Single-case design effect-size distributions: Association with procedural parameters.

Visual analysis is historically and conventionally used to draw conclusions about outcomes in single-case studies, but researchers are increasingly using effect sizes to supplement conclusions drawn about functional relations with additional information about magnitude of behavior change. However, there is limited information about the extent to which methodological choices (i.e., design type, measurement system) may impact the magnitude of behavior change. We conducted a systematic review of interventions conducted in elementary school classrooms to characterize effect sizes for engagement behaviors and challenging behaviors in those studies. We found that researchers most often used A-B-A-B and multiple baseline across-participants designs, that a variety of measurement systems were used for engagement but not challenging behavior, and that some variability in effect-size distributions can be explained by dependent variable type, design type, and measurement system. The empirically derived distributions from this study may be helpful for single-case researchers to contextualize past, ongoing, and future work related to engagement and challenging behavior. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Deriving relations at multiple levels of complexity following minimal instruction: A demonstration.

Recommendations for achieving generalized instructional outcomes often overlook the capacity for generative learning for most verbally competent humans. Four children (ages 5-8) participated in this project. In Study 1, we provided decontextualized discrete trial teaching to establish arbitrary relations between colors, pictures of characters, and researcher motor actions. All participants engaged in derivative responding, providing evidence of relational framing. Subsequently, we demonstrated that, with no additional instruction, these derivatives contributed to effective action within a socially valid context (i.e., Candyland gameplay). Study 2 extended the demonstration by teaching frames of opposition. Following teaching, all participants engaged in novel and contextually appropriate responding that entailed the derivation of both coordination and opposition between untrained stimuli. This outcome demonstrates how teaching simple relations can result in learning that manifests at higher levels of complexity (i.e., relational networking), providing some evidence that there can be socially valid benefits to decontextualized discrete trial instruction.

Centering Autistic Perspectives: Social Acceptability of Goals, Learning Contexts, and Procedures for Young Autistic Children.

Despite the importance of centering autistic perspectives in educational decision-making for autistic children, few studies have directly assessed autistic perspectives on the social acceptability of early childhood practices. We conducted an online survey to recruit perspectives of autistic adults on a current, comprehensive range of educational practices typically employed with autistic children. We also extended the survey to caregivers and early childhood practitioners, to identify commonalities and discrepancies between shareholder groups. We conducted a descriptive survey study to assess social acceptability of goals, learning contexts, and procedures typically implemented with young autistic children. We received responses from 660 individuals, 226 of whom identified as autistic. For Likert scale and ranked items, we reported median rating and ranking for each item, by shareholder group. For open-ended questions, we conducted open and axial coding, to determine consistent themes within and across shareholder groups. Respondents reported (a) high acceptability for goals promoting self-determination and low social validity for goals promoting masking; (b) high acceptability for antecedent interventions and low social validity for some forms of extinction; (c) that appropriate learning environments are highly context dependent, varying with individual needs; and (d) that the child is the most important shareholder in educational decision-making. We make recommendations to practitioners in response to survey results, including (a) respecting autistic culture and characteristics in selecting goals; (b) considering social, emotional, and psychological needs in selecting procedures; and (c) individualizing goals, learning contexts, and procedures based on the child's perspectives and unique needs.

Comparing Interventions With Speech-Generating Devices and Other Augmentative and Alternative Communication Modes: A Meta-Analysis.

PURPOSE: Optimal augmentative and alternative communication (AAC) systems for children with complex communication needs depend in part on child characteristics, child preferences, and features of the systems themselves. The purpose of this meta-analysis was to describe and synthesize single case design studies comparing young children's acquisition of communication skills with speech-generating devices (SGDs) and other AAC modes. METHOD: A systematic search of published and gray literature was conducted. Data related to study details, rigor, participant characteristics, design information, and outcomes were coded for each study. A random effects multilevel meta-analysis was performed using log response ratios as effect sizes. RESULTS: Nineteen single case experimental design studies with 66 participants (M age = 4.9 years) met inclusion criteria. All but one study featured requesting as the primary dependent variable. Visual analysis and meta-analysis indicated no differences between use of SGDs and picture exchange for children learning to request. Children demonstrated preferences for and learned to request more successfully with SGDs than with manual sign. Children who preferred picture exchange also learned to request more easily with picture exchange than with SGDs. CONCLUSIONS: Young children with disabilities may be able to request equally well with SGDs and picture exchange systems in structured contexts. More research is needed comparing AAC modes with diverse participants, communication functions, linguistic complexity, and learning contexts. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.22111181.

Using Progressive Time Delay to Increase Levels of Peer Imitation During Sculpting Play.

