Single-case Experimental Research Research Articles

Comparison of the What Works Clearinghouse Standards for Single-Case Research: Applications for Systematic Reviews

Systematic reviews of single-case experimental research (SCER) in special education often use the What Works Clearinghouse (WWC) Standards to assess the methodological rigor of studies within a given literature base. While significant changes were made between the two most recent versions of the WWC standards, no research to date has evaluated the extent to which these standards would result in different evaluation outcomes. To examine potential differences, we applied version 4.1 and 5.0 of the standards to a sample database of SCER addressing the challenging behavior of students with autism in general education settings. Systematic search, screening, and review procedures resulted in a total of 20 articles included for this review. Findings indicated a 27% change in overall ratings across the studies, with version 5.0 leading to lower ratings than version 4.1, due to factors such as a lack of assessment of procedural fidelity, therapeutic baseline trends, and insufficient data points in the first baseline phase. We discuss implications for research based on our findings and recommend future directions for SCER in the field of special education.

Examining Model Similarity for Exercise Self-Efficacy among Adults Recovering from a Stroke: A Community-Based Exercise Program

We used a single-case experimental research design to examine the effect of modelling (peer versus non-peer) on exercise self-efficacy in stroke survivors who participated in a community-based exercise program. Data were obtained using an ABCA design: (A1) no model/baseline 1 (3 weeks); (B) peer model (6 weeks); (C) non-peer model (6 weeks); and (A2) no model/baseline 2 (3 weeks). Four participants completed self-efficacy questionnaires after each weekly session. Overall, participants reported higher exercise self-efficacy in the model conditions (Cohen’s d range from −0.37 to 4.22), with ratings appearing highest for the non-peer model. Modelling in general may help stroke survivors increase their exercise self-efficacy. Lastly, we provide our reflections on the pragmatics of completing a study within a community setting.

Mental Health Literacy Intervention to Reduce Stigma Toward Mental Health Symptoms and Disorders in Women Rugby Players: A Feasibility Study

This feasibility study aimed to evaluate the effectiveness of an educational intervention on stigma toward mental health symptoms and disorders, mental health literacy, and help-seeking intentions among U.K. semielite women rugby players. Seven semielite women rugby players participated. An A-B-A single-case experimental research design was used to assess stigma toward mental health symptoms and disorders, mental health literacy, and help-seeking intentions at baseline, intervention, and follow-up phases. The intervention was successful in enhancing the players’ mental health literacy and reducing stigmatizing attitudes toward seeking professional psychological help. Acknowledging the study’s small sample size, the findings revealed that there is a need for scaffolding to support future developments, advancements, and maintenance of mental health support in women’s rugby. Practical implications of future findings from a larger-scale study may lead to policy reformation across the game to inform and improve systemic mental health support for women rugby players.

Research Ethics for Behavior Analysts in Practice.

Behavior analysts in practice have an advantage over many others in the helping professions-they have at their disposal a robust science of behavior change informed primarily by single-case experimental research designs. This is advantageous because the research literature is focused on individual behavior change and has direct relevance to behavior analysts who need to change the behavior of individuals in need. Also, the same experimental designs used to advance the basic and applied sciences can be used to evaluate and refine specific procedures as they are put into practice. Thus, behavior-analytic research and practice are often intertwined. However, when behavior analysts in practice conduct research and use their own clients as participants, several important ethical issues need to be considered. Research with human participants is subject to careful ethical oversight, but the ethical guidelines that have been developed are usually described in terms of research conducted by nonpractitioners working in universities or institutions. This article focuses on several areas of special concern when conducting research in practice settings, including dual relationships and conflicts of interest, obtaining informed consent, and using ethical review panels.

Self-management interventions for reducing challenging behaviors among school-age students: A systematic review.

