Single-case Experimental Design Research Articles

Prompting-fading with Visual, Auditory, Kinesthetic, Tactile (VAKT) Media for Reading Skills of Dyslexia Children

Dyslexia children have problems with recognition, data accuracy, poor decoding, and poor spelling skills. Of course they need appropriate learning or implement the advantages they have. There are several intervention methods that can overcome the learning difficulties of children with dyslexia, one of which is using multisensory (VAKT). This VAKT method maximizes the implement of the senses in its intervention. The implementation of VAKT can be collaborated with prompting-fading in dyslexic children. The purpose of this study was to determine whether the prompting-fading technique with VAKT media could improve early reading skills in dyslexic children in elementary school. This study uses a quantitative approach with a single-case experimental design. The instrument used in this study refers to the Early Grade Reading Assessment (EGRA). The results showed an increase in the initial reading ability score in dyslexic children. It can be concluded that the prompting-fading technique with VAKT media is able to improve the early reading ability of dyslexia children.
 Keywords: early reading ability, dyslexia, prompting-fading, VAKT media

Computer-Based Naming Treatment for Semantic Variant Primary Progressive Aphasia With History of Traumatic Brain Injury: A Single-Case Experimental Design.

The purpose of this study was to investigate the effectiveness of a self-administered naming treatment for one individual, B.N., presenting with semantic variant primary progressive aphasia (svPPA) and a history of traumatic brain injury (TBI). Naming treatment included components of Lexical Retrieval Cascade Treatment and was self-administered using an adaptive spaced retrieval software, Anki. Using a multiple-baseline, single-case experimental design, naming accuracy probes were taken during pretreatment, treatment, posttreatment, and follow-up (through 12 months) for 60 trained words and 10 untrained words. Item-level Bayesian generalized mixed-effects models were used to estimate (a) the treatment effect for trained words, (b) change in untrained words, and (c) maintenance of treatment effects from posttreatment to each subsequent follow-up. Statistical analyses revealed that a gain of 35 out of 60 trained words (35.3; 90% CI [30.6, 39.5]) was directly attributable to treatment. Following treatment, evidence of generalization to untrained words was not observed. During the follow-up period, there was gradual decline in naming accuracy of trained items. The positive treatment results reported here support the use of self-administered naming treatments for those with svPPA and a history of TBI. Although the utility of this treatment approach is constrained by patient factors including motivation, self-administered naming treatments represent a unique opportunity to expand access to speech-language intervention for people with svPPA, including those with concomitant diagnoses. https://doi.org/10.23641/asha.25119080.

Effects of a music therapy and music listening intervention for nursing home residents with dementia: a randomized controlled trial.

The aim of the present study was to evaluate the effects of an individual music therapy intervention and an individual music listening intervention on neuropsychiatric symptoms and quality of life in people with dementia living in a nursing home and on professional caregiver's burden to be able to make statements about their specific value of application in clinical practice. A multicenter single blind randomized controlled trial with three groups was performed: an individual music therapy intervention (IMTI) group (n = 49), an individual music listening intervention (IMLI) group (n = 56) and a control group (n = 53) receiving usual care. The interventions were given during three weeks, three times a week on non-consecutive days during 30-45 minutes for in total nine sessions. The endpoint of the study is the difference from baseline to interim (1,5 week), post-intervention (3 weeks) and follow-up (6 weeks) in reported scores of problem behaviour (NPI-NH) and quality of life (Qualidem) in people with dementia and occupational disruptiveness (NPI-NH) in care professionals. In total 158 people with dementia were randomized to one of the two intervention groups or the control group. Multilevel analyses demonstrated that hyperactive behaviour assessed by the NPI-NH was significantly more reduced for the IMLI group at follow up and that restless behaviour assessed by the Qualidem was significantly more reduced for the IMTI group at post and follow-up measurement compared to the control group. No significant effects between groups were found in other NPI-NH clusters or Qualidem subscales. In conclusion, because we found no convincing evidence that the IMTI or IMLI is more effective than the other both interventions should be considered in clinical practice. For the future, we advise further research into the sustainability of the effects with alternative designs, like a single case experimental design.