A multiple probe across participants with an embedded withdrawal single case research design was used to examine the effectiveness of a progressive time delay (PTD) procedure to teach preschoolers with disabilities to imitate their peers during a sculpting play activity. Data indicated the presence of a functional relation between the use of PTD and contingent reinforcement on increased levels of peer imitation across participants; levels also decreased when PTD was withdrawn, although not to baseline levels. Overall levels of peer imitation had a greater magnitude of change than demonstrated in previous research.

Concurrence on Nonconcurrence in Multiple-Baseline Designs: A Commentary on Slocum et al. (2022).

Slocum et al. (this issue) provide well-reasoned arguments for the use of nonconcurrent multiple baseline designs in behavior analytic work, despite historical preference for concurrent designs (i.e., simultaneous baseline initiation) and contemporary guidelines in related fields suggesting that nonconcurrent designs are insufficient for evaluating functional relations (What Works Clearinghouse, 2020). I provide a commentary, highlighting major contributions of this article and suggesting areas of further consideration. In sum, I agree with authors that researchers should avoid wholesale dismissal of nonconcurrent designs. I also agree that understanding how multiple-baseline designs control for and allow for detection of threats to internal validity is critical so that authors can apply the variation of the design that allows them to draw confident conclusions about relations between independent and dependent variables.

A Systematic Review of Augmented Input Interventions and Exploratory Analysis of Moderators.

Purpose Augmented input is the act of concurrently modeling language verbally and on a communication device, and is one strategy for teaching individuals to effectively use aided modes of communication. The purpose of this literature review is to assess the efficacy of augmented input for increasing communication and to identify intervention components, participant characteristics, and instructional contexts related to therapeutic outcomes. Method We double screened all potential sources and double coded all included sources. Database, forward, and backward searches yielded 99 single case designs in 26 sources. We coded characteristics of participants, instructional contexts, independent variables, and dependent variables. We also coded quality/rigor and primary outcomes for each design or comparison. Results Across high-quality studies, two thirds of designs indicated that augmented input was effective compared to baseline conditions and alternative interventions, and exploratory analyses indicated that receptive language skills, age, and diagnoses may moderate intervention efficacy. Most augmented input interventions included additional components that may serve as "active ingredients" (e.g., systematic prompting, contextual reinforcement). Most studies also did not report participant characteristics hypothesized to moderate intervention efficacy (e.g., joint attention skills, imitation repertoire). Results also indicated high risk of publication bias, with peer-reviewed sources twice as likely to include positive effects than dissertations and theses. Conclusions Across high-quality studies, augmented input was inconsistently effective as a stand-alone intervention. Packaged interventions that included augmented input were typically more effective than augmented input in isolation, particularly for individuals who were young, had strong receptive language skills, or had no comorbid diagnoses.

Augmentative and Alternative Communication and Speech Production for Individuals with ASD: A Systematic Review.

This review evaluated the effects of augmentative and alternative communication (AAC) on speech development in children with autism spectrum disorders (ASD); replicated, updated, and extended the systematic review by Schlosser and Wendt (American Journal of Speech-Language Pathology 17:212-230, 2008). Twenty-five single case design articles and three group design articles published between 1975 and May 2020 met inclusion criteria related to participant characteristics, intervention type, design, and visual analysis of dependent variable outcomes. Overall, AAC resulted in improved speech production; however, speech gains that did occur did not surpass AAC use.

Using Progressive Time Delay to Increase Levels of Peer Imitation During Play With Preschoolers With Disabilities.

Research suggests peer imitation can be taught using systematic procedures and can be embedded into ongoing play contexts with preschool-age children. However, additional research is needed to test procedures that may increase levels of peer imitation with toddlers with disabilities and in generalized contexts. We used a multiple probe across participants research design to evaluate the effectiveness of progressive time delay (PTD) to teach peer imitation to preschoolers with disabilities during a play activity with a peer. We also examined the efficacy of PTD in a generalized context (i.e., new peers, implementer, and materials). Visual analysis indicated a functional relation between PTD and unprompted peer imitation; however, generalization was variable across participants. Our results support previous research indicating PTD is effective in teaching children with disabilities to imitate their peers.

Response shaping to improve food acceptance for children with autism: Effects of small and large food sets.