Challenging classroom behaviors can interfere with student social and academic functioning and may be harmful to everyone in schools. Self-management interventions within schools can address these concerns by helping students develop necessary social, emotional, and behavioral skills. Thus, the current systematic review synthesized and analyzed school-based self-management interventions used to address challenging classroom behaviors. The current study aimed to inform practice and policy by (a) evaluating the effectiveness of self-management interventions at improving classroom behaviors and academic outcomes and (b) examining the state of research for self-management interventions based on existing literature. Comprehensive search procedures included electronically searching online databases (e.g., EBSCO Academic Search Premier, MEDLINE, ERIC, PsycINFO), hand-searching 19 relevant journals (e.g., School Mental Health, Journal of School Psychology), reference-list searching 21 relevant reviews, and searching gray literature (e.g., contacting authors, searching online dissertation/theses databases and national government clearinghouses/websites). Searches were completed through December of 2020. Included studies employed either a multiple group-design (i.e., experimental or quasi-experimental) or single-case experimental research design and met the following criteria: (a) utilized a self-management intervention, (b) conducted in a school setting, (c) included school-aged students, and (d) assessed classroom behaviors. Standard data collection procedures expected by the Campbell Collaboration were used in the current study. Analyses for single-case design studies incorporated three-level hierarchical models to synthesize main effects, and meta-regression for moderation. Further, robust variance estimation was applied to both single-case design and group-design studies to account for dependency issues. Our final single-case design sample included 75 studies, 236 participants, and 456 effects (i.e., 351 behavioral outcomes and 105 academic outcomes). Our final group-design sample included 4 studies, 422 participants, and 11 total behavioral effects. Most studies occurred in the United States, in urban communities, in public schools, and in elementary settings. Single-case design results indicated that self-management interventions significantly and positively impacted both student classroom behaviors (LRRi = 0.69, 95% confidence interval [CI] [0.59, 0.78]) and academic outcomes (LRRi = 0.58, 95% CI [0.41, 0.76]). Single-case results were found to be moderated by student race and special education status, whereas intervention effects were more pronounced for African American students (F = 5.56, p = 0.02) and students receiving special education services (F = 6.87, p = 0.01). Single-case results were not found to be moderated by intervention characteristics (i.e., intervention duration, fidelity assessment, fidelity method, or training). Despite positive findings for single-case design studies, risk of bias assessment indicated methodological shortcomings that should be considered when interpreting findings. A significant main effect of self-management interventions for improving classroom behaviors was also revealed for group-design studies (g = 0.63, 95% CI [0.08, 1.17]). However, these results should be interpreted with caution given the small number of included group-design studies. The current study, conducted using comprehensive search/screening procedures and advanced meta-analytic techniques, adds to the large amount of evidence indicating that self-management interventions can be successfully used to address student behaviors and academic outcomes. In particular, the use specific self-management elements (i.e., self-determining a performance goal, self-observing and recording progress, reflecting on a target behavior, and administering primary reinforcers) should be considered within current interventions as well as in the development of future interventions. Future research should aim to assess the implementation and effects of self-management at the group or classroom-level within randomized controlled trials.

Suppressing visual hallucinations in an adolescent by occipital transcranial magnetic stimulation: A single-case experimental research design

ABSTRACT Visual hallucinations after central or peripheral impairment, commonly called Charles Bonnet syndrome, are often highly distressing and with few available treatment options. Here we report a case where an adolescent developed severely distressing visual hallucinations after hypoxic damage to the occipital cortex following a suicide attempt. The patient received active and sham occipital continuous theta-burst stimulation (cTBS) in a single-case experimental research design and a subsequent open phase, to evaluate cTBS as a Charles Bonnet treatment. The visual hallucinations seemed to decrease more during active than sham cTBS in the blind phase, and in the following week of repeated five daily treatments they almost disappeared. A normalization of increased activity in the lateral visual network after cTBS was observed on a functional magnetic resonance imaging resting-state analysis compared with 42 healthy controls. Visual evoked potentials stayed largely unchanged both in the sham-controlled blind phase and the subsequent open phase. During the two weeks after the open phase with repeated cTBS sessions, the visual hallucinations gradually reappeared and almost returned to the baseline level. Our findings suggest that active cTBS over the primary visual cortex can reduce visual hallucinations through modulation of downstream visual regions, though the effect is temporally limited.