Effects of Self-Management Interventions on Challenging Behavior: A Systematic Review and Meta-Analysis

Purpose: The systematic review and meta-analysis evaluated the effectiveness of self-management interventions on classroom behaviors and academic outcomes. Methods: Review procedures followed Campbell Collaboration guidelines to search, select, and extract data from published and unpublished studies employing an experimental/quasi-experimental comparison group or single-case experimental design assessing the effects of a self-management intervention in schools. Seventy-five single-case design studies (236 participants; 456 effects) and 4 comparison group studies (422 participants; 11 effects) were included. Results: Single-case results indicated self-management interventions positively impacted challenging behaviors (LRRi = 0.69 [0.59, 0.78]) and academic outcomes (LRRi = 0.58 [0.41, 0.76]). A significant main effect for improving challenging behaviors was revealed in group design studies ( g = 0.63 [0.08, 1.17]). Discussion: Limitations, including methodological shortcomings in the single-group design studies and the small number of comparison group studies, should be considered when interpreting findings. Implications for practice and future research are discussed.

On the efficacy and efficiency of treating pediatric feeding disorder.

Inappropriate mealtime behavior (IMB) is a type of feeding challenge within the broader class of food refusal. The purpose of this study was to critically analyze the efficacy of interventions for the treatment of IMB through a meta-analysis of research using single-case experimental designs. We examined the extent to which different interventions resulted in decreases in IMB while also producing increases in food acceptance. This meta-analysis was also used to examine the efficiency of different interventions in achieving clinical significance. We identified 38 studies involving 266 cases in which IMB was treated with a behavioral intervention. The results indicated interventions that combined escape extinction and non-escape extinction had greater effect sizes for both reducing IMB and increasing food acceptance than either escape extinction alone or non-escape extinction alone. However, interventions that included escape extinction were slightly less efficient at decreasing IMB than were interventions that did not include escape extinction. We discuss the implications of these findings and provide recommendations for future research.

Tutorial: Artificial neural networks to analyze single-case experimental designs.

Since the start of the 21st century, few advances have had as far-reaching impact in science as the widespread adoption of artificial neural networks in fields as diverse as fundamental physics, clinical medicine, and psychology. In research methods, one promising area for the adoption of artificial neural networks involves the analysis of single-case experimental designs. Given that these types of networks are not generally part of training in the psychological sciences, the purpose of our article is to provide a step-by-step introduction to using artificial neural networks to analyze single-case designs. To this end, we trained a new model using data from a Monte Carlo simulation to analyze multiple baseline graphs and compared its outcomes with traditional methods of analysis. In addition to showing that artificial neural networks may produce less error than other methods, this tutorial provides information to facilitate the replication and extension of this line of work to other designs and datasets. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A Meta-Analysis of Treatment for Self-Injurious Behavior in Children and Adolescents With Intellectual and Developmental Disabilities.

Self-injurious behavior (SIB) among children and youth with developmental disabilities has not diminished in prevalence despite the availability of effective interventions, and the impact on quality of life for people and their families is devastating. The current meta-analysis reviews SIB intervention research between 2011 and 2021 using single-case experimental designs with children and youth up to 21 years old and provides a quantitative synthesis of data from high-quality studies including moderator analyses to determine effects of participant and study characteristics on intervention outcomes. Encouraging findings include a high level of effectiveness across studies in the decrease of SIB (Tau-U = -0.90) and increase of positive behavior (Tau-U = 0.73), as well as an increase in studies (relative to prior reviews) reporting intervention fidelity, generalization, maintenance, and social validity. However, our findings shed limited light on potential moderating variables in the development of interventions for children and youth who exhibit SIB. Of the potential moderators of intervention effects, only implementer (researcher/therapist vs. parent/caregiver) and setting (clinic vs. home) were significantly associated with improved outcomes. We discuss the need for more robust involvement of natural communities of implementers in SIB intervention research to better equip them to effectively and sustainably meet the needs of people they care for. We also discuss the importance of creating systems enabling broad access for children with SIB to effective interventions in service of reducing burden for people, families, and society over time.

