Quantifying Intervention Intensity: A Systematic Approach to Evaluating Student Response to Increasing Intervention Frequency

Response to intervention (RTI) has been discussed as a new model of assessment. Although the basic process by which RTI works has received frequent attention in the literature, the available research leaves several important questions unanswered (Kavale et al. in Learn Disabil Q 28(1): 2–16, 2005). One concept within RTI that has received little empirical consideration is intervention intensity. The purpose of this study was to evaluate the impact of the application of increased intervention frequency on the mathematics performance of students and to evaluate this increased frequency as a systematic means of increasing and quantifying intervention strength. Results indicate that although all students were responsive to the intervention, some participants were sensitive only to more frequent application of the treatment or at more intense levels of treatment. Through this methodology a means of quantifying treatment intensity was also identified and implications for future research are discussed.     

A Gradual Effects Model for Single-Case Designs

Single-case designs are a class of repeated measures experiments used to evaluate the effects of interventions for small or specialized populations, such as individuals with low-incidence disabilities. There has been growing interest in systematic reviews and syntheses of evidence from single-case designs, but there remains a need to further develop appropriate statistical models and effect sizes for data from the designs. We propose a novel model for single-case data that exhibit nonlinear time trends created by an intervention that produces gradual effects, which build up and dissipate over time. The model expresses a structural relationship between a pattern of treatment assignment and an outcome variable, making it appropriate for both treatment reversal and multiple baseline designs. It is formulated as a generalized linear model so that it can be applied to outcomes measured as frequency counts or proportions, both of which are commonly used in single-case research, while providing readily interpretable effect size estimates such as log response ratios or log odds ratios. We demonstrate the gradual effects model by applying it to data from a single-case study and examine the performance of proposed estimation methods in a Monte Carlo simulation of frequency count data.     

Comparing the effectiveness of behavioral treatment for chemotherapy-induced nausea and vomiting when administered by oncologists, oncology nurses, and clinical psychologists.

Adequate control of side effects during medical treatment of cancer increases patient compliance and quality of life. Antiemetic drugs are not an effective treatment for the one in three cancer patients on chemotherapy who experience anticipatory nausea and vomiting (ANV); the behavioral treatment of systematic desensitization has been found effective for ANV when delivered by clinical psychologists. This study examined the effectiveness of systematic desensitization when delivered by medical personnel versus clinical psychologists. Seventy-two consecutive cancer patients with ANV were randomly assigned to no-treatment control or to systematic desensitization from 5 behaviorally trained clinical psychologists, 6 clinical oncologists, or 10 oncology nurses. The treatment was found effective in reducing anticipatory nausea, anticipatory vomiting, posttreatment nausea, and posttreatment vomiting compared to control patients, with no significant differences in effectiveness found between clinical psychologists and oncology staff. Although medical personnel should not engage patients in psychotherapy or other interventions that cannot be completed successfully, they can treat patients effectively with systematic desensitization and should be encouraged to learn and use this and other behavioral intervention techniques to benefit total patient care.     

Evaluating Assistive Technology in the Education of Persons with Severe Disabilities

This commentary includes a brief discussion of issues raised by the articles and systematic review contained in this special issue addressing technology applications for persons with severe developmental disabilities. Topical areas include a discussion of; (1) a need to compare “high tech” with “low tech” applications, (2) procedural fidelity, (3) collateral effects associated with intervention, (4) the conditional use of newly established behavior, (5) response efficiency and contextual fit, and (6) treatment intensity.     

Shock intensity and signaled avoidance responding

Five rats were submitted to a signaled free-operant avoidance contingency. Throughout the experiment, shock intensity was varied from 0.1 to 8.0 mA, with shock duration constant at 200 milleseconds. Results indicate: (a) an all-or-none effect of shock intensity on response and shock rates, on percentage of shocks avoided, and on frequency of occurrence of responding during the preshock stimulus; and (b) no systematic effect of shock intensity on stimulus control, measured either by the percentage of stimulus presentations accompanied by a response or by the percentage of responses that occurred during those preshock stimuli. Such results indicate that for each subject there is a minimum shock intensity necessary to establish and maintain avoidance responding; intensities higher than this minimum value have little or no effect on responding (with an upper limit for those strong intensities with a general disruptive effect on behavior).     