Does sports-specific training improve measures of impairment developed for para sport classification? A multiple-baseline, single-case experiment

ABSTRACT Conceptually, sports-specific training should not influence measures of impairment used to classify Para athletes. This study evaluated the extent to which measures of strength, range of movement and coordination developed for Para swimming classification changed in response to a performance-focused swimming programme. A five-phase multiple-baseline, single-case experimental research design was utilized. Three participants with cerebral palsy and high support needs completed the 64-week study, which included two 16-week performance-focused swimming training blocks. Swimming speed, isometric shoulder extension strength, shoulder flexion range of movement and upper limb coordination were monitored throughout. Interrupted Time-Series Simulation Method analysis demonstrated large, significant changes in swimming speed (m/s) during the first (d = 2.17; 95% CI 0.45–3.88; p = 0.01) and second (d = 2.59; 95% CI 1.66–3.52; p = 0.00) training blocks. In contrast, changes in strength, range of movement and coordination were predominantly trivial and non-significant. This was the first study to investigate training responsiveness of measures developed for Para sport classification. Results indicate that despite significantly improved swimming performance, impairment measures remained relatively stable, and therefore these measures of impairment may be valid for the purposes of Para swimming classification. Further research is required in elite athletes, different sports and different impairment types.

The Effects of Technology Supports on Community Grocery Shopping Skills for Students With Intellectual and Developmental Disabilities: A Meta-Analysis

In this meta-analytic review, we investigated the effects of technology supports on the acquisition of shopping skills for students with intellectual and developmental disabilities (IDD) between the ages of 5 and 24. Nineteen single-case experimental research studies, presented in 15 research articles, met the current study’s inclusion criteria and the What Works Clearinghouse (WWC) standards. An analysis of potential moderators was conducted, and we calculated effect sizes using Tau-U to examine the impact of age, diagnosis, and type of technology on the reported outcomes for the 56 participants. The results from the included studies provide evidence that a wide range of technology interventions had a positive impact on shopping performance. These positive effects were seen for individuals across a wide range of ages and disability types, and for a wide variety of shopping skills. The strongest effect sizes were observed for technologies that provided visual supports rather than just auditory support. We provide an interpretation of the findings, implications of the results, and recommended areas for future research.

SSVEP BCI and Eye Tracking Use by Individuals With Late-Stage ALS and Visual Impairments.

Access to communication is critical for individuals with late-stage amyotrophic lateral sclerosis (ALS) and minimal volitional movement, but they sometimes present with concomitant visual or ocular motility impairments that affect their performance with eye tracking or visual brain-computer interface (BCI) systems. In this study, we explored the use of modified eye tracking and steady state visual evoked potential (SSVEP) BCI, in combination with the Shuffle Speller typing interface, for this population. Two participants with late-stage ALS, visual impairments, and minimal volitional movement completed a single-case experimental research design comparing copy-spelling performance with three different typing systems: (1) commercially available eye tracking communication software, (2) Shuffle Speller with modified eye tracking, and (3) Shuffle Speller with SSVEP BCI. Participant 1 was unable to type any correct characters with the commercial system, but achieved accuracies of up to 50% with Shuffle Speller eye tracking and 89% with Shuffle Speller BCI. Participant 2 also had higher maximum accuracies with Shuffle Speller, typing with up to 63% accuracy with eye tracking and 100% accuracy with BCI. However, participants’ typing accuracy for both Shuffle Speller conditions was highly variable, particularly in the BCI condition. Both the Shuffle Speller interface and SSVEP BCI input show promise for improving typing performance for people with late-stage ALS. Further development of innovative BCI systems for this population is needed.

