Tau-U Effect Sizes Research Articles

M-MAT Meta: Treatment of Self-Awareness and Language for Individuals With Severe Wernicke's Aphasia.

In this study, we evaluated the feasibility and efficacy of language plus goal management training program for individuals with aphasia. The intervention targeted expressive language, while concurrently integrating tasks designed to improve executive function and error awareness. A single-subject repeated-measures design was utilized to determine whether a combined treatment (Multi-Modal Aphasia Therapy PLUS Goal Management Training [M-MAT Meta]) would be efficacious for individuals with aphasia. This article reports on two participants with severe Wernicke's aphasia, who comprised one of the four dyads of the study. Treatment was administered in a small group setting (N = 2) for 2 hr per day, 3 days per week for 4 weeks. Individual video feedback sessions were conducted once a week. Analysis of outcomes included visual inspection and calculation of Tau-U effect sizes of probed treatment data as well as statistical analysis of standardized language and executive function assessments. Visual inspection indicated improvements in naming and discourse skills, which were maintained at the 1-month follow-up. Both participants' standardized scores indicated a significant decrease in aphasia severity, which was maintained 1 month posttreatment. Error awareness improved for one of the two participants, but this improvement was not maintained. Participants demonstrated increased inhibition of unwanted responses and took longer on the planning and problem-solving time required to complete the assessment, indicating a decrease in impulsivity. The results of this preliminary study suggest that M-MAT Meta may be an effective way to increase self-awareness and communication in individuals with severe Wernicke's aphasia.

A Synthesis of Academic Interventions for High School Students With Behavioral and Learning Difficulties

Many students who experience behavioral difficulties (BD) also experience learning difficulties (LD) in school; however, little research exists on how to support the academic achievement of students with co-occurring BD/LD. Even less research exists for students who experience these co-occurring difficulties at the high school or secondary level. The goal of this synthesis was to explore the effects of academic interventions on the academic outcomes (i.e., reading, mathematics, and writing) of high school students with co-occurring BD/LD. A total of nine, single-case design studies met criteria for this synthesis, including two dissertations. Four studies examined mathematics outcomes, four studies assessed reading outcomes, and two studies targeted spelling outcomes, with one study examining both mathematics and spelling. The calculated Tau-U effect sizes ranged from 0.54 to 1.0 across studies. Implications for research and practice are discussed with the goal of contributing to the small body of research on secondary-aged students with co-occurring BD/LD.

The use of Treatment and Education of Autistic and Related Communication Handicapped Children in schools to improve the ability of children with autism to complete tasks independently: A single-case meta-analysis.

To investigate the effectiveness of a Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH) intervention in schools for improving independent task performance in children with autism spectrum disorders (ASD). We screened relevant studies published up to December 2022 from Web of science, ERIC, PsycINFO and other databases using predefined inclusion/exclusion criteria to identify suitable intervention studies for meta-analysis. Tau-U effect sizes were calculated for each A-B comparison extracted from the included experiments. Moderated analyses were conducted to examine the type of intervention (independent variable), intervention target behaviours (dependent variable), participant characteristics, setting characteristics and intervener characteristics. A total of 14 studies (38 participants) met the criteria and were included in the meta-analysis. The analysis results showed that TEACCH had a significant intervention effect, and the overall intervention effect size was Tau-U = 0.85[0.77, 0.91]. There were significant differences in the intervention target behaviour variables (p < 0.01), limited variation in the intervention type variables, but no differences in participant characteristics, setting characteristics and intervenor characteristics. The use of TEACCH is effective in improving independent task completion in children with ASD and provides evidence-based recommendations for its extended use in schools.

Integrated Behavior Therapy for Exclusively Anxious Selective Mutism: A Nonconcurrent Multiple-Baseline Design across Five Participants.

