be found in several studies (c.f., Esch, et.al., 2010; Dixon, et. al., 2015).2

3. Using technology to organize andThe VB-MAPP is divided into fivestreamline assessment activities cancomponents:decrease clinician frustration and increasejob satisfaction.1.2.3.4.5.Milestones assessment“In a field already characterized byhours of unreimbursed activities,assessments as thorough as this onecan certainly benefit from a technologyboost.”Barriers assessmentTransition assessmentTask analysis and skills trackingPlacement and IEP goalsResearch on the use of technology toThe assessment components are intended toimprove assessment processes in healthcarebe used in a repeated fashion, both to obtainand education has demonstrated that,baseline levels and to track progress. The finalwith appropriate design and effectivetwo components are used to aid in forminguser training, time savings can be foundinterventions (Sundberg, 2008).by reducing administrative burdenWith so many features to offer, it is no surprise(Muehlhausen et. al., 2015); improving thethat the VB-MAPP has been widely embracedease of administration and scoring processesby behavior analysts. However, it can be(Vallejo et. al., 2007); and reducing timetime consuming to administer and requiresspent in validation processes for missing ora labor-intensive goal development process.erroneously reported data. (Zbrozek et. al.,In a field already characterized by hours of2013).unreimbursed activities (cf., Sundberg, 2016),Technology does more than save us theassessments as thorough as this one cantime and frustration of cumbersomecertainly benefit from a technology boost.and duplicative data entry. It also helpsThis is important for several reasons:to substantially reduce opportunity for1. When designed appropriately, techscoring calculation and conversion errors.applications can reduce the time required toAdditionally, algorithms can be created tocomplete various components of assessmentensure all possible comparisons are made,tasks.thereby enhancing the thoroughness of thereport. Algorithms are available to handle2. Opportunities for administration andcommon scoring problems such as missingscoring errors are decreased.Speeding up the VB-MAPP3centralreach.com

data; parameters can be set to block datafamilies. On the other hand, it is timeentry errors such as invalid values (Zbrozekconsuming to administer and report upon.et. al., 2013). Moreover, basic problems thatHaving no linked curriculum, it also createsarise from the use of paper and pencil areadditional work in the form of creatingeliminated entirely (e.g., illegible handwriting,goals and teaching plans. Current supportentering values in the wrong place, etc.;tools are available on the market to guideVallejo et. al., 2007).administration, scoring, and reporting; butour survey of nearly 2,000 VB-MAPP users“Technology does more than save usthe time and frustration of cumbersomeand duplicative data entry. It also helpsto substantially reduce opportunityfor scoring calculation and conversionerrors.”indicated concerns about the adaptabilityand efficiency of existing tools, and acontinued reliance on paper-and-pencilscoring.CentralReach’s VB-MAPPSurvey ResultsStudies of job satisfaction and burnout inmental health fields have shown a strongcorrelation with factors such as largeAdministration & Scoringcaseloads, time pressures, and inadequateAccording to Chart 1, the majority ofresources (Morse, et. al., 2012). Likewise,respondents use time-consuming manualsupport has been found for the idea that,processes such as paper-and-pencil or multi-given appropriate design and effective end-step spreadsheet-to-document input. Fifty-user training, technology enhances bothnine percent of the respondents indicatedjob effectiveness and satisfaction (Selwayadministration and scoring tasks take& Pilkington, 2002). Having more workbetween three to six hours to complete.than time is a demotivating factor for theChart 1conscientious employees that organizationsseek to keep, and technology can helpbalance the load.The VB-MAPP is the type of tool that bringsforth a dilemma for conscientious behavioranalysts. On the one hand, it provides awealth of information for making a realdifference in the lives of clients and theirSpeeding up the VB-MAPP4

Respondents were also asked about thewriting reports from scratch each time. Asfeatures that were most important to themseen in Charts 4 and 5, ease and affordabilityin selecting administration and scoringcontinue to be important factors in choosingmethods. Charts 2 and 3 clearly show thata method of report writing. The ability totime and ease of use are of paramountcustomize is also important to VB-MAPPimportance.users.Chart 2Chart 4Chart 3Chart 5Report WritingWhen it comes to report writing, 79%of respondents indicated that the tasktakes one to four hours, with 87% of allrespondents using self-created templates orSpeeding up the VB-MAPP5centralreach.com

Goal DevelopmentChart 6An additional challenge relates to theaforementioned labor-intensive goaldevelopment process. There are currentlyno commercially available tools that linkgoals directly to VB-MAPP items. Although,a significant portion of survey respondentsindicated they use templated goals,most endorsed starting from scratch foreach client (see Chart 6). 80% of surveyrespondents indicated spending one to fourChart 7hours on goal development alone. Again,time, affordability, and ease of customizationwere the leading factors in satisfaction withgoal development tools (see Charts 7 and 8).The complexity of the administration,scoring, reporting, and goal developmentprocesses inherent in existing optionsfor VB-MAPP use is costly. While surveyrespondents reported spending at leastsix hours start-to-finish, many statereimbursement plans have rules that willChart 8limit reimbursement to 400 or less perassessment (c.f., Florida Agency for HealthCare Administration, 2017; ColoradoDepartment of Health Care Policy andFinancing, 2017).When compared to the per-unit rates aprovider can make utilizing other, lessinformative assessments, use of the VBMAPP is considerably disincentivized.Speeding up the VB-MAPP6

