Component analyses using single-subject experimental designs: a review

Self-Control Training: A Scoping Review

We conducted a scoping review of the behavior analytic self-control training (SCT) literature. To identify included articles, we searched key terms in six databases for articles published between 1988 and 2021. We included empirical articles that used a behavioral approach to self-control training with human participants for whom increasing self-control choice was a clinically significant goal and measured self-control and impulsive choice as dependent variables. Twenty-five experiments from 24 articles with a total of 79 participants were included in the review. This review aims to summarize the characteristics of SCT procedures and outcomes, provide recommendations for future research directions, and offer practical suggestions to clinicians incorporating SCT into practice. We examined similarities across studies regarding the independent variables manipulated in SCT, dependent variables measured, metrics of successful interventions, and assessment of generalization and maintenance of self-control choice. Twenty-one experiments arranged concurrent self-control- and impulsive-choice options with positive reinforcement, and four experiments arranged self-control training with negative-reinforcement contingencies. Variations of SCT included progressively increasing delays, intervening activities, signaled delays, antecedent rules, and commitment responses. Providing an intervening activity during the delay was largely successful at increasing self-control choice. Maintenance and generalization of increased self-control choice were assessed in two and three experiments, respectively. Future research should focus on improving the generality of SCT procedures in clinical settings by increasing terminal delays, fading out intervening activities, including probabilistic outcomes, and combining appetitive and aversive outcomes.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40617-023-00885-y.

Single-Case Data Analysis: A Practitioner Guide for Accurate and Reliable Decisions

Practitioners frequently use single-case data for decision-making related to behavioral programming and progress monitoring. Visual analysis is an important and primary tool for reporting results of graphed single-case data because it provides immediate, contextualized information. Criticisms exist concerning the objectivity and reliability of the visual analysis process. When practitioners are equipped with knowledge about single-case designs, including threats and safeguards to internal validity, they can make technically accurate conclusions and reliable data-based decisions with relative ease. This paper summarizes single-case experimental design and considerations for professionals to improve the accuracy and reliability of judgments made from single-case data. This paper can also help practitioners to appropriately incorporate single-case research design applications in their practice.

Toward a synthesis of cognitive behaviour therapy via component analysis of self-regulation

The cognitive behavioural therapies (CBTs) are the choice psychotherapies for many clinicians treating a wide range of adult psychological disorders including various anxieties, mood, substance use, eating, schizophrenia and personality-related. Empirical research in the CBTs is ever increasing, and the accumulating evidence supporting efficacious treatments is substantial and well documented. However, with prolific research comes a seemingly accelerating and worrying trend of purportedly different therapies, and numerous hybrids and combinations of therapies and techniques. For many clinicians this is increasingly confusing and not helpful in clinical practice. This article is a critique of current trends and directions in clinical research, which show signs of limited effectiveness, fragmentation, and obfuscation. An alternative strategy is proposed-examining transdiagnostic therapeutic effects, which appear related to treating pervasive dysregulated emotions, with component analyses of four principal self-regulation components (viz., self-monitoring; functional analysis; identifying values, goals and treatment-plans; and feedback). Such a strategy is likely to lead to a more coherently synthesized and effective CBT.

A Component Analysis of Skill Acquisition Consequences with Listener Responses

We conducted a component analysis of skill acquisition consequences for correct and incorrect responses. In the learn unit (LU) condition, researchers praised correct responses and implemented a correction procedure contingent on incorrect responses. In the praise-only-for-correct-responses (PC) condition, researchers delivered contingent praise for correct responses and ignored incorrect responses. In the correction-only-for-incorrect-responses (CI) condition, researchers ignored correct responses and implemented the correction procedure contingent on incorrect responses. We manipulated this independent variable across educational and abstract stimuli and measured acquisition rate, duration, and maintenance of responses. The results showed that the LU and the CI conditions were both effective in teaching listener responses and were more effective than the PC procedure. Furthermore, the LU instruction was not necessarily more efficient than the CI condition on acquisition of listener responses. The results suggested that the correction procedure may be necessary and sufficient for skill acquisition and maintenance.

