Alternating Treatments Design Research Articles

Effectiveness of Video Prompting Versus Picture Prompting in Improving Daily Living Skills of Autistic Children.

Static picture (SP) schedules are an established intervention for children with autism spectrum disorder (ASD), but the use of video modeling (VM) has not been thoroughly investigated. To compare the effectiveness of VM prompts versus SP prompts in improving autistic children's independence with daily living skills. An experimental alternating treatment design. Approved private school for children with disabilities. Seventeen participants (13 male and 4 female; ages 9-18 yr) with an ASD diagnosis. Visual prompts using a tablet were provided during task participation, with data collected in two phases. Type and frequency of the prompts required to complete the task were documented for each participant during the intervention session. Both VM and SP conditions resulted in improvements in at least one phase. Most participants demonstrated a decrease in the number of required cues to complete the task and an increase in independence to complete the task. The decrease in number of cues required from baseline to end of data collection indicated clinically meaningful improvement in task completion. Both VM and SP prompts resulted in an increase in independence in daily living skills, with most participants demonstrating improvement in either condition, indicating that the use of visual prompts (either VM or SP) is effective with the ASD population. Plain-Language Summary: Occupational therapy practitioners who work with autistic children and adolescents often identify improving daily living skills as a goal area. Findings from this study build on evidence that supports the use of a visual aid (either static picture or video modeling) to improve autistic children's acquisition of daily living skills. The findings also highlight emerging evidence related to the level of function and effectiveness associated with the type of visual cue. Positionality Statement: This article primarily uses identity-first language (i.e., autistic person) and at times person-first language (i.e., person with autism) to reflect the variability in the language preferences of the autism community (Lord etal., 2022).

Teaching a foreign language to students with autism via telehealth in inclusive school settings

AbstractThe purpose of this study was to replicate previous research that examined the effects of tact and listener instruction on the emergence of bidirectional intraverbals, and to extend this research line to include teaching a foreign language to students with autism spectrum disorders (ASD) via telehealth. The study participants were four Chinese native primary school‐aged students. An adaptive alternative treatment design was used to compare the effects of tact and listener instruction on bidirectional intraverbals, and pre‐probe and post‐probe data demonstrated that both forms of instruction led to bidirectional intraverbal relations, with tact instruction being relatively more effective. Maintenance and social validity were assessed for all participants, and booster instructions were provided as needed. The results were discussed in the context of inclusive education and improving foreign language instruction for students with special needs.

Effects of a Contingent Responses Intervention on the Quantity and Quality of Vocalizations of Preschool Children with Autism Spectrum Disorder.

Multiple contemporary theories emphasize the quantity and quality of child vocalizations for promoting spoken language acquisition. Yet, empirical evidence for facilitating vocal development is strikingly lacking including for children with autism spectrum disorder (ASD) who have difficulty developing language. We evaluate use of contingent responses and vocal enhancement strategies to increase the quantity and quality of child vocalizations to which adults can respond with language-facilitating input for children with ASD. Three preschool children with ASD and minimal verbal skills participated. Using an alternating treatments design embedded within a multiple probe across participants design, we compared using contingent responses with and without vocal enhancement strategies versus a non-contingent control condition. Based on visual analysis and effect sizes, all participants showed a functional relation between both active intervention conditions and quantity of vocalizations, as predicted. For quality of vocalizations, changes under the active intervention conditions were less pronounced than those observed for quantity. Two participants showed a functional relation between at least one quality variable and the active interventions. Our hypothesis that vocal enhancement strategies would exhibit a value-added effect was partially supported for quantity and quality. Findings support using contingent responses to improve the quantity and to some degree the quality of vocalizations in young children with ASD and minimal verbal skills. Support for the added value of vocal enhancement strategies was mixed. Refining the intervention strategies is warranted to meet the needs of the understudied population of children with ASD and minimal verbal skills.

Leveraging Communication Partner Speech to Automate Augmented Input for Children on the Autism Spectrum Who Are Minimally Verbal: Prototype Development and Preliminary Efficacy Investigation.

