|New Quantitative Approaches to the Synthesis of Evidence in Applied Behavior Analysis|
|Monday, May 30, 2016|
|10:00 AM–11:50 AM |
|Grand Ballroom CD South, Hyatt Regency, Gold East|
|Area: DDA/PRA; Domain: Translational|
|Chair: Sarah Leadley (The University of Auckland)|
|Discussant: Einar T. Ingvarsson (University of North Texas)|
|CE Instructor: Sarah Leadley, M.S.|
The synthesis of evidence is central to the translation of scientific knowledge into practice. Most clinical sciences use meta-analysis methodology to aggregate the evidence from multiple individual studies. Meta-analyses are often used as the final scientific product preceding the transfer of evidence to health and education decision-makers and to the wider public. The use of meta-analysis in behavior analysis has been hampered by (a) the multiple metrics used across studies, (b) the limited use of randomized and non-randomized controlled studies, (c) the absence of purposely-developed effect size estimators for single-subject experimental designs, and (d) the lack of quantitative approaches to appropriately evaluate the idiosyncrasies of individual studies and individual participants within studies. Analytical developments over the last few years have helped to overcome some of these limitations. Some of these developments are illustrated in the current series of review studies. K. Hurl's meta-analysis compares the relative effectiveness of interventions for problem behavior that were and were not preceded by a functional assessment. R. Anderson's study features a quantitative synthesis of behavioral interventions for severe feeding disorders. J. McCormack will present a meta-analysis of the differential outcome effects in clinical and non-clinical population. Finally, A. Arnold-Saritepe will present a review of evidence-based practices for severe behavior in individuals with developmental disabilities and autism.
|Keyword(s): feeding disorders, functional analysis, meta-analysis, review|
|The Differential Outcome Effect in Humans: A Quantitative Synthesis of Evidence|
|JESSICA CATHERINE MCCORMACK (The University of Auckland), Javier Virues-Ortega (The University of Auckland)|
|Abstract: In conditional discrimination learning, the differential outcome procedure can be used to enhance learning by providing reinforcement unique to each stimulus or response. The purpose of this study was to examine the effect of the differential outcomes procedure in humans. An electronic search of the literature recovered 33 papers comparing the differential outcomes procedure to a non-differential outcomes control, from which 23 were suitable for meta-analysis. Effect size estimators (Hedges g) were calculated for a total of six dependent variables: overall accuracy, test accuracy, transfer accuracy, latency, errors, and trials to mastery. A random-effects meta-analysis revealed significant medium-to-large effect sizes for all three accuracy measures, and a large effect of differential outcomes for clinical populations. Seven papers were analyzed as single-subject designs. They showed improved accuracy and sessions to mastery when aggregated, but individual results were variable. The results suggest that the differential outcomes procedure can be a useful addition to discrimination- and equivalence-based interventions, especially for individuals with cognitive impairments and intellectual disabilities.|
|A Meta-Analysis of Single-Subject Experiments of Function-Based and Non-Function-Based Interventions|
|KYLEE HURL (University of Manitoba), Javier Virues-Ortega (The University of Auckland), Jade Wightman (University of Manitoba), Stephen N. Haynes (University of Hawaii)|
|Abstract: This study examined the relative effectiveness of interventions based on a pre-intervention functional behavioral assessment (FBA), compared to common-practice interventions not based on a pre-intervention FBA. We examined 19 studies that included a direct comparison between the effects of FBA- and non-FBA-based interventions with the same participants. A random effects meta-analysis of effect sizes indicated that FBA-based interventions were associated with large reductions in problem behaviors when using non-FBA-based interventions as a reference intervention (Effect size = 0.85, 95% CI [0.42, 1.27], p < .001). In addition, non-FBA based interventions had no effect on problem behavior when compared to no intervention (0.06, 95% CI [-0.21, 0.33], p = .664). Interestingly, both FBA-based and non-FBA-based interventions had significant effects on appropriate behavior relative to no intervention, albeit the overall effect size was much larger for FBA-based interventions (FBA-based: 1.27, 95% CI [0.89, 1.66], p < .001 vs. non-FBA-based: 0.35, 95% CI [0.14, 0.56], p = .001). In spite of the evidence in favor of FBA-based interventions, the limited number of comparative studies with high methodological standards underlines the need for further comparisons of FBA-based versus non-FBA-based interventions.|
A Quantitative Synthesis of Interventions for Pediatric Feeding Disorders (Tube Dependency)
|Sarah Leadley (The University of Auckland), RACHEL ANDERSON (The University of Auckland), Javier Virues-Ortega (The University of Auckland)|
There is a growing interest in treatments to transition children from tube feeding (e.g., nasogastric or gastrostomy tubes) to oral feeding. A number of literature reviews identify applied behaviour analysis as having the strongest evidence for the treatment of pediatric feeding disorders. However, few studies have reviewed the nutritional outcomes for tube fed children. These outcomes include primarily the reduction or elimination of tube feeds and weight gain. In addition, the individual studies available do not allow a cogent comparison of behaviour-analytic intervention with other multidisciplinary treatment studies, such as tube weaning or hunger provocation programs. In the current investigation we conducted a meta-analysis of treatments for children dependent on tube feeding, combining datasets of different metrics (e.g., single-case and group designs). This presentation will cover our meta-analysis methods, results, and implications for future research and clinical practice.
Evidence-Based Practice for Severe Behavior in Individuals With Developmental Disabilities and Autism
|ANGELA ARNOLD-SARITEPE (The University of Auckland), Katrina J. Phillips (The University of Auckland), Javier Virues Ortega (The University of Auckland)|
Severe behavior presents a significant challenge for both the individual and caregiver in terms of quality of life. Challenging behavior is commonly reported in individuals with intellectual disabilities, 10-15 %, however for those with autism and / or profound intellectual disabilities the prevalence is much higher, 39-65%. At least 10% of individuals in the latter category have challenging behavior that would be considered to be severe. Adolescent and young adult males make up two-thirds of this group. While the progression of severe behavior disorders has not been well documented, it would appear that the overall prognosis for this group of individuals is not good, with potentially 80% continuing to engage in these behaviors 20 years later. Many of the studies published contain complex multi-component interventions that do not always report long term follow up or generalization data. This paper aims to review the behavioral literature for the intervention of the most severe challenging behavior (e.g., aggression, property destruction and self-injurious behavior) using Reichow, Volkmar and Cicchetti?s (2008) method for evaluating and determining evidence-based practice. It is hoped that this review will support researchers and clinicians in developing effective long lasting interventions that allow those with severe behaviors to live a less restricted life in the community.