Test 8 Flashcards
What are two major problems with group designs used to evaluate the effectiveness of treatments
- Inter-subject variability between groups
2. Group averages obscure individual differences
When do you use and ADT
When you want to look at the efficacy of two or more treatments. This strategy also provides good control for threats to internal validity.
- when treatments are sufficiently different from one another
- BL data unavailable or unstable
- you want to determine the relative effectiveness of more than one treatment on a behaviour
What is meant by rapid alternation
Rapid alternation does not necessarily mean changing quickly in a fixed period of time. Instead, typically in alternating treatment design, rapid alternation means each time the client is seen then that client receives an alternate treatment.
How do you connect the data point in an alternative treatment design
- connect all the data points in each treatment A, then same for treatment B
- If over time, the series of data points separate, one could say that one treatment is more effective.
How should treatments be presented
Treatments should be presented randomly to control for sequential confounding. You should not proceed in an A-B-A-B-A-B-A-B fashion, but rather randomize the order of introduction of the treatments.
What is a between series design
A between series design is another name for an alternating treatments design. It is called this because it involves comparing results between two separate series of data points.
-comparing results from two separate data points.
Same as ADT
What is a within series design
A within series design is another term used to describe an A-B-A withdrawal design. It is called this because you look at data within the same series of data points.
-ABA withdraw designs look at data within a series of same data points
What is a multiple schedule design
A multiple schedule design is having two or more schedules at the same time. This is used to compare schedules on a culmulative record and look at effects of two schedules.
Ex: FR 10 w/ FR 100
What is a randomization design
A randomization design emphasizes the randomness of the alternation as well as the number of alterations.
What is multiple treatment interference
Multiple treatment interference raises the issue of whether administering treatment B after A is the same as administering treatment B alone. This is an issue which involves one treatment interfering with another treatment so you don’t get a true picture of the effects of an individual treatment.
Does Treatment B when alternated with Treatment A have the same effect as B alone*
What is sequential confounding
equential confounding is also called order effects. This asks the question of if the results of treatment may have been different had the phase order differed. Would treatment B have the same results if it had preceded instead of followed treatment A?
Treatment B might be different if always follows A – randomization is that solution
What are carry over effects
influence of one treatment on an adjacent treatment irrespective of overall sequencing..
What are positive carry over effects
if treatment B was MORE effective because it was alternated with treatment A compared to being them only treatment administered.
What are negative carry over effects
if treatment B was LESS effective because it was alternated with treatment A compared to being them only treatment administered.
What are alternation effects
Alternation effects are a specific type of order effects/sequential confounding that occurs when alternating treatments.
How do you control for carry over effects.
- counterbalancing the order of treatments
- separating treatment sessions with a time interval and presenting only one treatment per session
- slower, more discriminable alternations should minimize carryover effects
How do discriminative stimuli impact carryover effects
The better the discriminative stimuli then the less carryover effects that will occur because the organism can differentially respond to the discriminative stimuli.
they quicker the participants discriminate the faster carry over effects reduce/eliminate
What is independent verification
Independent verification is a method of assessing the extent to which carryover effects are present. It entails conducting a controlled experiment in which one or another of the component treatments in the alternating treatments design is administered independently.
administer one of the component treatments independently – compare
What is functional manipulations
A functional manipulation is another method of assessing the extent to which carryover effects are present. In this procedure, the strength of one of the components is manipulated and the experimenter observes the effect, if any, on the alternate treatment in the subsequent phase.k
the strength of one of the components is altered, i.e. increase amount of time for flooding
what functions does counterbalancing play
Counterbalancing functions to decrease all factors extraneous to the treatment and their influence on the dependent variable. It is up to the clinical researcher to determine which factors to counterbalance. It is also important to counterbalance the setting and time of day during which the procedures are administered if these might have an influence on the dependent variable.
What is the minimum number of data points per treatment
When comparing 2 treatments, need minimum of 2 data points per treatment, more would be better
what is meant by semi random order
“Semi-random” order means being careful not to bunch too many administrations of the same treatment together in a row. Thus, you might consider using a “semi-random” order with an upper limit on the number of consecutive occurrences permitted, with this determination based on the total number of alternations available.
What are the advantages of the alternating treatment design
- that it does not require withdrawal of treatment and questions on relative effectiveness can be answered without a withdrawal phase at all
- it can supply useful data more quickly than a withdrawal design because there isn’t the relatively lengthy baseline, treatment, and withdrawal phases
- it is relatively insensitive to background trends in behaviors because one is comparing the results of two treatments or conditions in the context of whatever background trend is occurring
- it has an overall flexibility because there is freedom when to begin with active treatment, it is amenable to many design variations, and can test effectiveness of treatments on the behavior change of large groups
What is a simultaneous treatment design
A simultaneous treatment design is when there are two or more treatments actually available simultaneously. Since the treatments are presented simultaneously, what happens is that the subject “chooses” a preferred treatment or condition.
Disadvantages to ATD>
- *1.Multiple treatment interference
2. Unnatural nature of rapidly alternating treatments
3. Limited capacity
4. Selection of treatments
F Design
alternating treatments comparison of the two interventions in a multiple baseline design across subjects
F why
- both escape exit and physical guidance have to potential to produce maladaptive Bx, so which one produces the least
- So effectiveness and maladaptive Bx, and parent preference.
F participants
3 kids
-primary nutrition was milk and formula delivered via bottle/cup
2-3yrs old
F BL
started intervention following at least 4 BL with acceptance below 40%
F random?
Each treatment type was randomly selected to be conducted in one of the two treatment rooms.