Augmentative and alternative communication (AAC) technology innovation is urgently needed to improve outcomes for children on the autism spectrum who are minimally verbal. One potential technology innovation is applying artificial intelligence (AI) to automate strategies such as augmented input to increase language learning opportunities while mitigating communication partner time and learning barriers. Innovation in AAC research and design methodology is also needed to empirically explore this and other applications of AI to AAC. The purpose of this report was to describe (a) the development of an AAC prototype using a design methodology new to AAC research and (b) a preliminary investigation of the efficacy of this potential new AAC capability. The prototype was developed using a Wizard-of-Oz prototyping approach that allows for initial exploration of a new technology capability without the time and effort required for full-scale development. The preliminary investigation with three children on the autism spectrum who were minimally verbal used an adapted alternating treatment design to compare the effects of a Wizard-of-Oz prototype that provided automated augmented input (i.e., pairing color photos with speech) to a standard topic display (i.e., a grid display with line drawings) on visual attention, linguistic participation, and (for one participant) word learning during a circle activity. Preliminary investigation results were variable, but overall participants increased visual attention and linguistic participation when using the prototype. Wizard-of-Oz prototyping could be a valuable approach to spur much needed innovation in AAC. Further research into efficacy, reliability, validity, and attitudes is required to more comprehensively evaluate the use of AI to automate augmented input in AAC.

A Comparison of Error Correction Methods Embedded in the Orton-Gillingham Approach to Spelling

The present study examined the effects of two error-correction procedures on the spelling performance of five students who were rising first through third grades. Each participant was diagnosed with a learning disability in reading and spelling. Using an Adapted Alternating Treatments Design, a teacher-led questioning procedure and a student-led visual comparison procedure were implemented in the unbranded Orton-Gillingham instructional model. Teacher- led questioning is the scaffolded model of error-correction described in Orton-Gillingham Simultaneous Oral Spelling instruction. Student-led visual comparison is a method which is well documented in the literature as highly effective for students with learning disabilities. The intervention results across participants showed little difference in students’ spelling accuracy under each condition. Responses to social validity questions indicated that student preference could be a determining factor in selecting which error correction method to implement in the Orton-Gillingham approach to spelling instruction.

Comparing Simultaneous and Sequential Food Presentation to Increase Consumption of Novel Target Foods.

Two methods of food presentation (simultaneous and sequential) were compared in an adapted alternating treatment design to determine effects on consumption of target foods for three children with autism in a school setting. Preferred and nonpreferred target foods were nominated by parents, and consumption of reported preferred and nonpreferred foods was directly tested. Preferred and nonpreferred foods were then paired together and assigned to one of two conditions. In the simultaneous condition, bites of preferred and nonpreferred food were presented at the same time, with the nonpreferred food placed behind or inside the preferred food. In the sequential condition, a bite of preferred food was delivered contingent on consumption of a bite of nonpreferred food. Consumption increased in the sequential condition for two out of three participants. Implications for treatment of food selectivity in a school setting are discussed.This study describes two simple interventions to increase consumption of nonpreferred foods that can be implemented in a classroom settingThese data contribute to previous studies comparing sequential versus simultaneous presentation of foods by conducting the procedures in participants' natural settingResults indicate the efficacy of sequential presentation of preferred and nonpreferred foods without the use of escape extinctionResults also suggest further research comparing sequential versus simultaneous food presentation is warranted, given the few direct comparisons that currently exist and their overall mixed results regarding relative efficacy.

Effects of the Blended Workshop Learning and Web-Based Learning Sequence on the Learning Level: A New Experiment

Background: Background: The blended electronic learning system, raised as a new approach in educational planning with great enthusiasm, seeks novel ways to properly combine the media; however, the sequence of in-person and distance educational methods is an issue neglected so far. This study aims to compare the effect of the sequence of blended workshop learning and web-based learning on the learning level of biostatistics in students who were members of the Student Research Committee at Arak University of Medical Sciences.
 Methods: This is a quasi-experimental study with an alternative treatment design. The statistical population consisted of the students who were members of the Student Research Committee of the university, including 38 medical students and 15 health students, who were selected through census sampling due to their limited number. The data were selected with 2 questionnaires: demographic characteristics and biostatistics multiple-choice questions to assess learning of statistical concepts in three levels of literacy, reasoning, and thinking. The validity and reliability of the translated statistics questions were assessed through content validity and bisection, respectively. The data were analyzed in SPSS-16 through independent and paired t-tests and analysis of variance.
 Results: The results showed a statistical difference between the groups in both faculties in statistical literacy and reasoning in blended learning (p>0.05). However, regarding statistical thinking, the difference was significant in the health faculty (p=0.044) and insignificant in the medical school (p>0.05).
 Conclusion: Given the statistical difference observed in the health group, we suggest holding in-person courses at first and online courses then.

