Randomized controlled trial of an applied behavior analytic intervention for food selectivity in children with autism spectrum disorder

Food selectivity is a common problem for children with autism spectrum disorder (ASD; Schreck, Williams, & Smith, 2004). Behavior‐analytic interventions have the most empirical support for feeding disorders (Sharp, Jaquess, Morton, & Miles, 2011). However, there are no randomized controlled trials that have evaluated its effects with a well‐defined cohort of children with ASD. In the current investigation, we randomly assigned 6 young children with ASD and food selectivity to either an applied behavior analytic intervention or a wait‐list control. We used a crossover randomized controlled trial to evaluate the effects of a multicomponent applied behavior analytic intervention on independent acceptance and mouth clean of 16 novel foods. We subsequently exposed the wait‐list control group to the intervention. We also evaluated the effects of the intervention on individual participants with single‐case designs. The percentage of independent acceptance and mouth clean increased for the applied behavior analytic intervention group, but not for the wait‐list control group until we implemented the intervention.     

Choosing among techniques for quantifying single-case intervention effectiveness

If single-case experimental designs are to be used to establish guidelines for evidence-based interventions in clinical and educational settings, numerical values that reflect treatment effect sizes are required. The present study compares four recently developed procedures for quantifying the magnitude of intervention effect using data with known characteristics. Monte Carlo methods were used to generate AB designs data with potential confounding variables (serial dependence, linear and curvilinear trend, and heteroscedasticity between phases) and two types of treatment effect (level and slope change). The results suggest that data features are important for choosing the appropriate procedure and, thus, inspecting the graphed data visually is a necessary initial stage. In the presence of serial dependence or a change in data variability, the nonoverlap of all pairs (NAP) and the slope and level change (SLC) were the only techniques of the four examined that performed adequately. Introducing a data correction step in NAP renders it unaffected by linear trend, as is also the case for the percentage of nonoverlapping corrected data and SLC. The performance of these techniques indicates that professionals' judgments concerning treatment effectiveness can be readily complemented by both visual and statistical analyses. A flowchart to guide selection of techniques according to the data characteristics identified by visual inspection is provided.     

Conceptualizing changes in behavior in intervention research: the range of possible changes model

An international movement has focused on identifying evidence-based interventions that were developed to change psychological constructs and that are supported by controlled studies. However, inconsistent findings within individual intervention studies and among multiple studies raise critical problems in interpreting the evidence, and deciding when and whether an intervention is evidence-based. A theoretical and methodological framework (Range of Possible Changes [RPC] Model) is proposed to guide the study of change in intervention research. The authors recommend that future quantitative reviews of the research literature use the RPC Model to conceptualize, examine, and classify the available evidence for interventions. Future research should adopt the RPC Model to both develop theory-driven hypotheses and conduct examinations of the instances in which interventions may or may not change psychological constructs.     

Initial development and evaluation of the student intervention matching (SIM) form

There is currently a large gap in both research and practice between student identification practices for those at-risk (i.e., universal screening, teacher referral, or extant data as early identification methods) and the selection of appropriate Tier 2 interventions for social, emotional, and behavioral concerns. The purpose of this study was to develop and test the treatment validity of the Student Intervention Matching (SIM) Form, an intervention matching protocol designed for use at Tier 2. To this end, single-case design methodology was employed to systematically evaluate outcomes associated with use of the SIM Form in the intervention selection process. Participants included eight elementary-age students arranged in sets of four student dyads. A multiple baseline design was used in order to examine the relative effectiveness of matched interventions according to the SIM Form, and mismatched interventions according to the SIM Form. Results indicated that interventions matched using the SIM Form were functionally related to improved student outcomes across a variety of dependent variables when compared to mismatched phases. Implications for practice and future research are discussed.     

