AN INVESTIGATION OF THE EVALUATION OF TREATMENT IN RESIDENTIAL FACILITIES FOR THE MENTALLY RETARDED

This investigation involved two independent but related studies. The first study was designed as an examination of the definition of the legal concept of treatment in residential facilities for the mentally retarded. The second study was designed to examine the acceptability of professional judgment evaluation feedback with regard to the legal concept of treatment. Included in the design of the second study was the development and field testing of a proposed method for improving the acceptability of professional judgment evaluation results with regard to the legal concept of treatment. Three groups of subjects were selected as representative of affected social systems whose interactions contribute to the development of the legal concept of treatment. The groups included attorneys (N = 24), parents and relatives of persons with mental retardation (N = 24), and a random sampling from the public (N = 24). The total number of subjects was 72. All subjects participated in both studies. The examination of the meaning of treatment began with the development of a precise definition of treatment. The definition included five elements adapted from a definition developed by the National Center for the Law and the Handicapped. The elements of the definition of treatment were: selection criteria, control, movement, success potential, and data availability. The study addressed the question, Can the definition of treatment be expanded to include a sixth element, evaluation? A rating instrument that consisted of twelve short, narrative items was developed. Two narrative items related to each of Martin\u27s five elements and two related to the proposed sixth element, evaluation. The instrument was field tested and refined prior to its use with the subjects. The subjects read the narrative items and rated their level of agreement with each item as it related to treatment. All subject groups rated evaluation as important or more important than most of Martin\u27s elements. It was concluded that the meaning conveyed from a definition of treatment without an external evaluation element would not be as clear as the meaning conveyed by a definition that included an evaluation component. The second study was designed to examine feedback from professional judgment evaluations of residential facilities for the mentally retarded. Will reactions to evaluation results differ depending on whether the feedback is behavioral or judgmental? Two rating instruments were developed. The first instrument called Form A consisted of fifteen randomly selected judgmental standards that were matched with fifteen corresponding units of evaluation feedback. The judgmental standards and feedback were obtained from evaluation reports of residential facilities for the mentally retarded. Following the development of Form A, the fifteen judgmental standards were rewritten following the steps normally used to write a behavioral objective. The rewritten standards were developed into a rating instrument called Form B. Both forms were field tested and refined prior to their use with the subjects. The subjects read either Form A or B and rated the relationship between the evaluation results and each element of treatment. The subjects also rated the relationship between the evaluation results and the overall concept of treatment. Depending on which form was read, differences that could not be accounted for through subject group identification were evident. The behavioral results were considered by all subject groups to be more closely related to treatment than were the judgmental evaluation results. It was concluded that an operant orientation to standards development would be beneficial with regard to the evaluation of treatment. It was further concluded that the approach to standards development proposed in this study demonstrated that alternatives to judgmental standards can be readily developed and implemented