Comparing technology with built-in decision-making on vocational skills for students with ASD and/or IDD

Purpose The purpose of this study was to compare mobile technology devices (i.e., Tablets) with built-in decision prompts and branching to improve the independent vocational performance of four secondary students with autism spectrum disorder (ASD) and/or intellectual and developmental disability (IDD). Materials and Methods An adapted alternating treatments design was used to compare the effectiveness of the prompting system presented on Apple iPads and Microsoft Windows-based tablets. The prompting system contained audio, video, and picture prompts. Further, we investigated the effectiveness of improving problem-solving through decision-making prompts and branching. Participants used the devices to make decisions on how to properly prepare a teacher’s lounge including filling salt and pepper shakers, cleaning tables, and filling silverware containers. Results Results indicated that both devices produced immediate and significant increases in independent responding for all participants. All participants also self-faded prompt dependence throughout the duration of the intervention as vocational skill acquisition increased. Conclusion Teachers and students have enhanced access to powerful devices capable of providing individual support for vocational skills. This study indicates that a multimedia prompting system with multiple prompt mediums can improve independent completion of targeted vocational skills while decreasing the reliance on technological support. Implications for rehabilitation Technology offers an effective and personalized support to encourage independent vocational skills in secondary participants with autism spectrum disorder (ASD) and/or intellectual and developmental disability (IDD). A technology support system that is universally designed with built-in decision-making offers a more authentic approach to transition support. The results have demonstrated that participants with ASD and/or IDD were successful completing a vocational task utilizing the universally designed prompting system, regardless of device. The results suggest that utilizing this approach to vocational support will not only improve independent success, but participants will also self-fade technology use as mastery is gained.

An Alternating Treatment Design Comparing Small Group Reading Interventions Across Early Elementary Readers

An Alternating Treatment Design Comparing Small Group Reading Interventions Across Early Elementary Readers

Impact of Behavior Modification on Female Campers’ Physical Activity in Summer Camp

In order to combat rampant health and wellness deterioration over the summer months, residential summer camps have been presented as a possible solution to thwart such declines in overall health and wellbeing. The purpose of this study was to determine the differential effects of prompting, and prompting combined with reinforcement on female campers’ step counts at a residential summer camp. The participants in this study were 104 female campers (Mage = 13.71), all attending the same residential summer camp. An alternating treatment design was implemented to evaluate campers’ daily physical activity across three conditions (baseline, prompting, and prompting combined with contingent reinforcement) throughout the duration of the 51 days camp experience. In accordance with standard Applied Behavior Analysis research, data were plotted graphically in order to employ visual analysis to determine functional relationships between the intervention (prompting only, prompting plus group contingency, and target behavior [step count]). Results of this study indicate that prompting with group contingencies (29%) and without (13%) successfully led to an increased amount of daily physical activity. Further, small variance within the group contingency group illustrates the breadth of success for this technique. This is the first comprehensive intervention focused primarily on influencing female campers’ physical activity levels in the residential camp context and demonstrates a cost-effective strategy for improving activity among female campers.

Evaluating the Efficacy of Behavior Modification Strategies on Physical Activity Levels Among Incarcerated Youth.

This study examined the impact of prompting only and prompting combined with independent group-oriented contingency on incarcerated adolescent males' physical activity level during a sport-leadership program. An alternating treatment design was employed to allow for the evaluation among multiple treatment conditions. The study occurred during 35 consecutive sport programming lessons at a juvenile correctional facility. Participants were 16 adolescent males (Mage = 18.79). Two behavior modification strategies, prompting only and prompting combined with independent group-oriented contingency, were employed. Data were plotted graphically so visual analysis could be determined in order to explore any functional associations between the treatment conditions (e.g., interventions) and target behavior (e.g., step count). Prompting only slightly increased physical activity, whereas prompting in conjunction with independent group-oriented contingency elevated activity levels by 36%, with a smaller standard deviation indicating that all participants were equivalently physically active. The results of this study underpin the expansive benefits of sport-leadership programming, not just in similar programs' ability to develop life skill integration, positively impact life during incarceration, improve attitudes, and promote physical activity, but also to provide elevated opportunities for youth to be physically active.