The Big Picture of Individual Differences in Physical Activity Behavior Change: A Transdisciplinary Approach

The goal of this research is to utilize a transdisciplinary framework to guide the selection of putative moderators of the effectiveness of an intervention to promote physical activity behavior adoption and maintenance in the context of a randomized controlled intervention trial. Effective interventions to increase physical activity are sorely needed, and one barrier to the identification and development of such interventions is the lack of research targeted at understanding both the mechanisms of intervention efficacy and for whom particular interventions are effective. The purpose of this paper is to outline our transdisciplinary approach to understanding individual differences in the effectiveness of a previously successful exercise promotion intervention. We explain the rationale for and operationalization of our framework, characteristics of the study to which we apply the framework, and planned analyses. By embracing a transdisciplinary orientation for individual differences important in the prediction of physical activity (spanning molecular approaches, animal models, human laboratory models, and social psychological models), we hope to have a better understanding of characteristics of individuals that are important in the adoption and maintenance of physical activity.     

Pro-criminal attitudes,intervention, and recidivism

We review the recent research literature on pro-criminal attitudes (PCAs) as a causal factor of recidivism with a focus on studies on the effectiveness of offender treatment programs targeting PCAs to prevent recidivism. The main conclusions that can be derived from the literature are: (1) the evidence supports the hypothesis that PCAs are related to reoffending; (2) most investigated offender treatment programs tend to reduce PCAs, although the general lack of adequate control group designs does not rule out alternative explanations for this reduction; and (3) there is no conclusive empirical evidence that intervention programs designed to reduce PCAs are effective in reducing recidivism. Empirical research in this area lacks the theoretical and methodological rigor to test causal models of the influence of treatment on reducing PCAs, and effects of PCAs on recidivism. Limitations of the empirical evidence are related to inadequate research designs and/or suboptimal data analysis strategies. Recommendations concerning optimized research designs and data analysis strategies that are likely to provide more conclusive evidence on the relation of PCAs, PCA treatment, and recidivism are given.     

The state of educational intervention research as viewed through the lens of literacy intervention

The characteristics of educational intervention research are reviewed: Educational intervention research is inspired by diverse theories, targeted at a variety of simple to very complex interventions, and includes a variety of methods and measurements. Some interventions have been studied much more than others, with the more studied ones often summarized in meta‐analyses and other integrative reviews. The study of some of the more complex interventions pose new ethical challenges. Although some intervention research impacts educational practice and policy, much more could and probably should.     

Reducing Escape without Escape Extinction: A Systematic Review and Meta-Analysis of Escape-Based Interventions

Individuals with disabilities may engage in challenging behavior to escape aversive stimuli, like academic tasks or non-preferred foods. Interventions to reduce these behaviors often employ escape extinction; that is, the implementer withholds escape following challenging behavior. Escape extinction can increase risk of injury, restrict autonomy, and worsen the learner–implementer relationship. To mitigate collateral effects, interventions can use strategies without escape extinction (i.e., escape-based); that is, implementers can provide escape contingent on challenging behavior during intervention, in conjunction with other intervention components. However, no comprehensive syntheses of these interventions have been conducted. We identified 39 articles that included escape-based interventions, which contained 273 single-case designs. Escape-based interventions were associated with lower levels of challenging behavior and higher levels of adaptive behavior than baseline conditions. Most comparisons between escape-based and escape extinction interventions showed no functional relation, indicating that escape extinction may not add substantial benefit to intervention efficacy.

     

助推手卫生的行为干预策略

保持手卫生是感染防控的重要策略, 但是如何提高其依从性成为预防传染性疾病和减少医疗机构获得性感染的一大挑战。以行为科学为基础的手卫生助推干预以更“隐性”的方式将洗手转变为一种可自动触发的行为习惯, 弥补了以知识分享和健康宣教为主的传统手卫生干预策略的诸多局限性。基于影响机制的不同, 手卫生助推干预策略可分为提供决策信息、优化决策选项、影响决策结构、提醒决策方向4个大类的框架体系。多模式助推策略的有效性也已在实践中得到印证, 但目前还非常缺乏在中国社会文化情境下开展的助推洗手行为的干预研究, 今后可尝试基于行为科学理论有针对性地在医院、学校和社区等公共场所开展此类干预研究和实践, 为感染防控、疾病预防和改善公共健康做出相应的贡献。     