The Application of Latent Curve Analysis to Testing Developmental Theories in Intervention Research

The effectiveness of a prevention or intervention program has traditionally been assessed using time-specific comparisons of mean levels between the treatment and the control groups. However, many times the behavior targeted by the intervention is naturally developing over time, and the goal of the treatment is to alter this natural or normative developmental trajectory. Examining time-specific mean levels can be both limiting and potentially misleading when the behavior of interest is developing systematically over time. It is argued here that there are both theoretical and statistical advantages associated with recasting intervention treatment effects in terms of normative and altered developmental trajectories. The recently developed technique of latent curve (LC) analysis is reviewed and extended to a true experimental design setting in which subjects are randomly assigned to a treatment intervention or a control condition. LC models are applied to both artificially generated and real intervention data sets to evaluate the efficacy of an intervention program. Not only do the LC models provide a more comprehensive understanding of the treatment and control group developmental processes compared to more traditional fixed-effects models, but LC models have greater statistical power to detect a given treatment effect. Finally, the LC models are modified to allow for the computation of specific power estimates under a variety of conditions and assumptions that can provide much needed information for the planning and design of more powerful but cost-efficient intervention programs for the future.     

Prediction of treatment outcomes and longitudinal analysis in children with autism undergoing intensive behavioral intervention

Outcome prediction is an important component of treatment planning and prognosis. However, reliable predictors of intensive behavioral intervention (IBI) have not been clearly established. IBI is an evidence-based approach to the systematic teaching of academic, social, verbal, and daily living skills to individuals with autism spectrum disorder. Incorporating longitudinal analysis to IBI outcome studies may help to identify outcome predictors of clinical value. Twenty-four children with autism underwent on average two years of IBI and completed language, daily living skills, cognitive, and motor assessments (Early Learning Accomplishment Profile and the Learning Accomplishment Profile-Diagnostic, 3rd edition) every six months. We used multilevel analysis to identify potential longitudinal predictors including gender, age, intervention intensity, intervention duration, total intervention time, and pre-intervention functioning. Results indicated that total intervention time, pre-intervention functioning, and age caused the greatest increase in goodness-of-fit of the longitudinal multilevel models. Longitudinal analysis is a promising analytical strategy to identify reliable predictors of the clinical outcome of IBI.     

EXAMINING THE THEORY AND CLINICAL UTILITY OF WRITING ABOUT EMOTIONAL EXPERIENCES

Abstract— Pennebaker's (this issue) intervention for writing about emotional experiences shows promise as a module for inclusion in therapeutic packages. There are conceptual, methodological ant practical issues to be considered, however. These issues are discussed, and parallels are drawn from the literatures on the moodregulatory function of dreams and on the effects of social support on health. Although there is evidence that anything about emotional experiences has beneficial effects on health, it is premature to recommend writing intervention as a treatment component for specific problems. What is needed at this point is systematic research to evaluate to clinical utility.     

Callous-Unemotional Traits and the Treatment of Conduct Problems in Childhood and Adolescence: A Comprehensive Review

The treatment of conduct problems among children and adolescents with callous-unemotional (CU) traits has been subject to much speculation; however, treatment outcome research has been surprisingly limited and findings have been mixed. This review examines the research to date in this field as it pertains to two key questions. First, are CU traits associated with clinical outcomes and processes in the family based treatment of child and adolescent conduct problems? Second, can family based intervention produce change in CU traits? Using a systematic search strategy, we identified 16 treatment outcomes studies that can be brought to bear on these questions. These studies provide strong evidence of unique associations between CU traits and risk for poor treatment outcomes, while at the same time indicating that social-learning-based parent training is capable of producing lasting improvement in CU traits, particularly when delivered early in childhood. We discuss the potential for this emerging evidence base to inform the planning and delivery of treatments for clinic-referred children with CU traits, and detail an ongoing program of translational research into the development of novel interventions for this high-risk subgroup.     

不同强度短时有氧运动对执行功能的影响

探讨短时有氧运动对执行功能的影响是否与运动强度和性别有关, 为从运动强度和性别角度选择合理的有氧运动干预方案改善执行功能提供基础。研究采用混合设计, 选取30名大学生(男女人数各半), 使用功率自行车实施30分钟的不同强度有氧运动, 使用Flanker任务、2-back任务和数字More-odd shifting任务分别测查被试基线、小强度短时有氧运动、中强度短时有氧运动和大强度短时有氧运动后执行功能的抑制、刷新和转换三个子功能的变化, 结果表明：不同强度的短时有氧运动对执行功能产生选择性的积极影响, 且不随性别变化而改变。     

Glucocorticoid involvement in memory formation in a rat model for traumatic memory