Improving Student Self-awareness of Cyberbullying Victims Through Reality Counseling Services

Self-awareness is an individual process of recognizing oneself. However, this selfawareness does not mean that a person is swept away in the current of his emotions so that the mood completely dominates him. Both the victim and the perpetrator. This study aims to determine the increase in student self-awareness of cyberbullying victims through reality counseling services. Counseling with a reality approach, using WDEP methods (Wants, Direction, Evaluation, Planning) helps individuals become rational and mentally strong. The participants in this study were students at SMP N 2 Selong who had experienced acts of cyberbullying and were declared to be in a psychologically disturbed situation. The study used an experimental method using a single case experimental design. The results showed that from a series of reality counseling assessment processes, such as counseling interviews, the subjects showed positive changes in the formation of self-awareness.
 Keywords: cyberbullying, self-awareness, reality counseling

Teaching receptive vocabulary to two autistic children: A replicated, clinic-based, single case experimental design.

This study was conducted in a clinical setting with the aim of replicating previously used procedures for teaching receptive vocabulary. Researchers increased the number of vocabulary words and maintained use of match-to-sample (MtS), prompting, and reinforcement procedures. Researchers were also interested in the efficacy of the intervention from caregivers' perspectives. Using a concurrent multiple baseline design, two autistic preschoolers with receptive language impairment were taught to identify 30 common objects. MtS, prompting, and reinforcement procedures were individualized to support each child. Maintenance checks and generalization probes were completed after a predetermined number of intervention sessions (i.e. three or four clinic sessions). A social validity questionnaire was completed by parents following the final maintenance check. Receptive object identification improved significantly for both participants. Despite exposure to vocabulary targets for only three or four sessions, they generalized the vocabulary targets to non-identical pictures and maintained words at maintenance checks. Participants were most successful when researchers individualized prompting and reinforcement. MtS, prompting, and reinforcement were effective procedures for improving object identification, even with a limited number of intervention sessions. To support varying learner profiles, modifying prompting and reinforcement procedures was necessary. Caregivers of both participants reported positive improvements in areas such as communication, attention, and behaviors. This replicated study provides support for MtS, prompting, and reinforcement as means of teaching receptive vocabulary to autistic preschoolers in a clinical setting. The materials used were simple and cost-effective. Overall, this study outlines and supports a flexible and effective evidence-based practice to teach receptive language to autistic children.

The effects of person-centred active rehabilitation on symptoms of suspected Chronic Traumatic Encephalopathy: A mixed-methods single case design.

The objective was to investigate the effectiveness of a person-centred active rehabilitation programme on symptoms associated with suspected Chronic Traumatic Encephalopathy (CTE). This was accomplished by (1) assessing the effect that a person-centred active rehabilitation programme had on participant symptoms, and (2) exploring how temporal contextual factors affected the participants' experience with, and perceived effectiveness of, the active rehabilitation programme. A twelve-month mixed-methods single case experimental research design was used with six cases (participants). Individual cases were involved in a 51-week study period including an initial interview and three-week baseline phase. Cases were then randomly allocated to one of two n-of-1 study designs (i.e., A-B, B-A, B-A, A-B or B-A, A-B, A-B, B-A) where A and B represent a non-intervention and intervention phase, respectively. Interviews were conducted regularly throughout the study whilst outcome measures were assessed at each follow-up. Analysis of the data included visual, statistical, and qualitative analysis. Visual and statistical analysis of cognitive and executive function, and mindful attention, demonstrated trivial-to-large effects with the summary reflecting positive or unclear results. A mixed picture was observed for mood and behaviour with effects considered trivial-to-large, and the summary demonstrating positive, unclear and negative effects. Qualitative analysis indicated a perceived improvement in outcome measures such as memory, attention, anxiety, and emotional control despite mixed quantitative findings whilst a clear impact of contextual factors, such as COVID-19, the political atmosphere, exercise tolerance, programme progression, and motivation were evident during the intervention. This study has provided primary-level evidence to suggest active rehabilitation as a potential intervention for the management of suspected CTE symptoms. This study has also demonstrated the benefit of a person-centred approach to both clinical research and practice, particularly by considering contextual factors for a better understanding of an intervention effect.