From question-behaviour effects in trials to the social psychology of research participation

The ‘question-behaviour effect’ (QBE) has attracted much recent attention within health psychology, where it has also been referred to as the ‘mere measurement’ effect. There are other conceptualisations of similar phenomena in related disciplines. This paper explores the implications of the QBE for the safety of inferences about intervention effectiveness within the context of randomised controlled trials evaluating health behaviour change interventions. It draws attention to poorly understood mechanisms by which bias is introduced with conventional thinking about trial design and analysis. The threat to valid inference on intervention effectiveness posed by the QBE applies even when its effects are small and regardless of the specific content of the QBE. The nature of the resulting bias does not fit well within existing bias classification schemes, such as that proposed by the Cochrane Collaboration. The QBE is one possible consequence of research participation and it is suggested that the social psychology of research participation is very much underdeveloped. Possible future directions for health psychology research in this area are considered.     

A computer-based intervention to reduce internalized heterosexism in men

Internalized heterosexism (IH) is a strong predictor of the psychological well-being of lesbian, gay, bisexual (LGB), or other same-sex attracted individuals. To respond to the call for interventions to address IH, the current study developed and tested an online intervention to reduce IH among gay, bisexual, and other same-sex attracted men. A total of 367 self-identified same-sex attracted adult males were recruited through various nationwide LGB-related sources and were assigned by birth month to either the experimental condition (focusing on IH reduction) or the control condition (a similarly structured invention focusing on stress management); 290 of these participants completed the intervention and all post-intervention measures. Mean levels of IH were compared by condition, indicating significant differences on the IH global score and 2 of the 3 IH subscale scores between the participants in the 2 conditions. The study findings support the promise of using the Internet to deliver IH interventions. Implications for research and practice are discussed.     

Effect sizes in ANCOVA and difference-in-differences designs

It is common practice in both randomized and quasi-experiments to adjust for baseline characteristics when estimating the average effect of an intervention. The inclusion of a pre-test, for example, can reduce both the standard error of this estimate and—in non-randomized designs—its bias. At the same time, it is also standard to report the effect of an intervention in standardized effect size units, thereby making it comparable to other interventions and studies. Curiously, the estimation of this effect size, including covariate adjustment, has received little attention. In this article, we provide a framework for defining effect sizes in designs with a pre-test (e.g., difference-in-differences and analysis of covariance) and propose estimators of those effect sizes. The estimators and approximations to their sampling distributions are evaluated using a simulation study and then demonstrated using an example from published data.     

An analysis of the effectiveness of university counselling services

It is important to demonstrate replicable evidence of the effectiveness of counselling procedures. The study aimed to contribute to the currently limited evidence base examining the effectiveness of university student counselling in the UK. Information on therapeutic outcome [based on Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) scores] for 305 individuals attending a large UK university counselling service was analysed. Following counselling intervention: there was a statistically significant improvement in CORE-OM scores with 63% of individuals showing a reliable improvement and only 2% showing a reliable deterioration. Of those who began with a score in the clinical range, 49% showed a clinically significant change. These results provide additional evidence for the effectiveness of university counselling interventions. Future research should aim to build on this preliminary research using randomised controlled trial designs.     

助推戒烟的行为干预策略

烟草危害是人类所面临的重大公共健康挑战之一。传统的控烟策略主要依赖健康宣教、烟草税和控烟条例等手段,但是较少考虑到吸烟行为的“非理性因素”及其心理机制,因此仍不能有效帮助吸烟者成功戒烟。行为科学的发展为助推吸烟者成功戒烟提供了新视角。以实施主体和干预的影响机制为划分标准,可将助推戒烟的行为干预策略分为由政府和公共健康服务部门执行的情境型干预策略和认知型干预策略以及吸烟者可自主执行的情境型和认知型干预策略,一方面便于吸烟者和相关部门选取可执行的戒烟行为干预策略,另一方面为进一步开发和验证助推戒烟的行为干预策略提供参考。虽然基于行为科学的助推干预策略已经取得了一定的进展,未来研究仍有必要进一步在真实世界中验证和评估戒烟助推干预策略的效果。未来也有必要进一步将行为改变技术融入到数字化的戒烟服务或应用小程序中去以提升其效果。未来也需要考察如何应用戒烟助推干预策略防止电子烟产品的负面影响并减少这类策略的误用和滥用。     