Toward deeper understanding and wide-scale implementation of naturalistic developmental behavioral interventions

LAY ABSTRACT

Naturalistic Developmental Behavioral Interventions (NDBIs) are a group of early interventions that use a variety of strategies from applied behavioral and developmental sciences. Although Naturalistic Developmental Behavioral Interventions have been demonstrated effective, Naturalistic Developmental Behavioral Interventions are not implemented on a wide scale within early intervention programs for children on the autism spectrum. Potential reasons likely stem from differing theoretical orientations of developmental and behavioral sciences and practitioners' lack training, knowledge, and support for implementing Naturalistic Developmental Behavioral Interventions. In support of efforts to promote wide-scale implementation of Naturalistic Developmental Behavioral Interventions, we (1) clarify their common features, (2) discuss possible misconceptions, and (3) offer reasons why Naturalistic Developmental Behavioral Interventions should be widely implemented. We also provide recommendations to the autism service community, intervention developers, and researchers.

The Family of Single-Case Experimental Designs

Single-case experimental designs (SCEDs) represent a family of research designs that use experimental methods to study the effects of treatments on outcomes. The fundamental unit of analysis is the single case-which can be an individual, clinic, or community-ideally with replications of effects within and/or between cases. These designs are flexible and cost-effective and can be used for treatment development, translational research, personalized interventions, and the study of rare diseases and disorders. This article provides a broad overview of the family of single-case experimental designs with corresponding examples, including reversal designs, multiple baseline designs, combined multiple baseline/reversal designs, and integration of single-case designs to identify optimal treatments for individuals into larger randomized controlled trials (RCTs). Personalized N-of-1 trials can be considered a subcategory of SCEDs that overlaps with reversal designs. Relevant issues for each type of design-including comparisons of treatments, design issues such as randomization and blinding, standards for designs, and statistical approaches to complement visual inspection of single-case experimental designs-are also discussed.

A Scoping Review of the Healthcare and Hygiene Literature for Individuals with Intellectual and Developmental Disabilities

OBJECTIVES

Previous reviews highlight the similarities in teaching healthcare and hygiene routines to individuals with and without intellectual and developmental disabilities. Additionally, similar interventions are used when interfering behaviors occur. Although these routines are topographically distinct, there are enough similarities to suggest effective procedures for one routine may be used to inform another. This scooping review aims to identify effective teaching and intervention procedures for healthcare and hygiene routines specifically for individuals with intellectual and developmental disabilities. We also evaluated the extent to which functional analyses were conducted; a dimension not included in previous reviews.

METHODS

Eligible articles targeted compliance or tolerance within the context of a defined healthcare or hygiene routine as a dependent variable and used an experimental design with a demonstration of experimental control. Articles were identified through PsycINFO, PubMed, and Academic Search Premier databases. Additionally, a hand search of five related journals was conducted. Data were collected on dependent variables, functional analyses, baseline contingencies, teaching procedures, and additional experimental components.

RESULTS

A total of 52 articles met inclusion criteria. Most experiments produced positive outcomes. The findings show all experiments involved a treatment package with multiple components. The most common teaching procedures were graduated exposure and DRA. A lack of functional analyses and social validity was noted.

CONCLUSIONS

Component analyses are needed to identify the most effective and efficient procedures. Pyramidal training to teach medical professionals how to provide preventative pyramidal training should be explored.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s41252-022-00249-7.

A Systematic Review and Quantitative Analysis of Interteaching

Interteaching is a behavioral teaching method that departs from the traditional lecture format (Boyce & Hineline in BA 25:215-226, 2002). We updated and expanded previous interteaching reviews and conducted a meta-analysis on its effectiveness. Systematic searches identified 38 relevant studies spanning the years 2005-2018. The majority of these studies were conducted in undergraduate face-to-face courses. The most common independent variables were manipulations of the configuration of interteaching or comparisons to traditional-lecture format. The most common dependent variables were quiz or examination scores. Only 24% of all studies implemented at least five of the seven components of interteaching. Prep guides, discussions, record sheets, and frequent assessments were the most commonly implemented. Meta-analyses indicated that interteaching is more effective than traditional lecture or other control conditions, with an overall large effect size. Furthermore, variations in the configuration of the interteaching components do not seem to substantially limit its effectiveness, as long as the discussion component is included. Future research informed by the present review includes: (a) investigating the efficacy of interteaching in additional academic areas, online environments, workplace training, and continuing education, (b) testing alternative outcome measures, generalization, and procedural integrity, (c) conducting systematic component analyses, and (d) measuring social validity from the instructor's perspective.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10864-021-09452-3.