Effects of omission and commission errors during tact instruction.

The purpose of the current study was to compare the effects of omission and commission errors of reinforcement during tact instruction via telehealth with three children, 6 to 7 years of age, who were diagnosed with an autism spectrum disorder. We used an adapted alternating treatment design to evaluate skill acquisition of target stimuli across high-integrity, commission errors, and omission errors conditions. The high-integrity condition produced mastery criteria in fewer sessions compared with the integrity-error conditions in four of six comparisons, and the omission condition reached mastery criteria in fewer sessions than the commission condition in five of six comparisons.

The Potential Promise of Using Adapted Alternating Treatment Designs to Assess Teachers’ Use of Classroom Management Practices

Teachers critically need classroom management skills. To develop these skills, teachers need high-quality professional development (PD). To support teachers, schools need practical tools for assessing the effects of PD on teachers’ use of classroom management practices. The adapted alternating treatments design (AATD) may be a tool for this purpose. We conducted an initial pilot investigation testing the potential of AATDs to evaluate the effects of PD on teachers’ use of classroom management practices for eight Pre-K–12 teachers. We successfully used AATDs to evaluate PD effects in all cases across two phases of PD (online module instruction, online module + peer coaching). Results suggest the potential promise of using AATDs to evaluate the effects of PD on teachers’ use of classroom management practices. Results also showed didactic training alone was often insufficient to increase use of practices, whereas peer coaching was effective in increasing use of at least one practice for all teachers.

Paying Attention in Class: Using In-Class Quizzes to Incentivize Student Attention

Background Methods are needed to incentivize student attention to class material. Objective The purpose of this study was to examine the effects of in-class quizzing to incentivize student attention to class material to boost exam performance. Method A randomized, alternating treatments design embedded in an introductory psychology class compared learning benefits of two types of quiz-based engagement activities, mastery quizzes, and concepts checks, as compared to a no-engagement activity control. Results Students performed significantly better on exam content linked to classes with quiz-based engagement activities. Learning benefits of engagement activities extended across levels of cognitive complexity indexed to Bloom levels, although were stronger for low-level items. The effects of engagement activities were also stronger for content directly discussed in class. There were no significant differences in learning outcomes between the two engagement activities. Conclusion Students performed better on exam content linked to class sessions with quiz-based engagement activities that incentivized attention to class material compared to those that did not. Teaching Implications Using in-class quizzes as attentional cues offers instructors a means of incentivizing student attention to class material with minimal disruption of class time and lecture flow, while also improving exam scores.

A comparison of TAGteach and video self-evaluation to improve dance movement accuracy.

Previous behavior-analytic research to improve dance performance has separately demonstrated the efficacy of TAGteach and self-evaluative video feedback. However, no research has directly compared these two interventions. In this study, we used an adapted alternating-treatment design to examine the effects of TAGteach versus self-evaluative video feedback to improve the accuracy of dance movements among four beginner-level dance students. All participants performed better on movements that were taught using TAGteach compared with those that were taught using video self-evaluation. However, conclusions about the superiority of TAGteach should be tempered until further research on this topic is conducted.

THE THREE GOOD THINGS INTERVENTION TO IMPROVE SUBJECTIVE WELL-BEING IN STUDENTS

ABSTRACT: The pressure from lectures experienced by students can have detrimental effects on their well-being and overall life satisfaction. Therefore, this study aimed to assess the effectiveness of three good things interventions in enhancing the subjective well-being of students. A total of 36 students from Makassar State University participated in this randomized experiment, using an alternative treatment design with a pretest. The Positive and Negative Affect Schedule (PANAS) and Satisfaction With Life Scale (SWLS) were used as measurement tools, and the data were analyzed through an independent sample t-test and analysis of covariance (ANCOVA). The result showed a significant difference in subjective well-being changes between participants who received the three good things intervention and those with a placebo memory, at a t-test significance value of 0.007 and ANCOVA significance of 0.008. Hence, it can be concluded that the three good things interventions positively impact the subjective well-being of students at Makassar State University. This study provided valuable insights on the positive impact of three good things interventions in improving subjective well-being.

Comparing the Effect of Echoic and Listener Responding in the Development of Complex Intraverbals.

