Single-subject Experimental Study Research Articles

Single-Subject Study on the Effects of Social Stories on the Social Interaction of a Child with Autism Spectrum Disorder in China

ABSTRACT Intervention using social stories is a widely used strategy for children with autism spectrum disorder. However, empirical studies on the efficacy of social stories in improving social interaction have yielded mixed results, and such research in China is scarce. This study examined the effectiveness of social stories for increasing social interaction, particularly initiation and response, verbal exchange, body language, eye contact, and combined interaction of a child with autism spectrum disorder. A single-subject experimental study was conducted with two baseline sessions, two intervention phases, and a follow-up period. The results demonstrated immediate and maintained effects after utilising social story intervention. The participant’s response behaviours improved more than initiation, and body language as well as eye contact improved more than verbal and combined interaction. Social validity findings revealed positive evaluations of the participant’s mother and head teacher. Social story intervention is a promising strategy for improving the social interaction of children with autism spectrum disorder and that should be explored further in future research.

Effect of Facial Emotional Feedback Through Facial Electrical Stimulation on Mood Change and Its Clinical Application in Participants with Mild Depression: A Multiple Baseline Case Study

Background: The facial feedback hypothesis proposes that facial expressions influence people's emotional experiences. Objectives: The current study, conducted in 2022, aimed to investigate the impact of facial feedback on the nature and magnitude of changes in emotion, mood, and cognitive-emotional factors among individuals with mild depression. This was achieved through the use of electrical stimulation of the facial muscles. This study aimed to investigate the impact of bilateral electrical stimulation on the frontalis muscles (which act as inhibitory muscles of the corrugator) and zygomaticus muscles on the emotions and moods of individuals with mild depression. Methods: In a single-subject experimental study with multiple baselines, six individuals with mild depression underwent daily sessions of facial electrical stimulation for 28 consecutive days. The stimulation was administered at two different sites, with three different baseline periods of 3, 6, and 9 days at each site. Specifically, three participants received electrical stimulation of the zygomaticus muscle, while the other three participants received electrical stimulation of the frontalis muscle. Visual analysis (diagrams and figures), within-phase examination, and between-phase examination were used to analyze longitudinal data using mixed model analysis (P < 0.05). Results: Mixed model analysis revealed significant changes in negative affect (P = 0.019), mood (P = 0.017), depression (P = 0.005), and symbol search (P < 0.001) among participants who received frontalis muscle stimulation. Additionally, the mood of participants who received zygomaticus muscle stimulation showed significant changes (P = 0.047) from pre-intervention to post-intervention. At the intervention and follow-up stages (one month after the last intervention session), all three participants who underwent frontalis muscle electrical stimulation met the standardized recovery criteria established by Segger et al. The reliable change index was measured at 8.46. A qualitative analysis of the depression scores revealed a significant difference in the post-intervention phase when frontalis muscle electrical stimulation was applied. Participants 4, 5, and 6 scored 9, 11, and 8, respectively. Conclusions: This preliminary study provides empirical evidence on using electrical stimulation of facial muscles to reduce negative mood and depression. Given the various factors that play a role, more research and focused controlled studies are needed to test these findings.

Genre-Based Approach for Better Recount Writing in the Classroom

Genre-Based Approach for Better Recount Writing in the Classroom

Cognitive behavioral therapy and traditional cooperative games in improving social skills: A single-subject experimental study

This study aimed to ascertain how cognitive behavior therapy and traditional games in children could improve their social skills. This research was a single-subject experimental study. The participant was a 6-year-old kindergarten student going by the alias “Kila”. The data was collected using interview and observation methods. The CBT techniques are puppets, storytelling, visualization, and imagery techniques. Traditional games are used after the CBT sections. These games involved peer groups to increase the social skills of the participants. The traditional games used are the ones that Indonesian people used to do, such as “Cublak-cublak Suweng,” “Clogs,” “Cardboard Bridge,” “Jump Rope,” and “Word Game.”. Data were collected through observation and interviews with participants, family members, teachers, and colleagues. Information about the participant can also be obtained using psychological tools such as intellectual and socialization. Data is analyzed based on the characteristics of previous and subsequent social capacity changes. The result showed that the CBT technique for children could change the participant’s negative automatic thoughts about her friends. Those traditional games could also improve Kila’s social skills, especially in her interpersonal behavior, such as making friends, communicating, giving feedback to her peers, and being involved in some interactions and communications. CBT techniques and traditional games have an impact on increasing the social abilities of participants. This can be seen from the improvement in participants’ social skills, such as interpersonal behavior, self-behavior, academic behavior, peer acceptance, and communication skills.