BACKGROUND: Food selectivity, characterized by food refusal, limited food repertoire, or preference for certain types of foods, is common among children with ASD. METHOD: In this study, researchers examined the effects of a response shaping procedure using a large rotating food set and a small constant food set on food acceptance for two boys with ASD. The small set consisted of three foods that were presented during every session; the large set consisted of 15 foods, of which three were presented during each session, in randomly ordered sets. Researchers measured the percentage of correct behaviors and the cumulative number of foods with which participants interacted. Two concurrently operating multiple baseline across behaviors designs were used to assess whether the shaping procedure resulted in increased correct responding compared to baseline conditions, and whether the intervention was differentially effective with large versus small food sets. RESULTS: The procedures were similar in efficiency for one participant, although he ate many more foods in the large set condition. For the other participant, shaping was successful at increasing some acceptance behaviors (e.g., putting food in his mouth) but only the small set resulted in eating a new food. CONCLUSIONS: Practitioners should consider use of less restrictive or intrusive interventions to promote food acceptance and the use of larger sets of foods, modified to include fewer foods in the case of poor response to intervention.

Teaching Preschoolers With Down Syndrome Using Augmentative and Alternative Communication Modeling During Small Group Dialogic Reading.

Purpose This study evaluated the effect of aided augmentative and alternative communication modeling (AAC-MOD) on the communication skills of children with Down syndrome (DS) during small group dialogic reading. Method Four children with DS between 3;1 and 5;3 (years;months; M = 4;5) and 5 typically developing peers between 3;5 and 5;9 (M = 4;3) participated. Effects were examined using a multiple probe across behaviors design with 4 children with DS. To simulate typical dialogic reading routines in inclusive classrooms, a strategy called Read, Ask, Answer, Prompt (Binger, Kent-Walsh, Ewing, & Taylor, 2010) was applied during the baseline and intervention sessions. Results A functional relation was demonstrated between (a) AAC-MOD and percentage of correctly identified symbols for 3 participants, (b) AAC-MOD and rate of symbolic communication for 2 participants, and (c) AAC-MOD and number of different words for 2 participants. Increases in number of multiple word combinations occurred for 2 participants. All 4 children maintained their percentage of correctly identified symbols. Increases in rate of symbolic communication did not generalize to thematic play contexts, a distal measure of response generalization. Conclusion AAC-MOD is an effective strategy for teaching target vocabulary and increasing rate of symbolic communication in young children with DS. Supplemental Material https://doi.org/10.23641/asha.10093538.

Functional Analysis and Treatment of Pica on a Preschool Playground.

Appropriate use of function-based assessments and interventions is crucial for improving educational outcomes and ensuring the well-being of children who engage in dangerous problem behaviors such as pica. A function-based assessment was conducted for a child engaging in pica in an inclusive childcare setting. Results suggest pica was maintained by access to adult attention. Function-based interventions were developed, assessed, and shared with the child's teaching team. Follow-up data suggest that his teachers continued to use the intervention and that levels of pica remained low.

A Primer on Single-Case Research Designs: Contemporary Use and Analysis.

The overarching purpose of this article is to provide an introduction to the use of rigorous single-case research designs (SCRDs) in special education and related fields. Authors first discuss basic design types and research questions that can be answered with SCRDs, examine threats to internal validity and potential ways to control for and detect common threats, and provide guidelines for selection of specific designs. Following, contemporary standards regarding rigor, measurement, description, and outcomes are presented. Then, authors discuss data analytic techniques, differentiating rigor, positive outcomes, functional relations, and magnitude of effects.

Systematic Review of Problem Behavior Interventions: Outcomes, Demographics, and Settings.

Interventions designed to decrease problem behavior for students with ASD are critical and may be differentially important for students from minority groups as those students tend to be assigned more negative outcomes related to problem behavior (e.g., suspensions). School-based interventions intended to decrease problem behavior for individuals with ASD were reviewed; 46 articles including 84 single case designs and 87 participants were analyzed regarding participant demographics, settings and implementers, intervention components, and study characteristics. We assessed outcomes for 55 demonstration designs with adequate rigor. Most research was conducted with students in segregated settings and, although race and ethnicity were rarely reported, proportions were different from other reviews in that children from some minority groups were overrepresented.

Single-case synthesis tools II: Comparing quantitative outcome measures.

Varying methods for evaluating the outcomes of single case research designs (SCD) are currently used in reviews and meta-analyses of interventions. Quantitative effect size measures are often presented alongside visual analysis conclusions. Six measures across two classes-overlap measures (percentage non-overlapping data, improvement rate difference, and Tau) and parametric within-case effect sizes (standardized mean difference and log response ratio [increasing and decreasing])-were compared to determine if choice of synthesis method within and across classes impacts conclusions regarding effectiveness. The effectiveness of sensory-based interventions (SBI), a commonly used class of treatments for young children, was evaluated. Separately from evaluations of rigor and quality, authors evaluated behavior change between baseline and SBI conditions. SBI were unlikely to result in positive behavior change across all measures except IRD. However, subgroup analyses resulted in variable conclusions, indicating that the choice of measures for SCD meta-analyses can impact conclusions. Suggestions for using the log response ratio in SCD meta-analyses and considerations for understanding variability in SCD meta-analysis conclusions are discussed.

