Single-Case Research: Documenting Evidence-based Practice

1. Single-Case Research:Documenting Evidence-based Practice Rob Horner University of Oregon

2. Main Message • For Applied Behavior Analysis to achieve wide spread adoption we need clear procedures by which single-case research can be used to document “evidence-based practices.” • Acknowledgements: • Dr. Edward Carr • Dr. James Halle • Dr. Gail McGee • Dr. Sam Odom • Dr. Mark Wolery “The use of single-subject research to identify evidence-based practices in special education” 2005 Exceptional Children, 71 (2) 165-179

3. The roles of Single-case research • Using Single-case research to examine behavioral principles • Using Single-case research to document effective interventions. • Using Single-case research to document evidence-based practices

4. A Challenge • Federal and state governments are being required/encouraged to allocate funding only for practices that are “evidence-based.” • The current standards for documenting a practice as “evidence-based”: • Are being managed by people who do not have experience with Single-case technology • Require use of a randomized control trials (RCT)

5. The Need • Build a set of unified, professional standards • Clarity in defining a “practice” • Criteria for documenting experimental control • Criteria for designating a practice as “evidence-based” • Meta-analysis technology • Collectively promote those standards

6. Clarity in defining a “Practice” • A “practice” is a procedure, or set of procedures, designed for use in a specific context, by individuals with certain skills/features, to produce specific outcomes for specific individuals.

7. Clarity in defining a “Practice” • Define a Practice by stipulating: • Procedures • Who uses the procedures • Contexts where procedures are appropriate • Population(s) for whom the procedures are intended • Specific outcomes expected

8. Clarity in defining a “Practice” • Issue • Size of practice (principle; single-component intervention; multi-component intervention) • ABA Practices (?): • Precision Teaching Self-delivered reinforcement • Time Out Peer tutoring • Toilet training Discrete Trial Training • Non-contingent reinf Direct Instruction • Positive reinforcement Time-Delay • Functional Communication Training • Acceptance and Commitment Therapy • Applied Behavior Analysis Positive Behavior Support

9. Criteria for documenting experimental control within Single-case designs • To assess an “effect” between two phases compare: • Level, Trend, Variability, Overlap, Immediacy of effect, similarity of effect for similar phases. • -- Parsonson & Baer (1978) • To assess if “effects” constitutes experimental control • Three demonstrations of the effect at three points in time. ------------------------------------------------------------------- • Need for Training Materials • Wayne Fisher (Munroe-Meyer Institute) Model Examples Training Graphs Fisher

10. Criteria for Defining a “Practice” as Evidence-based • At least 5 peer-reviewed studies • Practice is defined • Fidelity is documented • Experimental control is documented • Replication of experimental control across at least three contexts/researchers • At least 20 participants documenting effect

11. Example of using Single-Case Research to document Evidence-based Practice • Functional Communication Training • Procedure • Functional behavioral assessment/ functional analysis • Instruction on a functionally equivalent skill • Used in schools/home/community • Used by teachers, psychologists, interventionists • Used with individuals with typical abilities to severe disabilities who engage in problem behavior • Outcomes: Reduction in problem behavior and increase in use of functionally equivalent skill.

12. Example of using Single-Case Research to document Evidence-based Practice • Functional Communication Training • At least Five Studies • Bird, Dores, Moniz & Robinson (1989) • Brown et al., (2000) • Carr & Durand (1985) • Durand & Carr (1987) • Hagopian, Fisher, Sullivan, Acquisto & LeBlanc (1998) • Mildon, Moore, & Dixon (2004) • Wacker et al., (1990) • At least three locations/scholars • Six locations, Research Groups • At least 20 participants • 42 different participants document effect

13. Adequacy of Proposed Criteria • Identify a “practice” that you believe meets these criteria? • To what extent do these criteria meet the needs of the field?

14. Standards for Statistical Analysis • Analysis of Individual Studies • Time series models, HLM/SEM, non-parametric models • Statistical models exist for assessing if there is an effect between two phases • Current statistical models DO NOT account for whole design • Similarity of effect in similar phases • Three demonstrations of effect at three points in time • Meta-Analysis of Multiple Single-Case Studies • Documentation of effect size • HLM • Janet Marquis • Will Shadish • Tom Kratochwill

15. Summary • Single-case designs will not be used to document evidence-based practices unless Behavior Analysts propose a set of “accepted professional standards” • We need professional agreement • We need to promote the standards across non-ABA audiences • Federal agencies • Mental Health, Psychology, Education • Slides available at www.pbis.org