Decreasing nervous habits during public speaking: A component analysis of awareness training

Awareness training can produce decreases in nervous habits during public speaking. A systematic replication of Montes et al. (2020) was conducted to evaluate the independent and additive effects of awareness training components (i.e., response description, response detection) on speech disfluencies during public speaking. We extended prior research by evaluating response description alone, delivering the intervention virtually, using novel videos and speech topics during training, and measuring collateral effects on untargeted responses and speech rate. Response description was sufficient at reducing speech disfluencies for 4 of 9 participants. Response detection (video training) was necessary for 2 participants, and the subsequent addition of response detection (in-vivo training) was necessary for 3 participants. Reductions were maintained during follow-up and generalization probes for most participants. Collateral effects of awareness training components were idiosyncratic. A post-hoc analysis revealed that response description, when effective as a stand-alone intervention, may be more efficient than the full awareness training package.

Examination of the Effectiveness and Acceptability of a Play-Based Sibling Intervention for Children with Autism: A Single-Case Research Design

Complementary and reciprocal interactions are a defining feature of sibling relationships for young children. However, the social and communication difficulties of children with autism spectrum disorder (ASD) can make reciprocal play more difficult and play between siblings can be less rewarding. Sibling play can serve an important role in intervention and family cohesiveness, but there is no consistent method for involving siblings in intervention benefitting the sibling dyad. This study evaluated a novel treatment package including training siblings on play strategies to increase positive sibling play in combination with a sibling support group to offer social support for the neurotypical sibling (NT). The effects of the treatment package on NT sibling play and fidelity of implementation of naturalistic play strategies was examined using a concurrent multiple-baseline design across six dyads, five of whom completed the intervention. After behavior skills training, all NT siblings increased the number of strategies they used, and increased the frequency of initiations towards their sibling with ASD. In addition, the percentage of reciprocal play between siblings increased. Generalization probes and follow-up probes demonstrated above-baseline levels of performance across most dyads, indicating that the skills learned generalized across other toys and were maintained over time. Only three of the sibling support group sessions were completed due to the COVID-19 pandemic. Although the effectiveness of the sibling support group cannot be determined, social validity questionnaires suggest siblings and parents valued and liked the support group.

Supplementary Information

The online version contains supplementary material available at 10.1007/s43494-021-00043-5.

Behavior-Analytic Approaches to the Management of Diabetes Mellitus: Current Status and Future Directions

Diabetes mellitus is the seventh leading cause of death in the United States, requiring a series of complex behavior changes that must be sustained for a lifetime (e.g., counting carbohydrates, self-monitoring blood glucose, adjusting insulin). Although complex, all of these tasks involve behavior, making them amenable targets for behavior analysts. In this article, the authors describe interventions that have focused on antecedent, consequent, multicomponent, and alternate procedures for the management of diabetes, highlighting ways in which technology has been used to overcome common barriers to the use of these intensive, evidence-based interventions. Additional variables relevant to poorly managed diabetes (e.g., delay discounting) are also discussed. Future research and practice should focus on harnessing continued advances in information technology while also considering underexplored behavioral technologies for the effective treatment of diabetes, with a focus on identifying sustainable, long-term solutions for maintaining proper diabetes management. Practical implementation of these interventions will depend on having qualified behavior analysts working in integrated primary care settings where the interventions are most likely to be used, which will require interdisciplinary training and collaboration.

