Single-case Research Design Research Articles

Integrating Single-Case and Qualitative Approaches: A Mixed-Methods Analysis of a Science Comprehension Intervention for Students with Extensive Support Needs

Despite advances in inclusion and access to the general curriculum for students with disabilities at large, students with extensive support needs (ESN) continue to receive instruction that is disconnected from the general curriculum and general education peers. One area of the general curriculum that students with ESN have historically lacked access to is science. However, ongoing research in this area has identified several evidence-based and promising practices that support the science learning of students with ESN. This project used a convergent mixed-methods single-case research design, specifically a single case adapted alternating treatments design paired with qualitative methods, to explore how an intervention to support comprehension of science content supported student learning and engagement for four middle school students with ESN. Implications of the study findings, as well as the value added from the mixed-methods approach, will be discussed.

How much active teaching should be incorporated into college course lectures to promote active learning?

A long-standing controversy in the learning sciences involves the appropriate balance between more didactic forms of instruction (e.g., lecture) and those that involve more active teaching (e.g., student learning activities). There have been calls for second generation research that examines how much class time should be allocated to student learning activities and how much to lecture to maximize student learning in college courses—a question of the appropriate mix of instructor lecture and student activity. The purpose of the present study was to systematically compare the effects on learning outcomes of two mixtures of learning activities and lecture during a college course on research methods: mostly lecture (consisting of ∼67 % to 75 % lecture and ∼25 % to 33 % learning activities), and mostly activity (consisting of ∼67 % to 75 % learning activities and ∼25 % to 33 % lecture). In a between-subjects design, students in a research-methods in psychology course experienced in-class lessons that were mostly lecture or mostly activity across two different lessons. Participants in the mostly activity condition scored significantly higher on an assessment of learning than those in the mostly lecture condition for a lesson on single-case research designs (d = 0.38) which was less complex but performance between the two instructional conditions was similar for the lesson on direct observational methods which was more complex. Theoretical implications involve potential refinements to generative learning theory. Practical implications involve recommendations for when to provide high amounts of student learning activities during a class period.

Exploring threats to internal validity of direct assessment in single-case design research.

Single-case design research studies have historically used external observers to collect time series data that may be used to evaluate intervention effectiveness; however, single-case interventions implemented in educational settings may use the person implementing the intervention (e.g., teacher) to collect data in order to maximize feasibility. The implementer's knowledge of intervention goals and phase has the potential to influence assessment of dependent variables, particularly when ratings involving some degree of judgment (e.g., Direct Behavior Rating-Single Item Scales [DBR-SIS]) are used. Given the potential for rater effects and expectancy to influence data collection, this study sought to determine whether DBR-SIS measuring social skills collected in vivo by interventionists with full knowledge of intervention goals and phase were equivalent to data collected by external raters masked to intervention phase. Results indicated in vivo DBR-SIS differed from those completed by masked external raters, which has the potential to result in different conclusions regarding intervention effectiveness. The potential for negative effects resulting from sole reliance on in vivo ratings conducted by an interventionist may be mitigated by including additional data streams collected by external personnel masked to intervention phase or by using effect sizes that account for baseline trends. Implications for training and practice are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The effect of teacher education supported through consultation on acquisition communication skills in children with autism spectrum disorder

The purpose of this paper is to measure the effects of the consultation method that includes teaching and practicing the mand-modelling technique to teachers and parents to improve the communication skills of children with autism. Multiple probe design, which is one of the single-case research designs, was used in the study. The findings of this research show that families with children with autism can be successful in improving their children’s limited verbal communication skills through receiving training in milieu teaching techniques that parents receive from their children’s teachers and perform in parallel with their teachers. The results showed that using the consultation method to teach the mand-modelling technique to special education teachers by ensuring that the family participates in the education is effective in developing pragmatic language in children with autism.