Selective mutism (SM) is a rare childhood anxiety disorder which may be markedly detrimental to a child's academic and social functioning if left untreated. Cognitive-behavioral treatments for social anxiety disorders have been found to be effective for SM, yet a paucity of published studies have explored manualized treatment approaches carried out by novice clinicians. The purpose of the present study was to examine the adherence, effectiveness, and acceptability of a condensed, 16-session version of Integrated Behavior Therapy for Selective Mutism (IBTSM; Bergman, 2013), the first manualized treatment for SM. A nonconcurrent multiple-baseline single-case design was used across five children diagnosed with SM, exclusively anxious subtype. IBTSM was implemented with excellent adherence (M = 98%) over an average of 19 weeks (range = 16-22 weeks). Visual analyses of weekly caregiver ratings of social anxiety and speaking behaviors did not demonstrate a replicated intervention effect; however, Tau-U effect sizes and Reliable Change Index (RCI) calculations demonstrated significant individual improvements in social anxiety and speaking behaviors over time on several measures. Three children (60%) no longer met diagnostic criteria for SM following treatment. All caregivers rated IBTSM as acceptable, with specific endorsements of acceptability in the areas of time required and treatment quality.

The impact of teaching with schemas on structural word challenges

Instruction is adapted for students having a specific learning disability (SLD) that focuses on the fundamental structure of maths recommending problems as an evidence-based practice. Additionally, evidence-based schema-based education is viewed as a practical strategy for students with an SLD. This study expanded upon earlier efforts by (a) utilizing the implementer and a teacher, (b) assessing a flexible intervention's efficiency, and (c) assessing the performance of students on integrated and generalized schema structure issues. There were 12 impaired fourth and fifth graders receiving extra maths teaching in a resource room. The intervention package included arithmetic education based on schema and a problem-solving mnemonic. A multiple-probe approach involving different participant a functional connection was done using groups. Students performed better when given straightforward, generic, and integrated schema structures. The aggregate normalized mean difference between cases (BC-SMD) for this study was 3.05 (CI95 [2.54, 3.60]), while aggregate “Tau-U effect size (ES) was 95% (CI90 [83%, 100%]”).

Meta-Analysis of Tablet-Mediated Interventions to Teach Mathematics for Individuals With Autism Spectrum Disorder and/or Intellectual Disability

Tablet-mediated interventions have shown promise in improving the mathematical skills of individuals with autism spectrum disorder (ASD) and/or intellectual disability (ID). This meta-analysis aims to provide a quantitative synthesis of single-case experimental studies of using tablet-mediated interventions to teach mathematics to individuals with ASD and/or ID. Twenty-seven published studies between 2012 and 2022 were included. The Tau-U effect size index was used to gauge the overall effect size of tablet-mediated interventions. The obtained effect size (Tau-U = 0.98, 95% CI 0.92–1.00) indicated large improvements in mathematics performance after using tablet-mediated interventions. The analysis of potential moderating variables, including participant characteristics, intervention components, and target mathematical skills found no statistically significant moderators. Implications for researchers and practitioners who use tablet-mediated interventions to teach mathematics to individuals with ASD and/or ID are also discussed.

Improving Expository Text Comprehension in Adolescent Spanish–English Bilingual Learners With Learning Disabilities Using a Graphic Organizer

The purpose of this study was to examine the efficacy of a graphic organizer for improving the expository text comprehension of adolescent Spanish–English bilingual students with learning disabilities. Students included two females and one male. Using a multiple baseline single case design, students were taught to create a funnel map graphic organizer for 10 descriptive text passages. Students’ performance was assessed on their ability to correctly create the funnel map (criterion variable) and to comprehend expository passages during baseline, intervention, and maintenance phases. Each participant learned to create an accurate funnel map within four sessions. Text comprehension scores began to increase within three sessions. Results showed the positive effect of using the funnel map for improving comprehension of expository texts. Individual TAU effect sizes (.81–.92) and overall TAU-U effect sizes (.86) and a Between Case-Standardized Mean Difference (BC-SMD) of 1.87 showed the intervention to be highly effective.

Implementation of Check-In/Check-Out to Improve Classroom Behavior of At-Risk Elementary School Students.