Identifying and measuring the common elements of naturalistic developmental behavioral interventions for autism spectrum disorder: Development of the NDBI-Fi

LAY ABSTRACT

Naturalistic developmental behavioral interventions for young children with autism spectrum disorder share key elements. However, the extent of similarity between programs within this class of evidence-based interventions is unknown. There is also currently no tool that can be used to measure the implementation of their common elements. This article presents a multi-stage process which began with defining all intervention elements of naturalistic developmental behavioral interventions. Next, intervention experts identified the common elements of naturalistic developmental behavioral interventions using a survey. An observational rating scheme of those common elements, the eight-item NDBI-Fi, was developed. We evaluated the quality of the NDBI-Fi using videos from completed trials of caregiver-implemented naturalistic developmental behavioral interventions. Results showed that the NDBI-Fi measure has promise; it was sensitive to change, related to other similar measures, and demonstrated adequate agreement between raters. This unique measure has the potential to advance intervention science in autism spectrum disorder by providing a tool to measure the implementation of common elements across naturalistic developmental behavioral intervention models. Given that naturalistic developmental behavioral interventions have numerous shared strategies, this may ease clinicians' uncertainty about choosing the "right" intervention package. It also suggests that there may not be a need for extensive training in more than one naturalistic developmental behavioral intervention. Future research should determine whether these common elements are part of other treatment approaches to better understand the quality of services children and families receive as part of usual care.

Using Principles from Applied Behaviour Analysis to Address an Undesired Behaviour: Functional Analysis and Treatment of Jumping Up in Companion Dogs

The aim of this study was to investigate the feasibility and effectiveness of procedures successfully used in human related applied behaviour analysis practices to the field of clinical animal behaviour. Experiment 1 involved functional analyses to identify the reinforcement contingencies maintaining jumping up behaviour in five dogs. Experiment 2 comprised teaching dog owners a noncontingent reinforcement intervention (i.e., time-based reinforcement) via behavioural skills training. Single-case experimental methods were implemented in both experiments. The results of Experiment 1 showed that access to a tangible (dogs D01, D02, D03, and D04) and owner attention (dog D05) were reliably maintaining the jumping up behaviour. Experiment 2 demonstrated that noncontingent reinforcement effectively reduced jumping in three out of four dogs (Tau -0.59, CI 90% [-1-0.15], p = 0.026, Tau -1, CI 90% [-1--0.55], p = 0.0003, and Tau -0.32, CI 90% [-0.76-0.11], p = 0.22 for dyads D01, D02, and D05, respectively), and that behavioural skills training was successful in teaching owners to perform a dog training intervention with high fidelity. Although the results are promising, more canine-related research into functional analysis and noncontingent reinforcement, as well as implementation of behavioural skills training with animal caregivers, is needed.

Enhancing the training integrity of human service staff using pyramidal behavioral skills training

This experiment used a pyramidal training model to evaluate the effects of behavioral skills training (BST), delivered in a 1-time group-training format, on the extent to which 25 human service staff implemented BST when training others how to implement behavioral procedures. Results indicated that (a) the training workshop increased BST integrity to mastery levels for the majority of participants with varying levels of education, organizational positions, and training experience, (b) the training effects generalized to teaching an untrained skill, and (c) high levels of BST integrity maintained at follow-up 4 to 6 weeks after training for all 3 participants with whom probes were conducted. Moreover, participants indicated high levels of satisfaction with both the training workshop and BST as a training procedure.

Comparison of components of the Good Behavior Game in a preschool classroom

The Good Behavior Game (GBG) is an effective intervention package for decreasing disruptive behavior in various populations and environments. There is, however, limited research evaluating the GBG with preschoolers. Furthermore, few studies have evaluated the effects of components of the GBG, and of those that have, most have done so only after exposure to the GBG package. We evaluated the effects (a) of the GBG on disruptive behavior of preschoolers during group instruction and (b) the major components of the GBG before and after implementation of the GBG package (c) at both the group and individual level. Results suggest that the GBG package was necessary for decreasing disruptive behavior. However, after exposure to the GBG, a response-independent contingency was effective for maintaining low levels of disruptive behavior at both the group and individual level.

Elements of Phonological Interventions for Children With Speech Sound Disorders: The Development of a Taxonomy

PURPOSE

Our aim was to develop a taxonomy of elements comprising phonological interventions for children with speech sound disorders.

METHOD

We conducted a content analysis of 15 empirically supported phonological interventions to identify and describe intervention elements. Measures of element concentration, flexibility, and distinctiveness were used to compare and contrast interventions.