Smart Predict: adding partner-suggested vocabulary to increase efficiency in a dual tablet AAC typing application

Smart Predict is a novel two-tablet application developed to improve conversational efficiency for people who use augmentative and alternative communication (AAC) devices. The Smart Predict system consists of two distinct applications that were built for use with two Android tablets and/or phones with Bluetooth® capability. One application is referred to as the AAC User app and the second application is called the Partner app. Smart Predict integrates vocabulary supplementation from communication partners in real-time while persons who rely on AAC generate text and maintain full control to choose words within a word prediction line. Using single-case research designs with adapted alternating treatments under two counterbalanced treatment conditions (AAC User app alone versus AAC User app + Partner app), we examined message efficiency with persons who rely on switch scanning for on-screen keyboards. User experience questionnaires were administered to determine satisfaction and workload, and to provide feedback for future development efforts. Three adults with complex communication needs and motor impairments conversed with research staff about fourteen movie trailers. Characters per minute and switch selections per character produced by the person with complex communication needs and motor impairments were measured during 15-minute interviews to represent communication speed and effort. Results indicate that message efficiency increased with the dual-tablet Smart Predict, indicating faster message generation with the vocabulary supplementation system. User satisfaction increased and perceived effort decreased under the Smart Predict conditions. Given these results within a research and development framework, the Smart Predict concept is a viable feature that could be considered within smart AAC technologies.

Sandtray Therapy’s Impact on Trauma Symptoms in Adults

ABSTRACT Adults exposed to trauma report symptoms that harm their emotional and behavioral health affecting their functioning for a prolonged period. Creative interventions have been suggested as a unique expressive approach to assist adults with trauma symptoms. Sandtray therapy is one such technique; however, there is limited literature showcasing the effectiveness of the technique when working with adults with trauma symptoms. In this article, we assess the effectiveness of sandtray therapy on trauma symptoms for five adults with trauma exposures, using an A-B-A single-case research design. Participants completed seven to nine, 50-minute sandtray therapy sessions throughout the study. Results showed a decrease in trauma symptoms for four of the five participants. Thus, sandtray therapy could be an effective intervention for counselors to use with adults with trauma symptoms.

Self-Reported Home Program Adherence by People With Aphasia: Exploring Construct Validity.

The study purpose was to compare the practice patterns captured by self-reported logbook data and those recorded by a computerized home program application. The current study is part of a larger single-case research design study aimed at investigating the effect of logbook use on home program adherence in people with aphasia poststroke. Data from six adults with chronic aphasia with interest in improving their reading were used in this secondary analysis. Participants completed reading comprehension therapy tasks using a mobile application and tablet. The activities were self-directed and designed for people with aphasia to complete independently. We created an aphasia-friendly logbook based on best practices to allow participants to record their estimated total minutes practiced. Participants received instructions to practice the reading therapy application 80 min a day 7 days a week for the duration of the study. We calculated the difference in the total time per day recorded by each participant to the application data collected. All participants used the logbook to record their practice. There was a strong relationship between self-reported logbook practice and application-recorded practice for four of the six participants. Individual differences were noted and explored. These results suggest that some people with aphasia can use logbooks with aphasia-friendly modifications to accurately estimate the amount of practice completed outside of therapy sessions.

Inattention negatively moderates the effectiveness of a mathematics intervention in low performing primary school students

Research suggest that attention skills play distinct roles in children's acquisition of mathematics. Despite a growing number of mathematics interventions in general, little research has been devoted to mathematics interventions for students with attention/hyperactivity problems (ADHD). Extant literature suggests lower benefits of mathematics interventions for students with ADHD symptoms. This study aimed at investigating the influence of ADHD on the effectiveness of a mathematics intervention. In a single-case research design, a total of N = 10 students in Grades 2 and 4 with varying ADHD profiles were observed and trained in an ABAB-design with a computer-cased mathematics intervention. Intervention and progress monitoring were administered twice a week. The intervention showed heterogenous effects ranging from no to substantial learning progress during the intervention phases. Hierarchical piecewise regression models revealed lower learning progress for students with all ADHD symptoms as well as isolated attention difficulties. However, students with isolated hyperactivity but no attention difficulties did not respond less to the intervention. As a conclusion, mathematics interventions are supposed to address students with attention deficits more explicitly.

