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Optimizing behavioral health interventions with single-case designs: from development to dissemination PMC

abab design

To set the thresholds, we considered a broad range of effect sizes that were generally representative of the values that we observed in our current datasets. The value of PEM can vary between 0 and 100%, but random fluctuation alone should produce a value varying around 50%. Ma (2006) indicates that highly effective treatments produce a mean PEM value of 94%, moderately effective treatments a mean value of 76%, and ineffective treatments a mean value of 48%. We used the R statistical package to compute PEM automatically for our analyses (R code available from the first author). The main drawback of PEM is that it does not consider all points and is impervious to data trends. We are now in a position to evaluate whether SCDs live up to our ideals about optimization.

Can these designs be used in clinical settings?

The ABA and ABAB design can’t be used with variables that could cause irreversible effects. It also can’t be used when it would be unethical or unsafe for an individual to revert back to their baseline condition. It can also be hard to rule out a history effect if the dependent variable doesn’t return to its original state when the treatment or therapy is removed. In a basic AB design psychology experiment, there is a baseline (A) and an intervention (B). If A changes after the implementation of B, a researcher could conclude that B caused a change in A.

Statistical Analysis and SSED

One advantage of a single-case approach to establishing generality is that a series of strategic studies can be conducted with some degree of efficiency. Moreover, the data intimacy afforded by SCDs can help achieve scientific generality about behavioral health interventions. In some cases, the source(s) of variability can be identified and potentially mitigated (e.g., variability could be reduced by automating data collection, standardizing the setting and time for data collection). However, there may be instances when there is too much variability during baseline conditions, and thus, detecting a treatment effect will not be feasible. Excessive variability is a relative term, which is typically determined by a comparison of performance within and between conditions (e.g., between baseline and intervention conditions) in a single-case experiment.

Unlocking Vocational Opportunities for Individuals with Autism

” In the Randomized Control Trials, that outcome would be supported by similar findings among many people, but the lack of results invalidates a study of one individual. According to an article in the US National Library of Medicine, the primary requirement to judge the effectiveness of this model is the ability of the researcher to replicate the results. That replication becomes the basis for identifying the intervention as a universal method of treatment. This means researchers can use the same statistical procedures with ABAB that they do with a time series analysis. If you look back at the original A-B, you’ll notice that the training with a biscuit increased the ratio of response from 20% to 67% and the training with praise increased the behavior from 20% to 50%.

abab design

Results of the initial component corresponded to those of both subsequent components about 64% of the time. To put our results into perspective, an analysis would require a power of 0.87 for an initial true effect to be detected and replicated at least once 85% of the time and a power 0.86 for all three components agreeing on a true effect for 64% of the time. These results are consistent with the power of the dual-criteria method reported by Fisher et al. (2003) for large effect sizes.

abab design

Implementing ABAB Design in Behavior Analysis

As a result, it is possible that the order in which the interventions are given will affect the results. For example, the effects of two interventions may be additive, so that the effects of Intervention 2 are enhanced beyond what they should be because Intervention 2 followed Intervention 1. Alternatively, Intervention 1 may have measurable but delayed effects on the dependent variable, making it appear that Intervention 2 is effective when the results should be attributed to Intervention 1. Such possibilities should be considered when multi-treatment studies are being planned (see Hains & Baer, 1989, for a comprehensive discussion of multiple-treatment interference). A final, longer phase in which the final “winning” treatment is implemented for an extended time can help alleviate some of the concerns regarding multiple-treatment interference. In visually inspecting their data, single-subject researchers take several factors into account.

Single-Subject Experimental Design for Evidence-Based Practice

A third factor is latency, which is the time it takes for the dependent variable to begin changing after a change in conditions. In general, if a change in the dependent variable begins shortly after a change in conditions, this suggests that the treatment was responsible. During the intervention phases, the independent variable is introduced, and changes in the dependent variable are observed. In the baseline phases, the independent variable is removed or withheld, allowing researchers to determine if the changes observed during the intervention phase were indeed a result of the independent variable. Internal validity plays a vital role in ABA and ABAB design as it ensures that any changes observed in behavior are a direct result of the intervention being studied. In ABA, internal validity helps establish the effectiveness of specific behavior interventions and identifies the impact of the independent variable on the target behavior.

What is the difference between ABA and ABAB design?

Nonparametric statistical tests for single-case systematic and randomized ABAB…AB and alternating treatment ... - ScienceDirect.com

Nonparametric statistical tests for single-case systematic and randomized ABAB…AB and alternating treatment ....

Posted: Wed, 27 Dec 2017 00:58:04 GMT [source]

If the dependent variable changes when the intervention takes place and then returns to baseline, there is further evidence of a treatment effect. Since the ABA design has a high degree of experimental control, there is confidence that treatment effects are actually the result of the treatment and not something else. Both ABA and ABAB designs play a crucial role in behavior analysis research and contribute to the development of evidence-based interventions for individuals with autism and other behavioral challenges. The choice between these designs depends on the research question, the nature of the behavior being studied, and the available resources. In conclusion, ABA and ABAB designs have found practical applications in studying behavior and interventions, particularly in the context of autism.

There are, however, a number of points that can be made regarding the use (derivation, interpretation) of effect size indices that are common to all. The simplest and most common effect size metric is the percentage of nonoverlapping data (PND; Scruggs, Mastropieri, & Casto, 1987). Then, the number of data points that fall above (or below) the line is tallied and divided by the total number of intervention data points. If, for example, in a study of a treatment designed to improve (i.e., increase) communication fluency, eight of 10 data points in the intervention phase are greater in value than the largest baseline data point value, the resulting PND would equal 80%. In Panel A of Figure 2, no change is observed until the third session of the intervention phase.

Because each data point is generated by the same person, the data points are not independent of one another (violating a core assumption of statistical analysis—technically, that the error terms are not independent of one another). Thus, performance represented in each data point may likely be influencing the next (Todman & Dugard, 2001). Autocorrelated data will, in turn, artificially inflate p values and affect Type 1 error rates. When such changes are large and immediate, visual inspection is relatively straightforward, as in all three graphs in Figure 1. If only the average performance during each phase is considered, each of these graphs includes a between-phase change in level. During the baseline phase, performance in the dependent measure is highly variable, with a minimum of 0% and a maximum of 100%.

Also, recognizing that behavior change is idiosyncratic and dynamic, we may need methods that allow ongoing tailoring and testing. This may result in a kind of personalized behavioral medicine in which what gets personalized, and when, is determined through experimental analysis. Research methods are tools to discover new phenomena, test theories, and evaluate interventions.

One strategy for comparing the effects of two interventions is to simply extend the logic of withdrawal designs to include more phases and more conditions. The most straightforward design of this type is the ABACAC design, which begins with an ABA design and is followed by a CAC design. The second “A” phase acts as both the withdrawal condition for the ABA portion of the experiment and the baseline phase for the ACAC portion.

The AB phase design is one of the most basic and practically feasible experimental designs for evaluating treatments in single-case research. Although widely used in practice, the AB phase design has received criticism for its low internal validity (Campbell, 1969; Cook & Campbell, 1979; Kratochwill et al., 2010; Shadish et al., 2002; Tate et al., 2016; Vohra et al., 2015). These confounding effects can serve as alternative explanations for the occurrence of a treatment effect other than the experimental manipulation and as such threaten the internal validity of the SCED.

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