Effectiveness of trauma-focused art therapy (TFAT) for psychological trauma: study protocol of a multiple-baseline single-case experimental design

IntroductionTreatments such as eye movement desensitisation and reprocessing and (narrative) exposure therapies are commonly used in psychological trauma. In everyday practice, art therapy is also often used, although rigorous research...

Empowering patients with persistent pain: The potential of cognitive functional therapy in interdisciplinary care: A single-case experimental design

Introduction and purposePersistent musculoskeletal pain (PMP) is multifactorial and causes both societal and financial burdens. Integration of multifactorial management in patients with PMP remains challenging. A single-case experimental design was performed on three patients suffering from high impact PMP (lumbar spine, shoulder and knee) to i) assess the potential for Cognitive Functional Therapy (CFT) in interdisciplinary care, ii) describe in detail the clinical journey patients experienced during the intervention, and iii) evaluate the changes and associations in relation to the outcome measures of pain, disability, maladaptive movement behavior, subjective overall improvement, health related quality of life and work status. These were monitored over one year, at the end of each of the six intervention modules. ResultsAfter introducing the intervention systematic changes were seen, with medium to large changes (Non-overlap of All Pairs 0.67–1) for all outcome measures. Associations between changes of the outcome measures were large (r ≥ 0.50) and changes occurred concurrently. Minimally clinically important difference thresholds were exceeded for all outcome measures and two patients achieved relevant improvements related to work reintegration. DiscussionThe positive results of this study are comparable with recent CFT studies. However, the difference regarding the number of sessions and duration of the intervention is evident. The length of the intervention in this study seemed to enable continuous significant improvements up until 12 months post onset and follow-up. ConclusionCFT in interdisciplinary care was effective for all measures. The detailed descriptions of the clinical processes aim to improve clinical care.

A digital values-based microintervention for chronic back pain patients: lessons learned from a randomised experimental single-case study

BackgroundChronic pain usually lasts several years. During this time, value-oriented aspects of life often fade into the background in favour of coping with the pain, which is associated with a lower quality of life. Psychotherapeutic methods such as Acceptance and Commitment Therapy can alleviate this. However, for those who suffer from chronic pain, access to such therapies is limited. Electronic health interventions provide access to evidence-based methods. The aim of this study was to investigate the effectiveness and feasibility of a brief electronic values-based intervention on patients with chronic back pain.MethodsA study with a replicated AB single-case experimental design was conducted with 28 participants suffering from chronic back pain. Participants answered daily questions concerning their pain intensity and quality of life (wellbeing, pain catastrophising, acceptance of chronic pain, engaged living) for 10 to 17 days. The subsequent mobile intervention on value-oriented activities lasted an additional 10 days. During this time, daily assessments continued. Our analysis was performed using a hierarchical two-level modelling approach as well as visual and descriptive analysis.ResultsThe majority of participants did not measurably benefit from the intervention. Neither model-based inference nor visual analysis indicated plausible intervention effects. The results of one responder and one non-responder are presented. In their qualitative feedback, most participants described being satisfied with the intervention. The perceived usefulness of psychotherapy as a treatment for chronic back pain increased from pre- to post-intervention (p < .001, dz = 1.17).ConclusionsThis study shows that microinterventions for chronic back pain patients are feasible, but should be planned over a longer period of time to enable measurable changes. The electronic mobile format did not cause participants any difficulties.Trial registrationClinicalTrials.gov ID: NCT05205889, date of registration: January 12, 2022.