The multi-tiered school-wide positive behavioral interventions and supports offers a comprehensive model for the prevention of behavioral and academic problems in schools. This study evaluated Check-in/Check-out (CICO), a Tier 2 intervention, with three elementary school students from a high-need population, whose problem behavior was hypothesized to be maintained by teacher attention. The study employed a concurrent multiple baseline design across participants, a single case experimental design to examine the effects of CICO on student academic engagement and problem behavior during instruction. Results indicated that implementation of CICO with fidelity by the CICO coordinator, classroom teachers, and parents lead to increased academic engagement and reduced problem behavior in all three students. Tau-U Effect sizes were medium to large for academic engagement and small to medium for problem behavior across students. Data on two students indicate that systematically fading the number of times teachers utilize the daily report card has the potential for promoting maintenance effects. For one student, fading of the coordinator was successful. Social validity assessment indicated high levels of satisfaction with the CICO intervention by the participating students, teachers, and one parent.

Improving the Clinician-Client Relationship in Children’s Speech-Language Treatment: An Exploratory Online Training Study

Introduction: Clinician-client relationships impact treatment outcomes in speech-language pathology. Training clinicians to improve these relationships might therefore improve treatment outcomes but has not been examined in the field. This study is a preliminary investigation of whether training student clinicians can enhance clinician-client relationships in children’s speech-language treatment. Methods: The study followed a single-subject multiple baseline design. Five graduate student clinicians completed a web-based training on clinician-client relationships, which was implemented as a series of three modules discussing goals, tasks, and bond. The training’s impact on the student’s relationships with their child clients was examined through weekly ratings completed by the students, their supervisor, and some parents and children. Intervention effects were measured by visual analysis of baseline versus intervention phases and by Tau-U effect sizes. Results: Visual analyses supported change in just under half the possible opportunities, but improvements in the relationship were also present in many of the baseline phases. Tau-U effects that corrected for baseline trend reached significance in 18 of 29 instances, providing support for the effects of the intervention. Conclusions: This study provides initial evidence that clinician-client relationship training can be effective for speech-language pathology graduate students. Clinician-client relationship training is a promising area for future investigation.

Meta-Analysis of Mindfulness-Based Program Soles of the Feet for Disruptive Behaviors.

Mindfulness-based programs are a promising intervention modality for reducing disruptive behavior, and Soles of the Feet (SOF) is one program that teaches internal awareness of personal events (e.g., unpleasant emotions) and a self-regulation strategy to decrease disruptive behaviors. This study conducted a meta-analysis of single-case research design (SCRD) studies that implemented SOF to decrease disruptive behaviors. Existing SOF studies were evaluated using high-quality SCRD standards, resulting in 15 studies included in the analysis (49 participants; mean age 23.12 years (SD = 15.87); highly heterogeneous backgrounds). Studies were analyzed to calculate effect sizes using Tau-U, an innovative non-parametric statistical approach for estimating effect sizes in SCRD studies. The aggregated weighted Tau-U effect size of SOF across all studies was -0.87. Moderator analyses indicated SOF's effectiveness was robust across participant characteristics and delivery formats. This meta-analysis suggests that SOF is a moderately effective evidence-based practice for reducing disruptive behavior.

Using the Question-Answer Relationship Strategy to Improve Listening Comprehension in Young Children with Autism Spectrum Disorder.

Our purpose in this study was to examine the effects of an intervention package consisting of shared book reading and an adapted question-answer relationship (QAR) strategy comprised of visual supports and think-aloud scripts on listening comprehension in four preschool children with autism spectrum disorder (ASD). We used a single-subject concurrent multiple-baseline design across participants with continuous acquisition probes to evaluate the effects of the intervention package on producing acquisition and maintenance of listening comprehension across four types of comprehension questions. Visual analysis and Tau-U effect size indicated that the intervention package was effective in producing acquisition and maintenance of listening comprehension in preschool children with ASD. Directions for future research and clinical implications for early education practice are discussed.

Handheld Technology to Support Vocational Skills of Individuals with Intellectual and Developmental Disabilities in Authentic Settings: a Systematic Review

Employment enhances community integration and overall quality of life for individuals with intellectual and developmental disabilities (IDD). Rapidly evolving and widely used handheld technologies (e.g., tablets and smart phones) may empower improved outcomes of vocational training for individuals with IDD. This systematic review summarizes and evaluates peer-reviewed studies that involved handheld technology to facilitate vocational training in authentic community-based settings for people with IDD. Eleven studies involving 32 participants with IDD were systematically located and analyzed in terms of key variables, study rigor, and Tau-U effect size estimates. Overall, Tau-U score suggested a large to a very large effect for interventions involving handheld technologies to teach vocational skills. Results are used to offer preliminary guidance for practitioners and to suggest directions for future research and practice.