Effectiveness of Mindfulness Based Cognitive Therapy in Reducing Stress among Senior Medical Students: A Single Subject Experimental Study

Effectiveness of Mindfulness Based Cognitive Therapy in Reducing Stress among Senior Medical Students: A Single Subject Experimental Study

Virtual voice assistant applications improved expressive verbal abilities and social interactions in children with autism spectrum disorder: a Single-Subject experimental study

The use of interactive technologies has been demonstrated to enhance verbal and non-verbal communication, as well as the social interaction tendencies of children with Autism Spectrum Disorder (ASD). We examined effects of using Virtual Voice Assistant (VVAs) in children with ASD with respect to two outcomes: speech skills and social interaction skills. A single-case study included three children with ASD (4–11 years old) that utilized VVAs for three months. Pre- and post-intervention questionnaires and semi-structured interviews were used to measure the communication and social interaction skills of the participating children. Participant One, Two and Three showed improvement in the number of correct words produced the VVA intervention. All participants showed increases in social interactions in the intervention phase. Overall, the results showed that the VVAs had positive effects on the speech and social interaction skills of autistic children. The findings demonstrate that children with ASD may benefit from VVAs to improve their communication skills.

슬링을 사용한 타이밍과 협응훈련이 혈관 치매환자의 인지 및 운동성에 미치는 효과-단일사례연구

슬링을 사용한 타이밍과 협응훈련이 혈관 치매환자의 인지 및 운동성에 미치는 효과-단일사례연구

Bioevaluation of agro-waste for postprandial glucose and insulin concentration in blood.

To evaluate the effect of cookies supplemented with apple pomace and mango-peel powder on postprandial glucose and insulin concentration. The experimental study was conducted from February to August, 2018, at the Nutrition Counselling Centre, Government College Women University, Faisalabad, Pakistan. Different cookies with apple pomace and mango-peel powder were prepared and the most nutritive acceptable cookies were used to determine their postprandial effect on glucose and insulin concentrations against the control cookies made with white flour only in female subjects. Adult women were selected through advertisement with normal body mass index. Data was analysed using SPSS 17. All the 30 subjects received enriched and control cookies at different time slots during the study. The overall mean age of the sample was 25±10 years and each subject had body mass index <25kg/m2. Overall blood glucose and insulin concentrations were significantly lower with treatment cookies , compared to the control cookies (p<0.05). It was evident that fruit processing waste can be used as a nutraceutical agent in diet-based modules.

Speech treatment in nemaline myopathy: A single-subject experimental study

PurposeThe objective of this work was to verify the efficacy of a treatment based on myofunctional therapy techniques which aimed to improve the tongue strength, precision, and speed of a ten-year-old girl with nemaline myopathy (NM) and the repercussions of this therapy on her speech intelligibility. NM is a rare congenital muscle disorder that causes extreme muscle weakness, especially in the face and neck, as well as severe dysarthria and dysphagia, although this does not affect the nervous system or cognitive development. MethodThis was a single-subject experimental study which used an interrupted pre- and post-treatment time-series design, and which applied autoregressive integrated moving-average predictive models and Holt exponential smoothing. During the treatment phases, the participant’s tongue strength and the rate of speech diadochokinesia and voluntary lingual movements were estimated and the repercussions of the intervention in terms of speech intelligibility were ascertained via an experiment with ‘naïve’ judges. ResultsThe treatment produced a sustained and significant increase in the maximum strength of the patient’s tongue, which increased from an initial 4 kPa to 11 kPa at the end of the treatment phase. However, this was far from the average 58 kPa for age- and sex-matched normative data. There were no significant changes either in the rates of voluntary lingual mobility or speech diadochokinesia. Speech intelligibility, as assessed by naïve judges, improved from 40 % in the pre-treatment phase to 67 % in the post-treatment phase. ConclusionsNM and other rare primary muscle disorders allow us to estimate the effects of severe muscle weakness in people with dysarthria without cognitive impairment or alterations in central nervous system, peripheral nervous system or in gap junction. In this case, the treatment did not increase the patient’s lingual and articulatory movement speed but did increase her tongue strength from 5 % to 10 % of the levels otherwise expected for her age and significantly improved the intelligibility of her speech and communication.

