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Shepley C. Exploratory Time-Series Analysis of Consecutive Case Series Data: A Quality Improvement and Adherence Study of a Behavior Analytic Service Provider. J Autism Dev Disord 2024; 54:2240-2253. [PMID: 37017860 DOI: 10.1007/s10803-023-05940-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2023] [Indexed: 04/06/2023]
Abstract
Program evaluation is an essential practice for providers of behavior analytic services, as it helps providers understand the extent to which they are achieving their intended mission to the community they serve. A proposed method for conducting such evaluations, is through the use of a consecutive case series design, for which cases are sequentially gathered following the onset of a specific occurrence. Given the sequential nature in which data are collected within a consecutive case series, analytic techniques that adopt a time-series framework may be particularly advantageous. Although such methods are commonly used for program evaluation in medicine and economics, their application within the field of applied behavior analysis is largely absent. To serve as a model for providers undertaking evaluation efforts, I conducted a program evaluation of an outpatient severe behavior clinic, in which I employed quasi-experimental methods using an interrupted time-series analysis.
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Affiliation(s)
- Collin Shepley
- Department of Early Childhood, Special Education, & Counselor Education, University of Kentucky, 229 Taylor Education Building, Lexington, KY, 40506, USA.
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Jin Choo Y, Chang MC. Effects of telecardiac rehabilitation on coronary heart disease: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e29459. [PMID: 35839029 PMCID: PMC11132407 DOI: 10.1097/md.0000000000029459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 04/22/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND We performed a meta-analysis to investigate the effectiveness of telecardiac rehabilitation compared to center-based rehabilitation on cardiorespiratory fitness, blood pressure, blood lipids, body composition, and quality of life in patients with coronary heart disease. METHODS We searched the Medical Literature Analysis and Retrieval System Online, Cumulative Index to Nursing and Allied Health Literature, Cochrane, Embase, and Scopus databases and retrieved studies published until October 8, 2021. Randomized controlled trials were included to evaluate cardiorespiratory fitness, blood pressure, blood lipids, body composition, and quality of life after telecardiac rehabilitation and center-based rehabilitation in patients with coronary heart disease. The criteria of the Cochrane Handbook for Systematic Reviews of Interventions were used to evaluate the methodological quality of the studies. Funnel plot analysis and Egger test were performed to confirm the publication bias. RESULTS A total of 8 studies, including 750 participants, reported the effectiveness of the telecardiac rehabilitation and center-based rehabilitation included in the analysis. Except for total cholesterol and mental quality of life (P < .05), all parameters were not significantly different between telecardiac rehabilitation and center-based rehabilitation (P > .05). CONCLUSION Telecardiac rehabilitation was similar to the effects of center-based rehabilitation. The overall prognosis of patients with coronary heart disease can be improved by increasing patients' participation in cardiac rehabilitation through telerehabilitation.
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Affiliation(s)
- Yoo Jin Choo
- Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Min Cheol Chang
- Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea
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Colombo RA, Taylor RS, Hammond JL. State of Current Training for Severe Problem Behavior: A Survey. Behav Anal Pract 2021; 14:11-19. [PMID: 33732574 DOI: 10.1007/s40617-020-00424-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Ensuring that Board Certified Behavior Analysts (BCBAs) receive sufficient training in various forms of practice is an area of clinical importance that necessitates additional attention. Given that there is relatively limited information available on the extent to which BCBAs receive ongoing training and support, Reed and Henley (Behavior Analysis in Practice, 8, 16-26, 2015) conducted a study to evaluate the various types of training offered to BCBAs and aspiring certificants. As such, the purpose of the current investigation was to extend the findings of Reed and Henley by surveying BCBA respondents who practice (a) primarily in the home setting and (b) with clients who engage in severe problem behavior. The results are discussed with respect to 3 socially significant findings. First, 43% of respondents had been assigned their first severe case without initial or ongoing support. Second, only 35.2% of respondents received training on functional analyses more than 1 time. Finally, 5 respondents (4%) answered that the majority of their work was with clients 19 years old or older.
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Affiliation(s)
- Richard A Colombo
- Center for Applied Behavior Analysis, 707 Wilshire Blvd, Los Angeles, CA 90017 USA.,The Chicago School of Professional Psychology, Chicago, IL USA
| | - Rachel S Taylor
- Center for Applied Behavior Analysis, 707 Wilshire Blvd, Los Angeles, CA 90017 USA
| | - Jennifer L Hammond
- Center for Applied Behavior Analysis, 707 Wilshire Blvd, Los Angeles, CA 90017 USA
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Shepley C, Shepley SB, Allday RA, Tyner-Wilson M, Larrow D. Evaluation of a Brief Family-Centered Service Provision Model for Treating Children's Severe Behavior: A Retrospective Consecutive Case Series Analysis. Behav Anal Pract 2021; 14:86-96. [PMID: 33732579 PMCID: PMC7900314 DOI: 10.1007/s40617-020-00487-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
This article serves as an initial program evaluation of a service provision model for providing applied behavior analysis services to families with severe behavior needs. A retrospective consecutive case series design was used to evaluate the effectiveness, feasibility, and cost of the model. We analyzed records for all families served through the model from summer 2017 to fall 2018. A total of 55 families received services, with 87% of children having autism and 63% having an intellectual disability. Within-participant single-case experimental designs were used to evaluate the clinic's assessment procedures, and caregiver interviews were used to evaluate the feasibility and effectiveness of developed and implemented treatments. Conclusive assessment results were obtained for approximately 69% of children. For families that received treatment, 92% reported improved child behavior. Intent-to-treat analyses that included families that withdrew from services prior to receiving treatment indicated that 61% of families experienced improved child behavior. Assessment and treatment outcomes for families that attended all appointments are commensurate with those of other similar clinics reported in the literature; however, the percentage of families that withdrew from services is substantially higher. For families adhering to the clinic's services, children's challenging behavior may be effectively assessed and treated through brief outpatient contacts utilizing services based on applied behavior analysis.