A Meta-Analysis of Single-Case Research on Applied Behavior Analytic Interventions for People With Down Syndrome.

This systematic review evaluates single-case research design studies investigating applied behavior analytic (ABA) interventions for people with Down syndrome (DS). One hundred twenty-five studies examining the efficacy of ABA interventions on increasing skills and/or decreasing challenging behaviors met inclusion criteria. The What Works Clearinghouse standards and Risk of Bias in N-of-1 Trials scale were used to analyze methodological characteristics, and Tau-U effect sizes were calculated. Results suggest the use of ABA-based interventions are promising for behavior change in people with DS. Thirty-six high-quality studies were identified and demonstrated a medium overall effect. A range of outcomes was targeted, primarily involving communication and challenging behavior. These outcomes will guide future research on ABA interventions and DS.

Effects of a Text-Writing Fluency Intervention for Postsecondary Students with Intellectual and Developmental Disabilities

ABSTRACT Writing has implications for the academic, vocational, and social pursuits of students. Unfortunately, many students with disabilities – including those with intellectual and developmental disabilities – struggle with a foundational aspect of written expression: text writing within sentences and paragraphs. This study used a multiple-baseline across students' design to investigate the effects of a multicomponent intervention, explicit instruction with timed practice, on the fluent sentence text writing or sentence construction of four postsecondary students with intellectual and developmental disabilities. We tested effects on sentence text writing measures and application to paragraph text writing. Data were analyzed through visual analysis and Tau-U effect sizes. The results of the intervention suggest that the multicomponent intervention had mixed effects on the sentence text and paragraph text writing of students. How the study contributes to the broader writing literature is discussed and limitations are presented.

Caregiver Involvement in Communication Skills for Individuals with ASD and IDD: a Meta-analytic Review of Single-Case Research on the English, Chinese, and Japanese Literature

The current meta-analytic review analyzed 43 studies published in English, Chinese, and Japanese to determine the effects of caregiver involvement for promoting communication skills of individuals with ASD and IDD. Tau-U effect sizes, the Kruskal-Wallis H test, and the Dunn post hoc test were employed to calculate for moderator analyses: child age, settings, service delivery formats, and dosages of services provided to caregivers. The overall effect size for family involvement had a moderate effect on child communicative outcomes, as well as on child ages, settings, delivery formats, and dosages of services provided to caregivers of individuals with ASD and IDD. A statistically significant difference was found in children’s communication outcomes between the four dosage groups of services provided to caregivers.

Double-Bubble Thinking Maps and Their Effect on Reading Comprehension in Spanish-English Bilingual Middle School Students With Learning Disabilities

The purpose of this single case design study was to examine the efficacy of using double-bubble Thinking Maps to improve the reading comprehension of middle school Spanish-English bilingual middle school students with learning disabilities. Participants included three female Spanish-English bilingual middle school students with learning disabilities. In this multiple baseline across participants single case design study, we taught students to create a double-bubble map, a type of compare and contrast graphic organizer, for 12 expository compare and contrast text passages over 12 forty-five minute sessions. We assessed performance on creating the double-bubble map and on reading comprehension measures across baseline, intervention, and maintenance phases. Each participant learned to create an accurate double-bubble map for compare and contrast expository texts within two sessions. Reading comprehension scores began to increase within two intervention sessions for each participant. Results showed the positive effect of using the double-bubble Thinking Map to improve reading comprehension of compare and contrast texts. Individual (.895–.967) and overall (.94) TAU-U effect sizes showed the intervention to be highly effective. Based on the effect sizes, the double-bubble Thinking Map was effective for improving the reading comprehension of middle school Spanish-English bilingual students with learning disabilities.

