Organization – Model

Skills vs. Performance

There have been two models proposed to explain problems with organization (and OTMP in general), the skills deficit model and the performance deficit model.

The skills deficit model suggests that shortcomings in organizational behavior is because the individuals “lack the knowledge and proficiency to effectively organize materials,” and it suggests that improvement can be made with “behavioral treatment that emphasizes skills instruction, practice, and breaking skills into substeps.”^​1​

The performance deficit model, in contrast, suggests that “organizational  [problems] may not reflect a lack of knowledge, but rather difficulty implementing their knowledge in the moment.”^​2​

These difficulties are thought to come from “delay aversion,” (which makes it difficult to “wait for desired outcomes and work effectively over extended periods of time without considerable structure and reinforcement”^​1​), task-avoidance, and EF-based deficits that make it hard “to connect knowledge with performance in a manner that results in efficient self-directed adaptive behavior.”^​1​

According to the performance deficit model, interventions should use rewards to enhance motivation of goal-directed behaviors, “which should increase the occurrence of these behaviors and ostensibly reinforce the behavior chain linked to goal attainment as well.”^​1​

So, which model is correct? Both, it turns out.

This was illustrated in a study of ADHD children who had notable organizational deficits. Researchers gave one group skills-based interventions, another group performance-based interventions, and the control group was given no interventions at all. Before and after measures were taken on organizational functioning, academic functioning, homework behaviors, family functioning, attitude to school and teachers, global severity, and post-intervention measures were also taken on global improvement, treatment satisfaction, and adverse behavioral events. After the interventions had been implemented for 10-12 weeks, results were taken.

On individual measures, and excepting parent-rated organizational functioning (“measures children’s use of practical routines and tools to stay organized,” which was higher in the skills-based group) and academic performance (which was no different than controls, unlike in the skills-based group), the performance-based interventions group tended to show the most significant improvements, but the children who received skills-based interventions had better overall organizational functioning throughout the rest of school year.^​1​ The higher scores in the performance-intervention group suggest that treatments:

 “..with a performance-based, contingency management intervention that rewards them for meeting end-point behavioral goals may increase their use of existing organizational skills, or perhaps this intervention motivates them to implement [new] organizational skills to facilitate goal attainment.”^​1​

Overall, though the researchers were surprised that the results from both of the intervention groups “were largely comparable,” suggesting that both models may contribute to observed deficits in organizational function. ^​1​

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