Meta-analysis of single-case design research: Application of multilevel modeling.

This study describes the benefits and challenges of meta-analyses of single-case design research using multilevel modeling. The researchers illustrate procedures for conducting meta-analyses using four-level multilevel modeling through open-source R code. The demonstration uses data from multiple-baseline or multiple-probe across-participant single-case design studies (n = 21) on word problem instruction for students with learning disabilities published between 1975 and 2023. Researchers explore changes in levels and trends between adjacent phases (baseline vs. intervention and intervention vs. maintenance) using the sample data. The researchers conclude that word problem solving of students with learning disabilities varies based on the complexity of the word problem measures involving single-word problem, mixed-word problem, and generalization questions. These moderating effects differed across adjacent phases. These findings extend previous literature on meta-analyses methodology by describing how multilevel modeling can be used to compare the impacts of time-varying predictors within and across cases when analyzing single-case design studies. Future researchers may want to use this methodology to explore the roles of time-varying predictors as well as case or study-level moderators. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A Systematic Review of Data Analysis Decisions in Counseling Single-Case Research Designs to Inform Best Practices

Single-case research designs (SCRDs) are a vital tool to study a variety of topics pertinent to the counseling profession. Furthermore, SCRDs are a flexible methodology that counselors can use to assess the effectiveness of their treatments, thus acting as scientist-practitioners. We aimed to report the types of data analytic procedures used in counseling SCRDs to evaluate intervention effects. We searched 42 counseling affiliated journals between the years 2015 to 2021 and identified 50 SCRD studies. Results suggested all studies used visual analysis, yet few studies reported quantitative information that align with the recommended data characteristics to evaluate for visual analysis. The most prevalent effect sizes used were non-overlap indices, with percentage of data exceeding the median being the most frequent. No studies reported between-case metrics and few cases reported within-case metrics that capture magnitude of change. We discuss recommendations for making a priori data analytic decisions as well as strengths and limitations in available options.

Supplemental Material for Meta-Analysis of Single-Case Design Research: Application of Multilevel Modeling

Supplemental Material for Meta-Analysis of Single-Case Design Research: Application of Multilevel Modeling

The Effectiveness of Augmented Reality Offered with Constant Time Delay Procedure in Teaching the Functions of Organs to Students with Intellectual Disabilities

Introduction: Science course allows student to follow scientific developments, understand and interpret the events that occur around them, and develop scientific process skills. Different methods are employed in teaching science to student childeren with intellectual disabilities. There has been a recent increase in technology-supported methods. One of the technology-supported methods is Augmented Reality. For this reason, the effectiveness of the augmented reality provided with the constant time delay procedure in teaching the functions of the organs to childeren with intellectual disabilities was investigated in the present study. The study was conducted in the individual education setting of a private special education and rehabilitation center. Method: Three students who had intellectual disabilities participated in the study. The multiple probe design with probe conditions. Phases across behaviors, which is one of the single-case research designs, was used in the study. Findings: According to the study results, it was found that all participants acquired the target behaviors successfully and the participants retained the behaviors they acquired after the teaching of organs and their functions ended and they were able to generalize the behaviors they acquired to different materials. Discussion: Based on the results of the study, it can be argued that the Augmented Reality offered with the Constant Time Delay Procedure is effective in teaching science subjects to childeren with intellectual disabilities. It can also be argued that the permanence of the acquired behaviors is high when students who have mental disabilities are taught science subjects by using Augmented Reality along with the Constant Time Delay Procedure. To generalize the results obtained in the present study, it may be suggested that the same practice be performed with other experimenters and different age groups. For the social validity of the study, the teachers of the participants expressed positive opinions about the Augmented Reality offered with target behaviors and Constant Time Delay Procedure.