Examining Social Communication Effects of a Picture Communication Board in a Child With Autism

Purpose Augmentative and alternative communication (AAC) systems have been shown to increase requesting and protesting among minimally verbal children with autism spectrum disorder (ASD). However, there is a lack of research on using AAC to address social communication in ASD. Additionally, most previous research on AAC involves expensive, difficult-to-access technology. Enhanced milieu teaching and joint attention, symbolic play, engagement, and regulation interventions have been combined to successfully improve social communication in ASD. The purpose of this study is to examine the impact of introducing a low-technology, picture-based communication board using enhanced milieu teaching with joint attention, symbolic play, engagement, and regulation on social communication. Method An A-B-A-B single-subject design was implemented with a minimally verbal boy with ASD aged 3;4 (years;months). Three baseline sessions were followed by six intervention sessions and then repeated. Outcome measures included frequency of communicative acts, percentage of communication acts using AAC, and percentage of communication acts that were social. Visual analysis in combination with Tau-U effect sizes was used to evaluate the effects of intervention. Results Clear and immediate effects on frequency of communication (Tau-U = 0.97) and adoption of the AAC system (Tau-U = 1.00) were observed. The intervention did not clearly impact social communication (Tau-U = 0.17). Conclusions This study extends previous research indicating that AAC can quickly increase communication frequency to low-technology, accessible systems. The intervention dosage may have been insufficient to affect social communication, and further research should consider whether picture communication boards can positively influence social communication in young children with ASD.

Improving Word Problem Solving of Immediate, Generalized, and Combined Structured Problems via Schema-Based Instruction

ABSTRACT Instruction geared toward priming the underlying problem structures was suggested as an evidence-based practice for students with a learning disability. Schema-based instruction is one intervention aligned with this principle. We extended prior work by (a) using a teacher as the implementer, (b) providing teacher flexibility in intervention implementation, and (c) examining student performance for generalized and combined problem structures. The participants included fourth-grade students (n = 5) identified with a disability who received supplementary mathematics instruction in a resource room setting. The independent variable was schema-based instruction and the dependent variable was mathematical problem-solving performance. To evaluate if a functional relation existed, a multiple-probe design across participants was used. A functional relation was established; however, student performance did not reach socially significant levels. The aggregated Tau-U effect size was 81% [CI90 61, 100%] and the aggregated BC-SMD was 1.72 [CI95 1.00, 2.49]. Implications for research and practice will be discussed in regard to implementation fidelity and dosage of remedial instruction.

Effects of Schema-Based Instruction on Immediate, Generalized, and Combined Structured Word Problems

Instruction targeting the underlying math problem structure is identified as an evidence-based practice for students with a specific learning disability (SLD). Furthermore, schema-based instruction is identified as a potentially evidence-based practice for students with a SLD. This study extended prior work by (a) using a teacher as the implementer, (b) evaluating the efficacy of an adaptable intervention, and (c) evaluating student performance on generalized and combined schema structure problems. The participants included 12 fourth- and fifth-grade students with a disability and receiving supplemental mathematics instruction in a resource room setting. The intervention package consisted of a problem-solving mnemonic and schema-based instruction for mathematics. A multiple-probe design across participant groups was used to establish a functional relation. Students improved performance on word problems representing simple, generalized, and combined schema structures. The aggregated Tau-U effect size (ES) for this study was 95% (CI90 [83%, 100%]) and the aggregated between-case standardized mean difference (BC-SMD) was 3.05 (CI95 [2.54, 3.60]).

Effect of Video Embedded with Hotspots with Dynamic Text on Single-Word Reading by Children with Multiple Disabilities.

The purpose of the study was to evaluate the effects of an intervention using an AAC app programmed with video visual scene displays (VSDs) embedded with hotspots with the Transition to Literacy (T2L) feature on single-word reading. Three school-aged children with multiple disabilities participated in a multiple baseline across participants design. Four names of characters in favorite movies and shows served as target words for each participant. All three children demonstrated an increase in accurate identification of target words from baseline to intervention with Tau-U effect sizes for the participants of 0.69, 0.76, and 0.84, all of which were statistically significant (p<0.05). Clinicians can consider including the intervention evaluated in the current study as one component of literacy intervention for school-aged children with multiple disabilities. Future research should further evaluate video VSDs and the T2L feature for use with individuals with multiple disabilities.