Comparison of the effects of action observation training of community ambulation with different observational views on walking function in patients with chronic stroke: single-subject experimental study

Objectives The aim of this study was to compare the effects of the action-observation training (AOT) of community ambulation with different observational views (first-person versus third-person views) on walking function in patients with chronic stroke. Design A single-subject alternating design. Methods Three ambulatory patients with chronic stroke participated in this study. The AOT of community ambulation, in the first- and third-person views, was alternately applied in the intervention phase. Outcome measures included walking speed (10-m walking test) and peak knee flexion angle (PKFA) during walking. Results When the AOT was performed in the first-person view, walking speeds increased by 0.04, 0.09 and 0.09 m/s, and the PKFA increased by 11.88, 14.67 and 25.29°, for subjects 1, 2 and 3, respectively. After the AOT was performed in the third-person view, the 10MWT speeds increased by 0.04, 0.08 and 0.11 m/s, and PKFAs increased by 13.46, 16.21 and 23.27° for subjects 1, 2 and 3, respectively. However, in the intervention phase, for all the subjects, there were no significant differences in walking speed and the PKFA between the first- and third-person views (p > .05). Conclusions These findings indicate that the AOT of community ambulation may help in clinically improving walking function in patients with chronic stroke, regardless of observational views in the AOT. However, larger studies, with a robust design, are needed to make a definitive judgment on the usefulness of this treatment.

Initial Evidence on the Impact of Performance-Based Treadmill Training on Pulmonary Function and Physical Performance in a Child with Bronchopulmonary Dysplasia: Single-Subject Experimental Study

Aim: This study aimed to demonstrate the initial evidence on the impact of performance-based treadmill training on pulmonary function and physical performance of a patient with bronchopulmonary dysplasia (BPD).Methods: This study used a single-subject pre-experimental (A-B) research design (5 and 10 data points during the baseline and intervention phases, respectively) with a 4-month follow-up measurement. The subjects were a 5-year-old child diagnosed with bronchopulmonary dysplasia. Outcome measures were pulmonary function (forced vital capacity [FVC] and peak expiratory flow [PEF]) and physical performance (6-min walk test [6MWT], sit-to-stand test [STS], pediatric balance scale [PBS], and goal attainment scaling).Results: Applying the 2 standard deviation method, the FVC, PEF, 6MWT, and STS test scores showed significant improvement compared to baseline values. In addition, the PBS and goal attainment scaling scores improved by 5.36% (42 points to 45 points) and 29.61% (37.6 points to 59.75 points) after the intervention, respectively. Gains were maintained at the 4-month follow-up.Conclusions: These findings suggest that performance-based treadmill training may be a possible treatment option to improve the pulmonary function and physical performance of children with BPD. Further rigorous studies are needed to establish evidence regarding the effectiveness of the training program among this population.

Group pain neuroscience education combined with supervised exercises reduces pain and improves function of Brazilian women with central sensitisation and a low level of education: a single-subject study

Purpose: The purpose of this single-subject experimental study was to describe the patient’s outcome following pain neuroscience education in combination with therapeutic exercise for Brazilian women with central sensitisation and a low level of education.Methods: Eight Brazilian women with central sensitisation and a low level of education were screened from a total of 57 patients with musculoskeletal disorders in an outpatient physiotherapy department. Twelve sessions were performed, once a week, including group pain education and supervised exercises. The outcome measures of pain intensity, functionality, catastrophizing, kinesiophobia, quality of life, knowledge of pain physiology and global improvement rating were collected pre- and post-intervention.Results: There was an improvement in pain (before median = 8.5, after median = 5.0; Z = −2.032, p = .042) and functionality (before median = 2.5, after median = 5.6; Z = −2.366, p = .018) at post-intervention evaluation measured by the Wilcoxon signed-rank test. A meaningful improvement was observed in global perceived effect. There were no statistically significant differences for other outcomes.Conclusion: Following a combination of pain neuroscience education with therapeutic exercise, Brazilian women with central sensitisation and a low level of education showed pain relief and improved function. Nonetheless, psychosocial factors, knowledge of pain and quality of life did not improve with the intervention.