RESULTS

Seventy-two intervention elements were identified using a content analysis of intervention descriptions then arranged to form the Phonological Intervention Taxonomy: a hierarchical framework comprising 4 domains, 15 categories, and 9 subcategories. Across interventions, mean element concentration (number of required or optional elements) was 45, with a range of 27 to 59 elements. Mean flexibility of interventions (percentage of elements considered optional out of all elements included in the intervention) was 44%, with a range of 29% to 62%. Distinctiveness of interventions (percentage of an intervention's rare elements and omitted common elements out of all elements included in the intervention [both optional and required]) ranged from 0% to 30%.

CONCLUSIONS

An understanding of the elements that comprise interventions and a taxonomy that describes their structural relationships can provide insight into similarities and differences between interventions, help in the identification of elements that drive treatment effects, and facilitate faithful implementation or intervention modification. Research is needed to distil active elements and identify strategies that best facilitate replication and implementation.

Advancing the science and practice of precision education to enhance student outcomes

School psychology research and practice has considerable room for growth to go beyond "did an intervention work?" to "what intervention worked for whom and how did it work?" The latter question reflects a more precise understanding of intervention, and involves strategic efforts to enhance the precision of services students with academic, behavioral, emotional, or physical health problems receive to enhance the degree to which interventions are appropriately tailored to and produce benefit for individual students. The purpose of this special issue is to advance the notion and science of precision education, which is defined as an approach to research and practice that is concerned with tailoring preventive and intervention practices to individuals based on the best available evidence. This introductory article provides context for the special issue by discussing reasons why precision education is needed, providing definitions/descriptions of precision education research, and outlining opportunities to advance the science of precision education. Six empirical studies and one methodological-oriented article were compiled to provide examples of the breadth of research that falls under precision education. Although each of the article focuses on students with different needs (literacy deficits, math deficits, emotional and behavior problems, and intellectual disability), there is a common thread that binds them together, and that is each one captures the heterogeneity among students with particular problems or deficits and highlights the need to select and deliver more precise interventions to optimize student outcomes.

The Use of Behavioral Skills Training to Teach Graph Analysis to Community Based Teachers

In this study, the experimenter trained three teachers to implement data decision rules to detect when instructional changes should be made during the visual analysis of discrete-trial percentage graphs. The experimenter used a concurrent, multiple-baseline design across participants. The experimenter trained the teachers to follow decision-making rules using instruction, modeling, rehearsal, and feedback. Following intervention, participants increased the percentage of correct data-based decisions and decreased the percentage of errors.

Interventions to Improve Hand Hygiene Compliance in the ICU: A Systematic Review

OBJECTIVES

To synthesize the literature describing interventions to improve hand hygiene in ICUs, to evaluate the quality of the extant research, and to outline the type, and efficacy, of interventions described.

DATA SOURCES

Systematic searches were conducted in November 2016 using five electronic databases: Medline, CINAHL, PsycInfo, Embase, and Web of Science. Additionally, the reference lists of included studies and existing review papers were screened.

STUDY SELECTION

English language, peer-reviewed studies that evaluated an intervention to improve hand hygiene in an adult ICU setting, and reported hand hygiene compliance rates collected via observation, were included.

DATA EXTRACTION

Data were extracted on the setting, participant characteristics, experimental design, hand hygiene measurement, intervention characteristics, and outcomes. Interventional components were categorized using the Behavior Change Wheel. Methodological quality was examined using the Downs and Black Checklist.

DATA SYNTHESIS

Thirty-eight studies were included. The methodological quality of studies was poor, with studies scoring a mean of 8.6 of 24 (SD= 2.7). Over 90% of studies implemented a bundled intervention. The most frequently employed interventional strategies were education (78.9%), enablement (71.1%), training (68.4%), environmental restructuring (65.8%), and persuasion (65.8%). Intervention outcomes were variable, with a mean relative percentage change of 94.7% (SD= 195.7; range, 4.3-1155.4%) from pre to post intervention.

CONCLUSIONS

This review demonstrates that best practice for improving hand hygiene in ICUs remains unestablished. Future research employing rigorous experimental designs, careful statistical analysis, and clearly described interventions is important.