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Affiliation(s)
- Collin Shepley
- Department of Early Childhood, Special Education, and Rehabilitation Counseling, College of Education, University of Kentucky, 229 Taylor Education Building, Lexington, KY 40506 USA
| | - Sally B. Shepley
- Department of Early Childhood, Special Education, and Rehabilitation Counseling, College of Education, University of Kentucky, 229 Taylor Education Building, Lexington, KY 40506 USA
| | - R. Allan Allday
- Department of Early Childhood, Special Education, and Rehabilitation Counseling, College of Education, University of Kentucky, 229 Taylor Education Building, Lexington, KY 40506 USA
| | - Melanie Tyner-Wilson
- Developmental-Behavioral Pediatrics, College of Medicine, University of Kentucky, Lexington, KY USA
| | - Daniel Larrow
- Developmental-Behavioral Pediatrics, College of Medicine, University of Kentucky, Lexington, KY USA
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Shepley C, Shepley SB, Allday RA, Tyner-Wilson M, Larrow D. Rationale, Development, and Description of a Brief Family-Centered Service Provision Model for Addressing Children's Severe Behavior. Dev Neurorehabil 2021; 24:107-117. [PMID: 33206001 DOI: 10.1080/17518423.2020.1839979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
For families with children with autism that engage in severe behavior, the American Academy of Pediatrics recommends that functional assessment and management of environmental variables contributing to severe behavior occur prior to the prescription of psychopharmacologic treatment. Despite the inclusion of this recommendation in guidance articles published in pediatric journals for more than a decade, access to such services may not be feasible, in particular for families living in rural and geographically isolated communities. Given that families often view pediatricians as their first line of professional guidance for addressing challenges surrounding child development, the inaccessibility of appropriate services for managing healthcare is a concern for many pediatricians. To address this issue, a brief family-centered service provision model was developed through a collaboration between healthcare providers at a university-based hospital and Applied Behavior Analysis program faculty of the affiliated university. The hospital served many families living in rural areas of the state; therefore, the model utilized research-based practices with evidence of ecological validity for providing function-based assessment and treatment services. Within this manuscript we present a description of the model and its current implementation at a university-based hospital. For a data-based evaluation of the clinic and model, we refer readers to https://osf.io/qx8ak.
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Affiliation(s)
- Collin Shepley
- Department of Early Childhood, Special Education, and Rehabilitation Counseling, University of Kentucky, College of Education , Lexington, KY, USA
| | - Sally B Shepley
- Department of Early Childhood, Special Education, and Rehabilitation Counseling, University of Kentucky, College of Education , Lexington, KY, USA
| | - R Allan Allday
- Department of Early Childhood, Special Education, and Rehabilitation Counseling, University of Kentucky, College of Education , Lexington, KY, USA
| | - Melanie Tyner-Wilson
- Developmental-Behavioral Pediatrics, University of Kentucky, College of Medicine , Lexington, KY, USA
| | - Daniel Larrow
- Developmental-Behavioral Pediatrics, University of Kentucky, College of Medicine , Lexington, KY, USA
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Linstead E, Dixon DR, Hong E, Burns CO, French R, Novack MN, Granpeesheh D. An evaluation of the effects of intensity and duration on outcomes across treatment domains for children with autism spectrum disorder. Transl Psychiatry 2017; 7:e1234. [PMID: 28925999 PMCID: PMC5639250 DOI: 10.1038/tp.2017.207] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 06/14/2017] [Accepted: 07/13/2017] [Indexed: 11/12/2022] Open
Abstract
Applied behavior analysis (ABA) is considered an effective treatment for individuals with autism spectrum disorder (ASD), and many researchers have further investigated factors associated with treatment outcomes. However, few studies have focused on whether treatment intensity and duration have differential influences on separate skills. The aim of the current study was to investigate how treatment intensity and duration impact learning across different treatment domains, including academic, adaptive, cognitive, executive function, language, motor, play, and social. Separate multiple linear regression analyses were used to evaluate these relationships. Participants included 1468 children with ASD, ages 18 months to 12 years old, M=7.57 years, s.d.=2.37, who were receiving individualized ABA services. The results indicated that treatment intensity and duration were both significant predictors of mastered learning objectives across all eight treatment domains. The academic and language domains showed the strongest response, with effect sizes of 1.68 and 1.85 for treatment intensity and 4.70 and 9.02 for treatment duration, respectively. These findings are consistent with previous research that total dosage of treatment positively influences outcomes. The current study also expands on extant literature by providing a better understanding of the differential impact that these treatment variables have across various treatment domains.
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Affiliation(s)
- E Linstead
- Machine Learning and Assistive Technology Laboratory, Schmid College of Science and Technology, Chapman University, Orange, CA, USA
| | - D R Dixon
- Department of Research and Development, Center for Autism and Related Disorders, Woodland Hills, CA, USA
| | - E Hong
- Department of Research and Development, Center for Autism and Related Disorders, Woodland Hills, CA, USA
| | - C O Burns
- Department of Research and Development, Center for Autism and Related Disorders, Woodland Hills, CA, USA
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - R French
- Machine Learning and Assistive Technology Laboratory, Schmid College of Science and Technology, Chapman University, Orange, CA, USA
| | - M N Novack
- Department of Research and Development, Center for Autism and Related Disorders, Woodland Hills, CA, USA
| | - D Granpeesheh
- Department of Research and Development, Center for Autism and Related Disorders, Woodland Hills, CA, USA
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