A well-designed single-subject experimental study reveals potential of electroplataography in treating children with misarticulation of /r/

Q Is electropalatography (EPG) an effective method to treat rhotic errors in school-aged children with speech sound disorders?Design: This study adopted a multiple baseline design across five child...

Immediate effect of myofascial release on range of motion, pain and biceps and rectus femoris muscle activity after total knee replacement

ObjectivesThe role of a myofascial release (MFR) on flexion contractures after total knee arthroplasty (TKA) has not yet been elucidated. Therefore, the purpose of this study was to determine its immediate effect on such patients. MethodsIn this A-B single subject experimental study, 33 TKA's patients with knee flexion contracture had their gluteal, posterior fascia lata, posterior crural and plantar fasciae released. Patients' knee range of motion (KROM), pain and muscle electric activity were assessed pre- and post-intervention. ResultsAn increase in electric activity of the biceps femoris muscle was identified after treatment (pre RMS = 0.087 ± 0.066 V; post RMS = 0.097 ± 0.085 V; p = 0.037). Mean gain of KROM was 5.72 ± 6.27, correspondent to an 11.9% improvement (p = 0.01). Eight subjects had their pain decreased on 56.9% (p = 0.04). ConclusionsMFR increased muscle activity, reduced pain and improved the KROM of TKA patients. Thus, MFR is a useful resource of rehabilitation after TKA.

Favouring emotional processing in improvisational music therapy through resonance frequency breathing: a single-case experimental study with a healthy client

ABSTRACTResonance frequency breathing (RFB) is a form of slow breathing at around six breaths/min, whose immediate effects are to substantially increase heart rate variability (HRV) and to reduce stress levels. Since RFB has already been successfully used on its own to treat various emotional disorders, we wanted to evaluate its effect on emotional processing when used as a preparatory intervention in improvisational music therapy. To do so, we performed a single-subject experimental study with a healthy participant. We hypothesised that RFB would serve both as an emotional catalyst and emotional regulator, the actual outcome depending on the client’s current issues and needs. The study consisted of 10 music therapy sessions, with the breathing intervention used at the beginning of every other session, in alternation with a control intervention. The data collection focussed on HRV during talking and music-making, emotion and abstraction levels in verbal content, body language, and a set of music features extracted from the client’s improvisations. Our results show that the sessions starting with RFB were characterised by higher stress levels and the expression of more negative emotions, without it leading to hyperarousal and integration problems.

The contrast between cueing and/or observation in therapy for verb retrieval in post-stroke aphasia

BackgroundStudies measuring treatment efficacy for post-stroke verb anomia are scarce. These studies mainly assessed the efficacy of three strategies: semantic, phonological and sensorimotor. Following these previous treatments, the performance of most participants improved on treated verbs, while improvement on untreated stimuli and tasks was inconsistent. AimsThis study aimed to measure the effectiveness of a semantic–phonological strategy and a sensorimotor strategy for verb anomia in post-stroke aphasia. MethodsA multiple baseline single-subject experimental study was conducted with two participants (9–37 years post-stroke). Four phases were completed: (1) background assessment, (2) baselines, (3) therapy, and (4) follow-up. Three equivalent lists of verbs were created for each participant and two of them were trained with a different strategy: action observation+semantic–phonological cues, action observation alone. The stimuli of the third list (control list) were not treated. ResultsThe semantic–phonological cueing strategy led to a significant improvement. No improvement was observed after action observation. No generalization to untreated verbs was found. ConclusionsVerb naming can be enhanced by semantic/phonological cueing. In addition, other studies (clinical, neuroimaging, etc.) are needed to document the effect of action observation for the treatment of verb anomia.Learning outcomes: The reader will be able to (1) describe semantic–phonological therapies used in post-stroke verb anomia, (2) describe sensorimotor therapies used in post-stroke verb anomia, and (3) identify factors contributing to the efficacy of therapies to improve action naming in aphasia.

The influence of the design matrix on treatment effect estimates in the quantitative analyses of single-subject experimental design research.