A Bayesian Rate Ratio Effect Size to Quantify Intervention Effects for Count Data in Single Case Experimental Research

Single case experimental design (SCED) is an indispensable methodology when evaluating intervention efficacy. Despite long-standing success with using visual analyses to evaluate SCED data, this method has limited utility for conducting meta-analyses. This is critical because meta-analyses should drive practice and policy in behavioral disorders more than evidence derived from individual SCEDs. Even when analyzing data from individual studies, there is merit to using multiple analytic methods since statistical analyses in SCED can be challenging given small sample sizes and autocorrelated data. These complexities are exacerbated when using count data, which are common in SCEDs. Bayesian methods can be used to develop new statistical procedures that may address these challenges. The purpose of the present study was to formulate a within-subject Bayesian rate ratio effect size (BRR) for autocorrelated count data that would obviate the need for small sample corrections. This effect size is the first step toward building a between-subject rate ratio that can be used for meta-analyses. We illustrate this within-subject effect size using real data for an ABAB design and provide codes for practitioners who may want to compute BRR.

Single-case Experimental Research: Designing emotions by designing spaces - A pilot study

The belief that the environment shapes human emotions followed by behaviour is not new, as acknowledged by many researchers. Recent studies show that the most significant illness by 2030 is depression, as most of our time spent inside the buildings. Hence, the importance of "re-connecting architecture with emotions" is an essential solution to improve the quality of life. A single-case experimental design (SCED) aimed to investigate the relationship between neural underpinnings of the brain, for a single participant and various environments. Data collected was based on the Electroencephalography tests. Findings showed a significant contrast between different water elements and environmental settings, each with its unique effect on participant emotions as well as the electrical activity of the brain.Keywords: Depression; Neural underpinnings; Water-bodies environment; Quality of Life.eISSN: 2398-4287 © 2020. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.DOI: https://doi.org/10.21834/e-bpj.v5i13.2103

The Impact of Psychotherapeutic Reiki on Anxiety

ABSTRACT Reiki healing is one of several complementary and integrative therapies becoming increasingly prevalent in mental health counseling. It has been identified in the medical field for its usefulness in treating anxiety, depression, and pain but has rarely been studied for its counseling impact on client wellness. The existing literature on the use of Reiki with psychotherapy is largely conceptual in nature. This single-case experimental research found anxiety symptom reduction in three out of four participants through the implementation of an in-session psychotherapeutic Reiki (PR) intervention. The results suggest potential therapeutic benefits for integrating PR with traditional counseling. Included in the discussion of study results are clinical implications and importance, suggestions for future research, and limitations.

Illustrating novel techniques for analyzing single-case experiments: Effects of pre-session mindfulness practice.

In this article we describe and illustrate various visual and nonparametric techniques that can be used to evaluate the effectiveness of interventions in single-case experiments. Using an alternating treatments design across 2 cases, we tested whether practicing mindfulness would help a novice therapist stay focused and respond to a client more empathically and genuinely. Specifically, after taking a brief workshop on mindfulness, one male and one female doctoral trainee were asked, immediately before beginning each of 10 sessions, either to engage in a guided mindfulness practice for three minutes or a control activity of their choice. Five experimental and 5 control sessions were randomly scheduled for each therapist. The clients were unaware of the purpose of the study and the nature of the experimental manipulation. After each session, we administered measures of client-rated empathy, client- and therapist-rated real relationship, and therapist-rated level of hindering self-awareness. The graphed data were examined separately for each measure. Results showed that the client in Dyad 1 perceived the therapist as more empathic following mindfulness sessions, and the therapist reported less hindering self-awareness and rated the real relationship more favorably, with moderate to strong experimental effects. By contrast, Dyad 2 showed moderate to strong experimental effects for mindfulness practice on ratings of the real relationship, but not on empathy or hindering self-awareness. A cross-case comparison illustrates how replicated single-case experimental research with self-report data can advance our understanding of individual differences in response to psychotherapeutic interventions. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Applying the Taxonomy of Validity Threats from Mainstream Research Design to Single-Case Experiments in Applied Behavior Analysis.