Single-case synthesis tools I: Comparing tools to evaluate SCD quality and rigor.

Tools for evaluating the quality and rigor of single case research designs (SCD) are often used when conducting SCD syntheses. Preferred components include evaluations of design features related to the internal validity of SCD to obtain quality and/or rigor ratings. Three tools for evaluating the quality and rigor of SCD (Council for Exceptional Children, What Works Clearinghouse, and Single-Case Analysis and Design Framework) were compared to determine if conclusions regarding the effectiveness of antecedent sensory-based interventions for young children changed based on choice of quality evaluation tool. Evaluation of SCD quality differed across tools, suggesting selection of quality evaluation tools impacts evaluation findings. Suggestions for selecting an appropriate quality and rigor assessment tool are provided and across-tool conclusions are drawn regarding the quality and rigor of studies. Finally, authors provide guidance for using quality evaluations in conjunction with outcome analyses when conducting syntheses of interventions evaluated in the context of SCD.

Single-Case Experimental Design: Current Standards and Applications in Occupational Therapy.

Occupational therapy is a field with a long-standing history of recommending and implementing interventions designed to improve the quality of life of clients with disabilities. Often, the interventions are individualized to meet the needs of this diverse group of clients in dynamic settings. Identifying effective and efficient interventions for such a diverse group of clients and settings requires a flexible research approach. Single-case experimental designs (SCEDs) allow practitioners and researchers to answer experimental questions within the context of rigorous research designs. The purpose of this article is to highlight the similarities between the mission of occupational therapy and SCEDs. Recommendations for designing single-case studies with the framework provided by the Single-Case Reporting Guideline in Behavioral Interventions are provided. In addition, common problems and proposed solutions, along with implications for practitioners and researchers, are provided.

Chaining Functional Basketball Sequences (with Embedded Conditional Discriminations) in an Adolescent with Autism.

Individuals with developmental disabilities successfully participate in fewer recreation activities, including sports activities, than their typically developing peers. Although a functional basketball-playing repertoire might increase social opportunities and physical health for these individuals, no research has outlined a behavior-analytic strategy for teaching this sport. In our study, we taught a 13-year-old male diagnosed with autism to play basketball. During phase 1, we employed discrete-trial training to establish proficiency with nine fundamental basketball skills (i.e., recruiting attention, passing, dribbling, etc.). During phase 2, we used a forward chaining procedure to teach-specific sequences of these component skills that are appropriate for playing offense and defense and for participating in a full-court basketball drill. The participant learned all pre-requisite skills and response chains came under the control of contextually appropriate discriminative stimuli.

Initiation and Generalization of Self-Instructional Skills in Adolescents with Autism and Intellectual Disability.

Self-instruction using videos or other supports on a mobile device is a pivotal skill and can increase independence for individuals with disabilities by decreasing a need for adult supports. This study evaluated the effects of progressive time delay (PTD) to teach four adolescents with autism and intellectual disability how to initiate self-instruction in the presence of a task direction for an untrained task. Participants were screened for imitating video models prior to the study and were taught to navigate to videos on an iPhone(®) in history training. A multiple probe design across settings embedded in a multiple probe design across participants was used to evaluate the effects of PTD on initiation of self-instruction. All participants learned to self-instruct. Two participants generalized self-instruction to two novel settings. Two participants required instruction in two settings before generalizing to the third. Three participants generalized self-instruction in the presence of a task direction from the researcher to a task direction from their classroom teacher in all three settings. One participant generalized to a task direction presented by the classroom teacher in one setting, but not in the other two. All participants maintained self-instruction behaviors assessed 1 week after all participants met criteria in all settings. Self-instruction using videos or other supports on a mobile device is a pivotal skill and can increase independence for individuals with disabilities by decreasing a need for adult supports.

Teaching Children with Autism in Small Groups with Students Who are At-Risk for Academic Problems: Effects on Academic and Social Behaviors.

Students with ASD are often taught in individual instructional arrangements, even when they receive educational services in inclusive settings. Providing intervention in small group arrangements may increase opportunities for social interactions, particularly when these opportunities are systematically planned. In this study, academic instruction was conducted in small groups consisting of one student with ASD and peers who were socially competent but at risk for academic failure. All students learned targeted academic behaviors and increased their use of targeted social behaviors during instructional sessions. Generalization of social behaviors to a less-structured context was variable. Results suggest that small group instruction may be a feasible and preferred alternative to individual instruction for students with ASD.