-session type was quasi randomized (so they would receive each treatment condition across 2-3 days)
F criteria
after at least 9 sessions and acceptance had increased to at lest 80 for 3 consecutive sessions in one condition type.
- Then caregiver selected treatment.
- then 3 session withdrawal to BL
F data
trial by trial = % of target Bx observed
F DV
Acceptance Expulsion Neg vocalizations Disruptions Self injurious Bx
F acceptance
ind opening mouth 1.3cm or wider within 5s of spoon presentation
F expulsion
appearance of food past the outer edge of the lips following an accep- tance.
F Neg V
occurrence of crying, screaming, or whining louder than the child’s conversa- tional tone
F Dis
inter- ruption of the spoon presentation by the child
F SIB
hand-to-head or head-to-surface contact
F Reliability
- agree over total times 100
- calculated for 33% of meals
F other
- 2-5 meals every day
- weighed before and after meals
- recorded occurrence or non occurrence of target Bx
-each trial lasted 30s (some exceptions)
F procedure
- pref assessment done
- no acesso to food/liquid 1hr before and after session
- each meal 4 pureed foods, bite from each category offered
- random without replacement
- 20 spoons pres in each meal.
- amount increased for 2 participants in final phase. other increased when expulsions decreased
-trail began with verbal prompt and food pres to lower lip for 5s or until accepted.
F BL
Acceptance - social interaction and toy/activity for the remainder of the interval (30s or 15 if in last 10s)
Refusal - removal of speed and no access for the rest of the interval
Disruptive Bx - blocked
Expelled food - no replaced
other Bx - ignored
F non removal of the spoon
- procedure same as BL
- VP at start to stay in chair until food ate
- spoon remained at lip until allowed bite
Expelled - Tx caught and re present /or get new spoonful
When ate bite - social interaction and reward for the remainder (at least 15s)
F physical guidance
- same as BL
- Vp at start that Tx will help
- expelled food represented for 5s
- if not accepted Tx opened mouth and put in
- spoon in mouth with food - social and reward
F parent selection/withdrawal
- described each procedure to parents
- when kid exposed for at least 9 sessions with above 80%, caregivers shown graphs and videos
- allowed to ask Q
- asked which treatment they preferred for they kid
- all chose physical guidance
- next did withdrawal to BL then pref treatment reintroduced
- caregivers taught to do feeding before discharge
F follow up
weekly follow up sessions with caregivers for the first month
sub monthly
-follow up was watching meal
F Results
BL moderate-low acceptance
Treatment: increased acceptance, ex decreased fo 2 at start. Mean 2.3 across treatments
-Bx higher during initial treatment and non removal
F follow up
C: increase in Bx, medical intervention, Bx decreased
97% acceptance last 2 months of follow up
P:gradually increased , started to self feed, some problems near the end of meals
98%
D: No follow up data
F discussion
- Both worked, PG was quicker and have less neg Bx.
- easy to discriminate between treatments
F s/l
- multiple treatment interference (carryover effects, fail to return to BL levels )
- results maintained and increased consumption
- not age appropriate amounts
- didnt look at the effect of reinforcement alone
- ask parents pref
FA past
- many diff interventions, some work sone done. Adversice S always works
- so it is important to find a way to identify the limiting conditions of treatment before intervening.
- different treatment for different functions.
FA subjects
9 with dev delay
exhibited M-H rates of SIB
FA Human subjects protection
- in order to study the participant s had to be allowed to engage without restraint.
- each participant received medical exam (rule out organic factors)
- determined criteria for termination due to physical risk
- if interrupted SIB participant was removed from room and interrupted SIB
- 4th following session participants were examined by ire who noted changes in physical status.
- each case also reviewed weekly.
FA recording
continuous 10s intervals
-positive over total times 100
FA DV
% of intervals during which one or more self injurious responses were scored.
FA IOA
35 of sessions
agree/total time 100
96.8/82.8/91.7 for each subject
FA treatment conditions
8 sessions (2 per (condition) each day (morning/afternoon)
- order random
- each session 15m
- staff rotated, to control for experimenter specific effects
FA social disapproval
Exp entered together
- variety of toys on table/floor
- Ex told part to play with toys while they do some work
- then Ex looked busy with book
- attention given contingent on SIB (statements of concern/disapproval) paired with brief physical contact.
FA academic demand
- difficult academic tasks that subjects wouldn’t complete on their own
- Exp presented trials using graduated 3 prompt procedure
- verbal, 5s, model, 5s, physical - social praise when completed
- when SIB ended trial for 30s and change over delay for repeated
- designed to determine if SIB was maintained by escaping demands
FA unstructured play
Subject and Ex in room with toys (1m apart).
Allowed to play with or alone with toys
-no demands
-social praise when playing appropriately every 30s
SIB ignored
-this was the control/and enriched environment
FA alone
put in room alone without toys
- resemble impoverished environment
- want to look at if SIB is automatically maintained
FA Results
-varied widely across subjects (4.5-91.2%)
-considerable variability within subjects across experimental conditions
-within subject patterns did not appear to relate to overall level of SIB
PATTERNS:
low Sib during unstructured play
-greatest during alone
-some participants showed differentiation between conditions and one did not.
FA SIB in multiple conditions
- maybe didn’t discriminate
- multi functional
- need more specific conditions
FA limitations
- methodology didn’t control for very subtle aspects of contingencies that may affect behaviour (some overlap)
- incomplete analysis (reversal or comparison of another techniques)
- enviro didn’t imitate natural setting
FA strengths
medical eval throughout