Contextual fear conditioning under training conditions involving high stressor intensities has been proposed as an animal model for traumatic memories. The strength of memory for this task has been related to the intensity of the conditioning stressor and post-training corticosterone values. However, administration of a glucocorticoid receptor (GR) antagonist only attenuated memory for this task in rats conditioned at a moderate shock intensity (0.4 mA), but failed to influence conditioning in rats trained at a high shock intensity (1 mA). Here, we further questioned whether interfering with glucocorticoid action at the time of training might be effective in influencing contextual fear conditioning in rats trained under different shock intensities. Rats were subcutaneously injected with the glucocorticoid synthesis inhibitor metyrapone (50, 100 mg/kg) 90 min before being trained in the contextual fear conditioning task, at either 0.4 or 1 mA shock intensities. The results showed that metyrapone, in a dose-dependent manner: (i) attenuated long-term expression of contextual fear conditioning, both in 0.4- and 1 mA-trained rats; and (ii) efficiently prevented increased plasma corticosterone concentration. In addition to further supporting a facilitating role of glucocorticoids in memory consolidation, these findings suggest a critical involvement of these hormones in the formation of traumatic memories.     

Extraordinary claims in the literature on high-intensity interval training (HIIT): IV. Is HIIT associated with higher long-term exercise adherence?

Nonadherence to and dropout from regular exercise and physical activity are important reasons why the field of exercise science has yet to fulfill its promise of improving public health on a global scale. Researchers have claimed that High-Intensity Interval Training (HIIT) is a feasible and sustainable exercise modality that may result in higher long-term adherence than moderate-intensity continuous exercise. If true, this would be a breakthrough discovery that could unlock the potential of exercise as a health-promoting intervention. We performed a systematic search of the literature and identified eight trials comparing HIIT to moderate-intensity continuous exercise, all of which involved follow-up periods of at least 12 months (i.e., SWIFT, Small Steps for Big Changes, SAINTEX-CAD, SMARTEX-HF, Generation 100, FITR, OptimEx-Clin, HITTS). Findings from these trials demonstrate that, while unsupervised, individuals initially assigned to HIIT tend to exercise at lower-than-prescribed intensities and HIIT groups demonstrate no advantage in long-term adherence.     

Experimental results of affective valence and arousal to avatar's facial expressions.

The objectives of this study were to propose a method of presenting dynamic facial expressions to experimental subjects, in order to investigate human perception of avatar's facial expressions of different levels of emotional intensity. The investigation concerned how perception varies according to the strength of facial expression, as well as according to an avatar's gender. To accomplish these goals, we generated a male and a female virtual avatar with five levels of intensity of happiness and anger using a morphing technique. We then recruited 16 normal healthy subjects and measured each subject's emotional reaction by scoring affective arousal and valence after showing them the avatar's face. Through this study, we were able to investigate human perceptual characteristics evoked by male and female avatars' graduated facial expressions of happiness and anger. In addition, we were able to identify that a virtual avatar's facial expression could affect human emotion in different ways according to the avatar's gender and the intensity of its facial expressions. However, we could also see that virtual faces have some limitations because they are not real, so subjects recognized the expressions well, but were not influenced to the same extent. Although a virtual avatar has some limitations in conveying its emotion using facial expressions, this study is significant in that it shows that a new potential exists to use or manipulate emotional intensity by controlling a virtual avatar's facial expression linearly using a morphing technique. Therefore, it is predicted that this technique may be used for assessing emotional characteristics of humans, and may be of particular benefit for work with people with emotional disorders through a presentation of dynamic expression of various emotional intensities.     

Taking a bright view of negative priming in the light of dim stimuli: further evidence for memory confusion during episodic retrieval.

A same-different letter-matching task was used to examine the effects of stimulus intensity on negative priming, which is poorer performance when target letters have been presented as distractor letters on the immediately preceding trial. In Experiment 1, stimulus intensity was manipulated between-participants, whereas in Experiment 2, it varied randomly from trial-to-trial within-participants. In Experiment 1, negative priming was equivalent for both stimulus intensities. In Experiment 2, negative priming effects were larger for repeated intensity stimuli than for nonrepeated intensity stimuli, when stimulus intensity was dim. Furthermore, for repeated intensity stimuli, negative priming effects were enhanced when the overt response required to the stimulus was repeated from prime to probe trial. These results are consistent with the hypothesis that negative priming may be due to memory confusion, rather than to inhibition of the distractor stimuli.     