The quantitative methods for analyzing single-subject experimental data have expanded during the last decade, including the use of regression models to statistically analyze the data, but still a lot of questions remain. One question is how to specify predictors in a regression model to account for the specifics of the design and estimate the effect size of interest. These quantitative effect sizes are used in retrospective analyses and allow synthesis of single-subject experimental study results which is informative for evidence-based decision making, research and theory building, and policy discussions. We discuss different design matrices that can be used for the most common single-subject experimental designs (SSEDs), namely, the multiple-baseline designs, reversal designs, and alternating treatment designs, and provide empirical illustrations. The purpose of this article is to guide single-subject experimental data analysts interested in analyzing and meta-analyzing SSED data.

S.P.44 Evaluation of a balance exercise programme in DM 1: A single-subject experimental study with 11 participants

The aim of this study was to evaluate the effects of an individualised balance exercise programme in patients with myotonic dystrophy type 1 (DM1). A single-subject experimental design was used: baseline, intervention and second baseline (ABA) with repeated assessments. Eleven DM1 patients with subjective or objective balance difficulties (outpatients) participated in a balance exercise programme with individualised exercises at the hospital-based physiotherapy department. The balance exercise programme was attended during 10 weeks (two sessions/week). Primary outcome measure was self-assessed balance confidence in three self-chosen activities, in which the balance was a problem. Secondary outcome measures were the Activities-specific Balance Confidence (ABC) scale, dynamic balance performance assessed with Step test and Timed Up and Go, together with Timed 10 m walk at maximum pace, isometric muscle force in leg muscles and number of falls. The most important findings were: 7/11 patients experienced a significant increase in balance confidence (>+2SD) in at least one self-selected activity, 9/11 scored a higher overall balance confidence in ABC scale (mean +13%, p = 0.014), and increased balance performance in Step test (mean +18%, p = 0.008). All patients deteriorated in the ankle dorsiflexor force (mean −17%, p = 0.003). The knee extensor force remained unchanged. The study showed that self-assessed balance confidence, as well as balance performance measured with Step test, is likely to increase following an individualised balance exercise programme in persons with DM1. It is important to note that distal muscles in DM1 patients are at risk of exhaustion during exercise, these patients therefore require close supervision when participating in these training sessions.

Balance and gait improved in patients with MS after physiotherapy based on the Bobath concept

Patients with multiple sclerosis (MS) tend to have movement difficulties, and the effect of physiotherapy for this group of patients has been subjected to limited systematic research. In the present study physiotherapy based on the Bobath concept, applied to MS patients with balance and gait problems, was evaluated. The ability of different functional tests to demonstrate change was evaluated. A single-subject experimental study design with ABAA phases was used, and two patients with relapsing-remitting MS in stable phase were treated. Tests were performed 12 times, three at each phase: A (at baseline); B (during treatment); A (immediately after treatment); and A (after two months). The key feature of treatment was facilitation of postural activity and selective control of movement. Several performance and self report measures and interviews were used. After intervention, improved balance was shown by the Berg Balance Scale (BBS) in both patients, and improved quality of gait was indicated by the Rivermead Visual Gait Assessment (RVGA). The patients also reported improved balance and gait function in the interviews and scored their condition as 'much improved'. Gait parameters, recorded by an electronic walkway, changed, but differently in the two patients. Among the physical performance tests the BBS and the RVGA demonstrated the highest change, while no or minimal change was demonstrated by the Rivermead Mobility Index (RMI) and Ratings of Perceived Exertion (RPE). The findings indicate that balance and gait can be improved after physiotherapy based on the Bobath concept, but this should be further evaluated in larger controlled trials of patients with MS.

Behavioral analysis and treatment of poor diabetic self-care and antisocial behavior: A single-subject experimental study

A 14-year-old male adolescent who evidenced both inconsistent diabetic self-care and antisocial behavior was treated using behavioral family therapy. An extended baseline assessment of self-care, antisocial behavior and mother-child conflict indicated a cyclic coercion-countercoercion process in which the mother's attempts to discipline the son's antisocial behavior resulted in the son's deliberate poor self-care until a diabetic episode occurred, terminating his mother's disciplinary actions. Treatment sequentially focused on self-care, antisocial behavior, mother-child conflict, and school attendance and behavior. Self-monitoring and a reinforcement salary were insufficient to alter self-care; the addition of a potent punishment for poor self-care led to improved self-care and less frequent diabetic crises but increased antisocial behavior. Maternal monitoring of the son's activities and peer associates, a behavioral contract, and communication/problem-solving training resulted in a reduction in antisocial behavior and conflict, and in increased school attendance. Treatment gains were maintained at a two-month follow-up.