Effects of a Least-to-Most Prompting Procedure on Multisymbol Message Production in Children With Autism Spectrum Disorder Who Use Augmentative and Alternative Communication

PURPOSE

In this study, we investigated the efficacy of a least-to-most (LTM) prompting procedure (Ault & Griffen, 2013; MacDuff, Krantz, & McClannahan, 2001; Neitzel & Wolery, 2009) for increasing use of multisymbol messages in school-age children with autism spectrum disorder (ASD) who use augmentative and alternative communication (AAC) during a storybook reading activity.

METHOD

In the study, we used a single-subject, multiple-probe research design across participants (Kazdin, 1982) with 6 children (ages 8-12) with ASD and who used AAC systems for communication. There were 4 phases in this investigation: (a) baseline, (b) intervention, (c) generalization, and (d) maintenance.

RESULTS

All participants exhibited a positive increase in multisymbol message production almost immediately upon introduction of the LTM prompting procedure.

CONCLUSIONS

The results of the investigation contribute important information on the efficacy of the LTM prompting procedure for teaching use of multisymbol messages to school-age children with ASD who use AAC.

Yoga Research and Public Health: Is Research Aligned With The Stakeholders' Needs?

Research on yoga is witnessing an unprecedented proliferation currently, partly because of great interest in yoga's health utility. However, yoga research does not seem to be sufficiently public health oriented, or its quality corresponding to its quantity. Yoga research is falling short to enable key stakeholders like end users, prescribers, and payers to meaningfully, confidently, and fruitfully answer the questions like: Is it generalizable? Is it standardizable? Which yoga style should be used/recommended/paid for? Or will it be worth the money? Therefore, it is important to examine the alignment to purpose or value of yoga research from a public health point of view so as to make it more practical. The issues such as lack of clear definition of yoga, wide variation in its dosage, cacophony of lineage-based styles, no data about comparative effectiveness between the yoga components, confounders and biases clouding the evidence regarding its benefits, too little data on long-term adherence, equivocal results about its cost effectiveness, discussions lacking embrace of better methods in research, and absence of a theory of yoga are examined. This is not a detailed discussion of every issue yoga research faces, but a high-level overview of those that have direct practical bearing. In the end, a few pragmatic approaches are offered. The article suggests that yoga-component analysis, development of a theory of yoga, adoption of a health-aligned functional typology of yoga, development and testing of a simple universal basic prototype of yoga intervention, emphasis on research about long-term adherence, and discouragement for mere proof of concept research might make yoga research serve the stakeholders better. It urges the research community to practice "context cognizant scholarship" to disentangle health compatible yoga from its historical-cultural-social body before examining it for health or medical application.

A component analysis of toilet-training procedures recommended for young children

We evaluated the combined and sequential effects of 3 toilet-training procedures recommended for use with young children: (a) underwear, (b) a dense sit schedule, and (c) differential reinforcement. A total of 20 children participated. Classroom teachers implemented a toilet-training package consisting of all 3 procedures with 6 children. Of the 6 children, 2 showed clear and immediate improvements in toileting performance, and 3 showed delayed improvements. Teachers implemented components of the training package sequentially with 12 children. At least 2 of the 4 children who experienced the underwear component after baseline improved. Toileting performance did not improve for any of the 8 children who were initially exposed to either the dense sit schedule or differential reinforcement. When initial training components were ineffective, teachers implemented additional components sequentially until toileting performance improved or all components were implemented. Toileting performance often improved when underwear or differential reinforcement was later added.

Advance Notice for Transition-Related Problem Behavior: Practice Guidelines

Transitions between daily activities can occasion or elicit problem behavior in individuals with intellectual and developmental disabilities (IDD). Providing advance notice to signal an upcoming transition is a common practice in early and special education settings (e.g., Riffel 2010; Sandall et al. 2005). While the literature contains many demonstrations of the efficacy of various advance notice procedures, other studies have shown negative results. Practitioners are faced with the challenge of deciding whether advance notice is a viable treatment option for transition-related problem behavior in light of these contradictory findings. To assist the practitioner in this decision-making process, we provide a brief review of the advance notice literature, concentrating on the studies reporting that advance notice is ineffective at reducing transition-related problems. The goal is to provide practitioners with a better understanding of the environmental conditions under which advance notice is likely to be ineffective at decreasing problem behavior as well as the conditions under which it can be effective at reducing transition-related problem behavior. Discriminating these conditions may yield a useful set of practice guidelines for deciding when advance notice is a viable treatment option for decreasing transition-related problem behavior.