Mainstream research design in the social and behavioral sciences has often been conceptualized using a taxonomy of threats to experimental validity first articulated by Campbell and his colleagues (Campbell & Stanley, 1966; Cook & Campbell, 1979). The most recent update of this framework was published by Shadish, Cook, and Campbell (2002), in which the authors describe different types of validity and numerous threats to each primarily in terms of group-design experiments. In the present article, we apply Shadish et al.'s analysis of threats to internal, external, statistical conclusion, and construct validity to single-case experimental research as it is typically conducted in applied behavior analysis. In doing so, we hope to provide researchers and educators in the field with a translation of the validity-threats taxonomy into terms and considerations relevant to the design and interpretation of applied behavior-analytic research for the purposes of more careful research design and the ability to communicate our designs to individuals outside of behavior analysis, using their own vocabulary.

High-technology augmentative and alternative communication for individuals with intellectual and developmental disabilities and complex communication needs: a meta-analysis

The use of mobile technology is ubiquitous in modern society and is rapidly increasing in novel use. The use of mobile devices and software applications (“apps”) as augmentative and alternative communication (AAC) is rapidly expanding in the community, and this is also reflected in the research literature. This article reports the social-communication outcome results of a meta-analysis of single-case experimental research on the use of high-tech AAC, including mobile devices, by individuals with intellectual and developmental disabilities, including autism spectrum disorder. Following inclusion determination, and excluding studies with poor design quality, raw data from 24 publications were extracted and included 89 A-B phase contrasts. Tau-U nonparametric, non-overlap effect size was used to aggregate the results across all studies for an omnibus and moderator analyses. Kendall’s S was calculated for confidence intervals, p-values, and standard error. The omnibus analysis indicated overall low to moderate positive effects on social-communication outcomes for high-tech AAC use by individuals with intellectual and developmental disabilities.

A Meta-Analytic Review of Family-Implemented Social and Communication Interventions for Individuals with Developmental Disabilities

This study presents a meta-analysis of single-case experimental research on family-implemented interventions for improving the social and other communicative behaviors of individuals with developmental disabilities (DD). A total of 40 studies were included in this meta-analysis. The Tau-U effect size with the Kruskal-Wallis and the Dunn post hoc tests were calculated to analyze the following variables: age, communication and language characteristic, intervention type, and dependent variable. Overall, the results indicate that family-implemented interventions have a moderate effect on the social and other communicative behaviors of individuals with DD. Analyses for age yielded statistically significant findings for preschool-aged individuals compared to adolescent- and adult-aged individuals. Small to moderate effect sizes were noted across categories for communication and language characteristic, intervention type, and dependent variable. Limitations and implications for future research and for practitioners are discussed.

The Use of Single-Case Experimental Research to Examine Physical Activity, Exercise, and Physical Fitness Interventions: A Review

This review identified studies that have utilized single-case experimental methods to evaluate physical activity, exercise, and physical fitness interventions. A total of 10 studies met the inclusion criteria. Single-case experimental design studies were inclusive to clinical populations and able to demonstrate an intervention effect. Future researchers should use validated and reliable assessments of physical activity or physical activity capacity, establish stable baseline assessments of their target behavior prior to the introduction of any intervention, use statistical tests to establish clinical and statistical significance, and move away from simple A-B designs that do not rule out the effects of extraneous variables.

Single-case experimental designs in medical education

This paper presents an argument for more extensive use of single-case experimental research designs in medical education research. Single-case experimental designs consist of a group of experimental techniques that are widely used in the social sciences but are just beginning to be utilized by medical researchers. The method emphasizes reliable observations of behavior, repeated measurements of outcome, and individualized tailoring of objectives for each subject; all of these occur within a system that allows an experimental analysis to be conducted. Single-case designs are particularly useful when only small numbers of participants are available for a relatively long period of time. Trends in medical education toward individualized instruction, adult-centered learning, and fine-grained analyses of medical skills and knowledge make this field especially amenable to single-case experimental designs. Issues of internal and external validity, generality, practicality, and ethics are discussed, and several typical designs are illustrated. While the emergence of qualitative research methods in medical education may prove useful, single-case designs can maintain experimental science's emphasis on methodologic rigor, while allowing the flexibility often needed to conduct research in applied settings.