Readability and Reading Level of Behavior Treatment Plans in Intellectual Disabilities

Behavioral treatment plans are developed and implemented to enhance an individual's skills or reduce maladaptive behavior. Often, they are written by doctoral-level psychologists and implemented by direct care staff. However, recent research on readability suggests that behavioral plans may not be implemented as designed because the direct care staff that implements them may not be able to fully understand or read the plans as they are written. The purposes of our study were to analyze the readability and reading level of 20 behavior treatment plans written by professional staff and to determine if the plans were understandable and written at an acceptable reading level. We used the RAIN to assess 20 randomly selected behavioral treatment plans for readability and the SMOG formula to assess reading level. Results showed that none of the treatment plans met all 12 criteria for readability examined by the RAIN. Further, reading levels of the plans measured by the SMOG ranged from 12 to 16 suggesting that an average reading level of 14 was required to read them. These results suggest that behavioral treatment plans are not being written in a manner that facilitates understanding by direct care staff and are written at six grade levels higher than the reading level of an average American. Our findings indicate an urgent need for psychologists to write behavioral treatment plans at least at the reading level of the staff who are entrusted to implement them.