Using Teacher Prompts to Increase Leadership Skills in Preschool Children

Abstract Background Early childhood leadership leads to positive outcomes for young children, including social competence. Objective The purpose of the present study was to examine the leadership behavior exhibited by three preschool aged children and to determine if teacher prompting could increase the frequency of leadership behaviors exhibited by preschool children. Methods A single case research design was utilized; specifically, we employed a multiple baseline design across preschool children to measure child leadership behaviors and teacher prompting. Results Baseline observations revealed that children engaged in Parten’s original 1933 framework of both directing and following, reciprocally directing or sharing leadership, and directing the group at varying levels. Using Pigors (Leadership and domination among children, 9:140–157, 1933) definition of “guidance of others toward a desired goal,” Leadership Prompting Intervention was used to increase children’s leadership behaviors. Results indicated that both teachers increased their level of leadership prompting, and all three children increased the behaviors of directing the group. Conclusions Teacher prompting is a low cost, low labor-intensive intervention that can be easily integrated into the early childhood classroom routine to increase children’s leadership skills. This study adds to the limited research on early childhood leadership (ECL) by providing insight into how teacher prompts can influence children’s leadership behavior in a specific context and setting.

Effects of portable interventions on school psychologists' graph-rating inconsistency.

The visual analysis of data presented in time-series graphs are common in single-case design (SCD) research and applied practice in school psychology. A growing body of research suggests that visual analysts' ratings are often influenced by construct-irrelevant features including Y-axis truncation and compression of the number of data points per X- to Y-axis ratio. We developed and tested two brief interventions, based on the research in cognitive and visual science, to reduce visual analysts' inconsistency when viewing unstandardized graphs. Two hundred practicing school psychologists visually analyzed data presented on standardized graphs and the same data again on unstandardized graphs. Across all conditions, participants were more willing to identify meaningful effects on unstandardized graphs and rated the data as showing significantly larger effects than on the corresponding standardized graphs. However, participants who answered additional (task-relevant) questions about the level or trend of graphed data showed greater rating consistency across the types of graphs in comparison to participants who answered task-irrelevant but challenging questions or control participants. Our results replicated prior research demonstrating the impact of SCD graph construction on practicing school psychologists' interpretations and provide initial support for an intervention to minimize the impact of construct-irrelevant factors. Limitations and future directions for research are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Who really decides? Feeding decisions 'made' by caregivers of children with cerebral palsy.

There are no definitive guidelines for clinical decisions for children with cerebral palsy (CP) requiring enteral feeds. Traditionally, medical doctors made enteral feeding decisions, while patients were essentially treated passively within a paternalistic 'doctor knows best' approach. Although a more collaborative approach to decision-making has been promoted globally as the favoured model among healthcare professionals, little is known about how these decisions are currently made practically. This study aimed to identify the significant individuals, factors and views involved in the enteral feeding decision-making process for caregivers of children with CP within the South African public healthcare sector. A single-case research design was used in this qualitative explorative study. Data were collected using semi-structured interviews and analysed using reflexive thematic analysis. Four primary individuals were identified by the caregivers in the decision-making process: doctors, speech therapists, caregivers' families and God. Four factors were identified as extrinsically motivating: (1) physiological factors, (2) nutritional factors, (3) financial factors and (4) environmental factors. Two views were identified as intrinsically motivating: personal beliefs regarding enteral feeding tubes, and feelings of fear and isolation. Enteral feeding decision-making within the South African public healthcare sector is currently still dominated by a paternalistic approach, endorsed by a lack of caregiver knowledge, distinct patient-healthcare provider power imbalances and prescriptive multidisciplinary healthcare dialogues.Contribution:This study has implications for clinical practice, curriculum development at higher education training facilities, and institutional policy changes and development, thereby contributing to the current knowledge and clinical gap(s) in the area.

The Effects of Paraeducator-Implemented Interventions on Student Literacy Skill Acquisition: A Review

Paraeducators are increasingly tasked with delivering early literacy instruction to students with disabilities in elementary schools. This review synthesized findings from 19 studies that examined paraeducator-implemented early literacy instruction and reported the included studies’ descriptive characteristics, methodological quality, and treatment outcomes. Studies were rated for methodological quality using the Council for Exceptional Children’s quality indicators. This systematic review was the first to describe paraeducator-implemented early literacy instruction in elementary school settings across single-case research designs and between-group research designs and the first to apply a set of quality indicators to rate study quality. The synthesized evidence suggests that, with the appropriate training and supervision, paraeducators were able to facilitate student acquisition in phonological knowledge, word reading, fluency, comprehension, and spelling domains. Implications for research and practice are discussed.