Type I error rates and power of two randomization test procedures for the changing criterion design

Single-case experimental design (SCED) data can be analyzed following different approaches. One of the first historically proposed options is randomizations tests, benefiting from the inclusion of randomization in the design: a desirable methodological feature. Randomization tests have become more feasible with the availability of computational resources, and such tests have been proposed for all major types of SCEDs: multiple-baseline, reversal/withdrawal, alternating treatments, and changing criterion designs. The focus of the current text is on the last of these, given that they have not been the subject of any previous simulation study. Specifically, we estimate type I error rates and statistical power for two different randomization procedures applicable to changing criterion designs: the phase change moment randomization and the blocked alternating criterion randomization. We include different series lengths, number of phases, levels of autocorrelation, and random variability. The results suggest that type I error rates are generally controlled and that sufficient power can be achieved with as few as 28–30 measurements for independent data, although more measurements are needed in case of positive autocorrelation. The presence of a reversal to a previous criterion level is beneficial. R code is provided for carrying out randomization tests following the two randomization procedures.

Effectiveness of CO-OP group intervention for children with developmental coordination disorder: single-case experimental design study protocol

IntroductionWith the Cognitive Orientation to daily Occupational Performance (CO-OP) approach, children with developmental coordination disorder learn to use a problem-solving strategy to deal with their motor difficulties and perform daily...

Internet-Delivered Therapy for Parents With Health Anxiety by Proxy: Protocol for a Single-Case Experimental Design Study.

Health anxiety (HA) by proxy is described as parents' obsessive worries that their child is severely ill although this is not medically confirmed. Research on HA by proxy suggests that it is highly distressing for the parent and that the child may be at risk of developing maladaptive symptom coping strategies. No targeted treatment for this group exists. We developed PROXY, an 8-week psychological internet-delivered treatment for parents with HA by proxy. The treatment components of PROXY are informed by cognitive behavioral therapy as well as acceptance and commitment therapy, and it was developed in collaboration with parents experiencing HA by proxy and clinical experts. This paper describes the protocol for a study investigating the potential effects of PROXY on parents' worries about their children's health using a single-case experimental design (SCED). Five parents clinically evaluated as experiencing HA by proxy will be included. A replicated randomized SCED study will be conducted in which each participant will be randomized to receive treatment after a baseline period of between 7 and 26 days (phase A). The treatment phase duration is 8 weeks for all participants (phase B), followed by a follow-up phase lasting between 14 and 33 days (phase C), ensuring that all participants remain in the study for 96 days. Participants will report daily anxiety level by SMS text message throughout the study. They will also answer self-report questionnaires, including questions on HA by proxy and own HA, 4 times during the study. Data will be submitted to structured visual analysis to inspect anxiety level, the variability of anxiety, trends, the overlap of data points among phases, when effects occur, and the consistency of data patterns across participants. Furthermore, randomization tests will be conducted for each participant to test the null hypothesis that PROXY will have no effect on participants' anxiety. The recruitment of parents began in June 2022. As of March 2, 2023, a total of 4 parents have been included in the study. Data collection was expected to cease in April 2023. To the best of our knowledge, this protocol describes the only study of treatment for HA by proxy. As the prevalence of this condition is still unknown, a SCED was chosen because this method allows the inclusion of very few participants while still providing information on effects and treatment courses. Conducting the study with a replicated randomized phase design enables methodologically sound testing despite the inclusion of very few participants. The results will inform researchers on individual treatment courses and effects, which may direct future research in terms of the possible mechanisms of change, ideas for how to refine the treatment content, and how the treatment may be offered to patients in the future. ClinicalTrials.gov NCT04830605; https://clinicaltrials.gov/study/NCT04830605. DERR1-10.2196/46927.

Cognitive behavioural therapy for depression and anxiety in a carer for two family members with dementia: a single case experimental design study.