Guides you throughadministration. Gives scoring hints. Calculates summary scores. Plots the scores.TheCentralReachVB-MAPPdoes all ofthe following Automatically generates areport.i. This report is customizable.ii. Sections of the reportyou will typically want tocustomize are highlighted,so you can find it easily. Automatically creates goalsbased on the VB-MAPP scores.iii. Pulls zeros and half pointscores for youiv. These goals are fullycustomizablev. You can activate the onesyou want, and save othersfor later.Speeding up the VB-MAPP7centralreach.com

The CentralReach SolutionAs the opportunity to streamline the VBMAPP tasks presented itself, CentralReachlistened to survey respondents and rose tothe challenge. In partnership with the authorof the VB-MAPP himself, Mark L. Sundberg,CentralReach developed a completeelectronic version of the VB-MAPP, designedto save clinicians time and money whileAs our survey results verify, cliniciansmaking the powerful tool less daunting andsometimes worry that goals yielded by goalmore accessible.banks will lack the level of individualizationto adequately address their client’s needs.CentralReach cares about this, too. For thatreason, each goal can be customized at alllevels. When a goal is suggested, it is prepopulated with commonly used metrics.Using a linear progression, clinicians canmodify each goal element, including (but notlimited to):1. The behavior to change2. The behavior definition3. The direction of changeWith CentralReach’s digital VB-MAPP,4. The goal rateidentifying client skill deficits has never been5. The subgoal incrementsfaster and more efficient! You will be able6. The instructional settingsto pair the great, electronic power of VB-7. The prompt types and levelsMAPP with the other wonderful clinical toolsCentralReach has to offer (electronic dataAdditionally, clinicians can add their owncollection, advanced goal analysis, progressgoals if the goal bank does not yield exactlyreporting), all on ONE cloud-based platform.what is wanted.Speeding up the VB-MAPP8centralreach.com

Benefits of the VB-MAPP onCentralReach: Behavior AnalystScenarioin a place where she could maintain andBecause CentralReach offers an all-in-oneOn the day of Jamal’s initial visit, Nitaclient information platform for behaviorused the practice management softwareanalysts, incorporating assessments such asto create a note for billing purposes. Asthe VB-MAPP provides several advantagesshe conducted her interview with Jamal’sto clinicians. First, it eliminates time lost tomother, she placed more extensive notesshuffling between different record formats.into a google doc, which she later convertedConsider this typical experience:into a formatted report to share laterupdate the list frequently. She created aGoogle Doc to do this.with Jamal’s interventionists. To recordNita works as a Behavior Analyst in abehavioral observations on Jamal, shemulti-disciplinary clinic for children withused an app she likes on her iPad. As sheAutism Spectrum Disorders. The clinicaladministered the VB-MAPP over the nextpsychologist in the practice recentlyseveral sessions, she utilized the paperdiagnosed 4-year-old Jamal and referredprotocol, keeping several different runninghim to Nita for intervention to buildlists of tacts, mands, etc., observed bothcommunication skills. Upon receiving thespontaneously and with prompting in thereferral, Nita also received a paper copy ofsmall amount of space available for doingthe psychologist’s report (which includedso. When she ran out of space on thediagnosis, test results, and broad goalprotocol, she began attaching post-it notesrecommendations), and the intake papersto the protocol to track his word lists.completed by Jamal’s mother prior totesting.When the VB-MAPP administration wascomplete, she consolidated all of the listsAfter reading this, she wanted to speak tointo another Google Doc and filled out anJamal’s mother prior to his arrival to ensureExcel spreadsheet to record his levels andshe had reinforcing items for him. Contactcode his chart. She then wrote goals basedinformation was available in the clinic’son the information gathered in the VB-MAPPpractice management software program.assessment, the interview with his mother,After speaking with Jamal’s mother, sheand the recommendations made by thewanted to record the identified reinforcersSpeeding up the VB-MAPP9

Conclusionpsychologist. In so doing, she switchedbetween two Google Docs, three paperCentralReach strives to be the best all-files, an iPad app, and the clinic’s practiceinclusive platform for behavior analyticmanagement software platform.service providers and interdisciplinaryIf Nita had been using CentralReach, shepractices. By streamlining multi-stepcould have opened Jamal’s file and seen hisprocesses with a system robust enough tointake forms and psychological report. Atautomate frequently used rote processes,the click of a button, she would have foundyet flexible enough to allow users tohis mother’s phone number. Using a customcustomize how those processes are handled,contact form, she could have collectedCentralReach saves you time and money andand recorded information about Jamal’sallows your practice the freedom to focus onreinforcers as she spoke with his mothergrowth. Our success in cutting down the timeon the phone. At the first appointment, sheand effort required to set up program bookscould have entered any new informationthat reflect best practices have readied us forcollected through interview into a note, whileapplying the same skill set to saving you timesimultaneously generating the informationand effort administering, scoring, charting,needed for billing insurance. She also couldreporting, and establishing goals from yourhave collected real-time data while observingVB-MAPP assessments.Jamal. When it was time to administer theVB-MAPP, she would have remained on theCentralReach platform for administration,then allowed the system to automatically generate scores, charts, and reports. Shewould have then chosen from a list ofInterestedin Learning More?system-recommended goals, customizedthem for Jamal, and added others fromscratch if she wanted. In so doing, she wouldEmail Ushave never needed to leave the CentralReachsystem.Speeding up the VB-MAPP10centralreach.com p