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

Over the past 70 years, single-case design (SCD) research has evolved to include a broad array of methodological and analytic advances. In this article, we describe some of these advances and discuss how SCDs can be used to optimize behavioral health interventions. Specifically, we discuss how parametric analysis, component analysis, and systematic replications can be used to optimize interventions. We also describe how SCDs can address other features of optimization, which include establishing generality and enabling personalized behavioral medicine. Throughout, we highlight how SCDs can be used during both the development and dissemination stages of behavioral health interventions.

INTEGRATING TECHNOLOGICAL ADVANCEMENTS IN BEHAVIORAL INTERVENTIONS TO PROMOTE HEALTH: UNPRECEDENTED OPORTUNITIES FOR BEHAVIOR ANALYSTS

The use of mobile devices is growing worldwide in both industrialized and developing nations. Alongside the worldwide penetration of web-enabled devices, the leading causes of morbidity and mortality are increasingly modifiable lifestyle factors (e.g., improving one's diet and exercising more). Behavior analysts have the opportunity to promote health by combining effective behavioral methods with technological advancements. The objectives of this paper are (1) to highlight the public health gains that may be achieved by integrating technology with a behavior analytic approach to developing interventions, and (2) to review some of the currently, under-examined issues related to merging technology and behavior analysis (enhancing sustainability, obtaining frequent measures of behavior, conducting component analyses, evaluating cost-effectiveness, incorporating behavior analysis in the creation of consumer-based applications, and reducing health disparities). Thorough consideration of these issues may inspire the development, implementation, and dissemination of innovative, efficacious interventions that substantially improve global public health.

Single-case experimental designs to evaluate novel technology-based health interventions

Technology-based interventions to promote health are expanding rapidly. Assessing the preliminary efficacy of these interventions can be achieved by employing single-case experiments (sometimes referred to as n-of-1 studies). Although single-case experiments are often misunderstood, they offer excellent solutions to address the challenges associated with testing new technology-based interventions. This paper provides an introduction to single-case techniques and highlights advances in developing and evaluating single-case experiments, which help ensure that treatment outcomes are reliable, replicable, and generalizable. These advances include quality control standards, heuristics to guide visual analysis of time-series data, effect size calculations, and statistical analyses. They also include experimental designs to isolate the active elements in a treatment package and to assess the mechanisms of behavior change. The paper concludes with a discussion of issues related to the generality of findings derived from single-case research and how generality can be established through replication and through analysis of behavioral mechanisms.

Single-subject experimental design for evidence-based practice

PURPOSE

Single-subject experimental designs (SSEDs) represent an important tool in the development and implementation of evidence-based practice in communication sciences and disorders. The purpose of this article is to review the strategies and tactics of SSEDs and their application in speech-language pathology research.

METHOD

The authors discuss the requirements of each design, followed by advantages and disadvantages. The logic and methods for evaluating effects in SSED are reviewed as well as contemporary issues regarding data analysis with SSED data sets. Examples of challenges in executing SSEDs are included. Specific exemplars of how SSEDs have been used in speech-language pathology research are provided throughout.

CONCLUSION

SSED studies provide a flexible alternative to traditional group designs in the development and identification of evidence-based practice in the field of communication sciences and disorders.

Assessment and Treatment of Feeding-Related Problem Behaviors of a 16-Year-Old Girl With PDD-NOS

This case study describes the successful implementation of a behavioral intervention for the mealtime problem behaviors of a 16-year-old girl with Pervasive Developmental Disorder Not Otherwise Specified attending a private school for students with developmental disabilities. Initially, an analogue-functional analysis using a pairwise single-case experimental design was conducted, and based on the results of this assessment, a multicomponent function-based intervention was developed. The results obtained demonstrated that interventions for problem behaviors developed in hospital-based clinics can be implemented in community-based educational settings successfully. The results also demonstrated that behavioral intervention strategies shown to be effective with young children with developmental disabilities also work for a teenager with an autism spectrum disorder, illustrating the generality of a behavioral approach to feeding difficulties. Methodological limitations of the case study, advantages of a community-based treatment approach, and recommendations for clinicians are provided.