Comparison of Using Modified and Nonmodified Books on Comprehension of Students With Extensive Support Needs

Modified books are frequently used as comprehension supports for students with extensive support needs (ESN), despite limited evaluations of their creation process or impact on comprehension. This study evaluates the impact of individualized book and comprehension question modifications made through a systematic decision-making process on student comprehension during nonfiction shared book reading in general education classes. A repeated acquisition single-case research design was used to compare student comprehension of nonmodified and modified books for one first-grade and one fourth-grade student with autism and moderate intellectual disability. Findings indicate student comprehension was higher after reading modified grade-level, nonfiction books compared with similarly matched nonmodified books. These findings show students with ESN can access grade-level books in general education settings with individualized modifications. Recommendations for research and practice are shared. These recommendations include a systematic process for identification of the type and intensity of book modifications that may support comprehension for students with ESN.

Treatment for social media addiction with hypnotic-oriented counseling

BackgroundResearch has identified social media addiction as a new and often unrecognized clinical disorder that impacts users' ability to control social media use which can lead to relational, work, and social problems. Adolescent who experiences addiction to social media will be very dependent and willing to spend a long time accessing social media so that they experience addiction to social media. This paper reports the findings of a study that used an A-B-A single-case research design to investigate the effect of hypnotherapy to reduce social media addiction in adolescents. Participants consisted of two high school students (N = 2) who had social media addiction behavior in the severe category. Hypnotic-oriented counseling interventions in reducing social media addiction was provided in 5 sessions. Treatment focused on enhancing motivation, emotional release, conflict resolution and empowerment using direct suggestion, parts therapy, circle of excellence technique and anchor. Participants completed the Social Media Addiction Scale for Adolescent. Data was collected before, during, and after the hypnotic-oriented counseling intervention.ResultStudents who took part in hypnosis-oriented counseling sessions experienced a significant reduction in social media addiction symptoms during and after the intervention. They report becoming increasingly able to manage social media use healthily.ConclusionHypnotic-oriented counseling intervention was effective in reducing social media addiction symptoms in students.

Assessment of Teaching Approaches Employed by Teachers in Teaching Students with Visual Impairment in Tanzania Inclusive Secondary Schools

This study assessed the teaching approaches employed by secondary school teachers teaching in inclusive classrooms incorporating students with visual impairment in Tanzania. The aim of the study was to find out the extent to which the approaches suited the students’ learning needs. The study adopted a qualitative research approach, employing a single case research design. Purposive sampling procedures were employed to obtain a sample of 24 respondents. Data were collected through semi-structured interviews, non-participant observations and documentary reviews. The collected data were analyzed through thematic data analysis procedures and presented using descriptions, tables and charts. The findings have revealed that some of the teaching approaches executed by teachers accommodated the learning needs of students with visual impairment, while others did not. It is recommended that teachers should adapt teaching approaches that suit students with visual impairment. Further, the government should organize more regular trainings and professional development courses for raising teachers’ awareness on inclusive issues.

Just Dollars and Cents: Making Change via a Virtual Money Manipulative

Providing high-quality services to students with disabilities in rural settings can be challenging, as rural schools often lack resources both in and out of the classroom. One potential option to provide high-quality mathematics instruction to students with disabilities in rural areas is using virtual manipulatives and online instruction. In this study, a single-case research design was used to examine the progress of three high school students with intellectual and developmental disabilities (IDDs) as they used a virtual money manipulative within an online learning environment to solve making change problems. The researchers found a functional relation between the intervention package (i.e., a virtual money manipulative, modeling, system of least prompts) and the dependent variable of accuracy in solving making change problems across three students. In addition, all three students demonstrated an increase in independence during each session and maintained their accuracy and independence after the intervention concluded.