High-intensity sound increases the size of visually perceived objects

The effect of audiovisual interactions on size perception has yet to be examined, despite its fundamental importance in daily life. Previous studies have reported that object length can be estimated solely on the basis of the sounds produced when an object is dropped. Moreover, it has been shown that people typically and easily perceive the correspondence between object sizes and sound intensities. It is therefore possible that auditory stimuli may act as cues for object size, thereby altering the visual perception of size. Thus, in the present study we examined the effects of auditory stimuli on the visual perception of size. Specifically, we investigated the effects of the sound intensity of auditory stimuli, the temporal window of audiovisual interactions, and the effects of the retinal eccentricity of visual stimuli. The results indicated that high-intensity auditory stimuli increased visually perceived object size, and that this effect was especially strong in the peripheral visual field. Additional consideration indicated that this effect on the visual perception of size is induced when the cue reliability is relatively higher for the auditory than for the visual stimuli. In addition, we further suggest that the cue reliabilities of visual and auditory stimuli relate to retinal eccentricity and sound intensity, respectively.     

The effects of Brazelton intervention: A review

This article reviews research that has used the Brazelton Neonatal Behavioral Assessment Scale (NBAS; Brazelton, 1984) as an intervention. It discusses separately the various effects NBAS intervention has been found to have in areas such as parent-infant interaction, infant development, temperament, and parental attitudes and satisfaction. Inconsistent findings are noted in each of these areas. This article then addresses issues that may play a role in the effectiveness of NBAS intervention, including the risk status of the population, the intensity of the intervention, and the receptivity of the parent. It concludes by suggesting that realistic goals be set concerning the expectations for early, short-term intervention such as the NBAS.     

Reformed and evolutionary epistemology and the noetic effects of sin

Despite their divergent metaphysical assumptions, Reformed and evolutionary epistemologists have converged on the notion of proper basicality. Where Reformed epistemologists appeal to God, who has designed the mind in such a way that it successfully aims at the truth, evolutionary epistemologists appeal to natural selection as a mechanism that favors truth-preserving cognitive capacities. This paper investigates whether Reformed and evolutionary epistemological accounts of theistic belief are compatible. We will argue that their chief incompatibility lies in the noetic effects of sin and what may be termed the noetic effects of evolution, systematic tendencies wherein human cognitive faculties go awry. We propose a reconceptualization of the noetic effects of sin to mitigate this tension.     

The effect of color intensity and appropriateness on color-induced odor enhancement

Coloring solutions has been shown to increase perceived odor intensity. In Experiment 1, subjects rated the odor intensity of red strawberry and green mint solutions that had four levels of color intensity. Ratings of strawberry odor peaked at the medium color intensity and ratings of mint odor increased monotonically with color intensity. Thus, color-induced odor enhancement can increase with increasing color intensity but need not. Experiment 2 found that the color intensities producing maximum odor enhancement in Experiment 1 are not always the ones perceived as most appropriate for the odorants. Using different odors, Experiment 3 found that color intensity has some influence on the strength of the color-induced odor enhancement and color appropriateness has little. The presence or absence of color in the solution seems to be the most important variable.     

Stimulus-response compatibility in intensity-force relations.

Romaiguère, Hasbroucq, Possama?, and Seal (1993) reported a new compatibility effect from a task that required responses of two different target force levels to stimuli of two different intensities. Reaction times were shorter when high and low stimulus intensities were mapped to strong and weak force presses respectively than when this mapping was reversed. We conducted six experiments to refine the interpretation of this effect. Experiments 1 to 4 demonstrated that the compatibility effect is clearly larger for auditory than for visual stimuli. Experiments 5 and 6 generalized this finding to a task where stimulus intensity was irrelevant. This modality difference refines Romaiguère et al.'s (1993) symbolic coding interpretation by showing that modality-specific codes underlie the intensity-force compatibility effect. Possible accounts in terms of differences in the representational mode and action effects are discussed.     

Transferring cues for cooperation: Helping students follow group instructions

In this study, we piloted a teaching procedure to help a learner attend to group pronouns (calls), such as “Everyone,” as precursors for cooperating with instructions. A student was first taught to attend to the teacher when a bell rang; the teacher then paired the bell with group call words and faded the bell out to transfer stimulus control to the calls. This antecedent intervention led to increased attending to group calls and cooperation with the instructions. We used a hybrid design of alternating treatments and multiple baselines to evaluate the effects of the intervention. We briefly assessed maintenance after the systematic fading of the intervention and again after 2 weeks. The results suggest that attending occurred through listener responding rather than through the traditional measures of eye gaze and orienting. We explore the effects in terms of stimulus control, behavioral classes, component skills, chaining, and high‐p and low‐p effects.