This study aimed to compare the effects of echoic and listener responding in the emergence of complex intraverbal behavior in four children with autism spectrum disorder (ASD). Each participant was taught to provide an echoic response or a listener response for different discriminative stimuli for each condition. We used a nonconcurrent multiple probe design across participants and adapted an alternating treatment design to compare the effects between the two conditions. Pre- and posttests were used to evaluate the effects of the two different prompt types in the emergence of complex intraverbals. The results indicate that the echoic response was more effective than the listener response at increasing the emergence of complex intraverbal responses in three out of four participants.

Focusing on the locus of the breakdown for treatment of anomia: a pilot study

ABSTRACT The primary goal of this study was to evaluate the treatment effects of semantic feature analysis (SFA) and phonological components analysis (PCA) on word retrieval processing in persons with aphasia (PWAs). After identifying the locus of the breakdown in lexical retrieval processing, 15 monolingual native Persian speakers with aphasia were divided into two groups. After three naming trials, participants with dominant semantic deficits received SFA, and participants with primary phonological deficits were provided with PCA three times a week for eight weeks. Both approaches improved participants’ naming and performance on language tests, including spontaneous speech, repetition, comprehension, and semantic processing. However, the correct naming of treated and untreated items was higher in mild-to-moderate participants, with mostly circumlocution and semantic paraphasias in the SFA group. The same holds for mild-to-moderate participants with mostly phonemic paraphasia who received PCA therapy. Moreover, the results showed that participants’ baseline naming performance and semantic abilities could be associated with the treatment outcomes. Although limited by a lack of a control group, this study provided evidence supporting the possible benefits of focusing on the locus of the breakdown for treating anomia through SFA and PCA approaches, specifically in participants with mild to moderate aphasia. However, for those with severe aphasia, the treatment choice may not be as straightforward because several variables are likely to contribute to this population’s word-finding difficulties. Replication with larger, well-stratified samples, use of a within-subjects alternating treatment design and consideration of treatments’ long-term effects are required to better ascertain the effects of focusing on the locus of breakdown for treatment of anomia.

A Comparison of Social Stories with and without Video Modeling in Teaching How to Respond to Lures of Strangers to Children with Autism

Introduction: The purpose of this study was to compare the effectiveness and efficiency of social stories with and without video modeling in teaching how to respond to lures of strangers to children with autism. Method: The study was conducted with four children aged 10-13 years diagnosed with autism. Target skills for the students were how to avoid abduction by strangers and how to respond if a stranger knocked at the door. An adapted alternating treatments design was used in the study. Findings: The findings of the study showed that both procedures were equally effective on promoting acquisition for three of the four students with autism. The findings showed that social stories alone was more effective than social stories with video modeling for one student. There was no considerable difference between the two procedures in terms of efficiency. Social validity findings showed that opinions of the participants and their mothers were positive overall. Discussion: It is likely appropriate for teachers, researchers, practitioners, and families to use only one of the teaching practices compared in this study, taking into account the characteristics and preferences of their students in teaching the skills of protection from strangers. To generalize the findings from this study, it can be suggested that similar studies be conducted with different practitioners and participants in various age groups.

Comparing a Modified Structured Mix with a Modified Random Rotation Procedure to Teach Auditory-Visual Conditional Discriminations to Children with Autism

We evaluated two procedures to teach auditory-visual conditional discriminations (receptive labeling) to children with autism. The procedures evaluated a modified Structured Mix (SM) procedure and a modified Counterbalanced Random Rotation (RR) procedure. The modified SM procedure was based on the logic of simplifying the task by breaking it down into smaller, successive steps and by requiring mastery of each step before introducing the next. Compared to previous studies, the modified SM procedure contained fewer steps, less prompting, and a less stringent mastery criterion. The modified RR procedure targeted all three stimuli simultaneously by presenting them across consecutive trials, both during training and error correction. Sample stimuli were presented in a counterbalanced random order and the comparison stimuli were presented in counterbalanced random positions. Participants were nine children with autism. An adapted alternating treatments design was used. Results showed that the modified SM procedure was more efficient for four of the nine participants, the modified RR procedure was more efficient for one of the nine participants, both procedures were equally efficient for two participants, and neither procedure was effective for two of the nine participants. The modified SM procedure appeared more efficient than the SM procedure employed in previous studies. Despite results, further research is warranted to examine within subject comparisons between original discrimination training procedures and modified procedures.