Evidence suggests that cognitive behavioural therapy (CBT) can be a helpful approach for older adults experiencing anxiety and depression. Some research has suggested this is also the case for those caring for a family member with dementia. Little research has been conducted into the impact of CBT for older adults juggling the demands of caring for multiple family members with dementia. This case study aimed to evaluate the application of CBT to 'Mrs P', a 68-year-old client experiencing anxiety and depression whilst caring for two family members with dementia. A single case experimental design study was conducted to assess the effectiveness of CBT formulation and intervention, including cognitive restructuring of unhelpful thoughts about caregiving and increasing engagement in pleasurable activities. Mrs P's depression and anxiety scores improved significantly throughout treatment, and she met her goal of being able to manage when caregiving activities go wrong during daily life. CBT may be a helpful approach to reducing anxiety and depression in dementia family caregivers.

Which Meditation Technique for Whom? An Experimental Single-Case Study Comparing Concentrative, Humming, Observing-Thoughts, and Walking Meditation

ObjectivesMeditation encompasses a variety of techniques, but little is known on how and for whom they work. This study explored potential mechanisms of four different meditation techniques in beginners and which technique might be suited for whom.MethodUsing an experimental single-case design, we compared the longitudinal effects of concentrative, humming, observing-thoughts, and walking meditation. Forty-four healthy participants without meditation experience were randomly assigned to one of the four techniques and 42 completed the treatment. Following a baseline period of 2 to 4 weeks, participants learned and practiced their technique 20 min daily for 6 to 8 weeks and completed daily online questionnaires throughout the entire study period. At pretest, we assessed participants’ motivation and personality. We analyzed the data visually and by conducting single-case meta-analyses, correlation, and multivariate analyses.ResultsBody awareness, decentering, and emotion regulation improved reliably and continuously over time, for all four techniques. Thus, these processes could represent common mechanisms for novice meditators. Walking meditation led to the smallest improvements in decentering and mind-wandering, but the highest in body awareness and emotion regulation. Individuals varied in response to the treatment. The two “classic” techniques (concentration, observing-thoughts) led to more consistently positive multivariate response patterns and to better responses in participants high in neuroticism. In contrast, those high in extraversion benefitted more from the two unusual ones (humming, walking). We additionally observed interesting interactions with different motivational reasons.ConclusionsWith this study, we hope to contribute to theory building and answering two urgent questions—what the key mechanisms of meditation are and who benefits most from what kind of practice.

Characteristics of Missing Data in Single-Case Experimental Designs: An Investigation of Published Data.

Single-case experimental designs (SCEDs) have grown in popularity in the fields such as education, psychology, medicine, and rehabilitation. Although SCEDs are valid experimental designs for determining evidence-based practices, they encounter some challenges in analyses of data. One of these challenges, missing data, is likely to be occurred frequently in SCEDs research due to repeated measurements over time. Since missing data is a critical factor that can weaken the validity and generalizability of a study, it is important to determine the characteristics of missing data in SCEDs, which are especially conducted with a small number of participants. In this regard, this study aimed to describe missing data features in SCEDs studies in detail. To accomplish this goal, 465 published SCEDs studies within the recent 5 years in six journals were included in the investigation. The overall results showed that the prevalence of missing data among SCEDs articles in at least one phase, as at least one data point, was approximately 30%. In addition, the results indicated that the missing data rates were above 10% within most studies where missing data occurred. Although missing data is so common in SCEDs research, only a handful of studies (5%) have handled missing data; however, their methods are traditional. In analyzing SCEDs data, several methods are proposed considering missing data ratios in the literature. Therefore, missing data rates determined in this study results can shed light on the analyses of SCEDs data with proper methods by improving the validity and generalizability of study results.

The interest to expand group-based studies with single-case experimental design studies in the investigation of the effects of physical exercise in frail older adults: an opinion article.

The interest to expand group-based studies with single-case experimental design studies in the investigation of the effects of physical exercise in frail older adults: an opinion article.