Characteristics of single-case designs used to assess intervention effects in 2008

This article reports the results of a study that located, digitized, and coded all 809 single-case designs appearing in 113 studies in the year 2008 in 21 journals in a variety of fields in psychology and education. Coded variables included the specific kind of design, number of cases per study, number of outcomes, data points and phases per case, and autocorrelations for each case. Although studies of the effects of interventions are a minority in these journals, within that category, single-case designs are used more frequently than randomized or nonrandomized experiments. The modal study uses a multiple-baseline design with 20 data points for each of three or four cases, where the aim of the intervention is to increase the frequency of a desired behavior; but these characteristics vary widely over studies. The average autocorrelation is near to but significantly different from zero; but autocorrelations are significantly heterogeneous. The results have implications for the contributions of single-case designs to evidence-based practice and suggest a number of future research directions.     

The emerging relationship of psychology and the Internet: proposed guidelines for conducting Internet intervention research

The Internet is rapidly developing into an important medium of communication in modern society, and both psychological research and therapeutic interventions are being increasingly conducted using this new communication medium. As therapeutic interventions using the Internet are becoming more prevalent, it is becoming increasingly important to conduct research on psychotherapeutic Internet interventions to assist in the development of an appropriate standard of practice regarding interventions using this new medium. In this article, we examine the Internet and the current psychological uses which are being initiated using this medium. Ethical concerns related to the psychological use of the Internet are discussed, and guidelines are proposed for the conduct of Internet intervention research.     

Challenges of Evaluating Multilevel Interventions

This article uses the Comprehensive Mixed-Methods Participatory Evaluation (CMMPE; Nastasi and Hitchcock Transforming school mental health services: Population-based approaches to promoting the competency and wellness of children, Thousand Oaks, CA: Corwin Press with National Association of School Psychologists 2008; Nastasi et al. School-based mental health services: creating comprehensive and culturally specific programs. Washington, DC: American Psychological Association 2004) model as a framework for addressing the multiplicity of evaluation decisions and complex nature of questions related to program success in multilevel interventions. CMMPE defines program success in terms of acceptability, integrity, social or cultural validity, outcomes (impact), sustainability and institutionalization, thus broadening the traditional notions of program outcomes. The authors use CMMPE and an example of a community-based multilevel sexual risk prevention program with multiple outcomes to discuss challenges of evaluating multilevel interventions. The sexual risk program exemplifies what Schensul and Tricket (this issue) characterize as multilevel intervention–multilevel evaluation (M–M), with both intervention and evaluation at community, health practitioner, and patient levels. The illustration provides the context for considering several challenges related to M–M designs: feasibility of randomized controlled trials within community-based multilevel intervention; acceptability and social or cultural validity of evaluation procedures; implementer, recipient, and contextual variations in program success; interactions among levels of the intervention; unanticipated changes or conditions; multiple indicators of program success; engaging multiple stakeholders in a participatory process; and evaluating sustainability and institutionalization. The complexity of multilevel intervention and evaluation designs challenges traditional notions of evaluation research and experimental designs. Overcoming these challenges is critical to effective translation of research to practice in psychology and related disciplines.     

Impact of treatment integrity on intervention effectiveness

Treatment integrity has cogent implications for intervention effectiveness. Understanding these implications is an important, but often neglected, undertaking in behavior analysis. This paper reviews current research on treatment integrity in applied behavior analysis. Specifically, we review research evaluating the relation between integrity failures and the efficacy of behavioral interventions. Avenues for future research are provided.     

Comparison of mediational selected strategies and sequential designs for preventive trials: Comments on a proposal by pillow et al.

Summary Mediational selection designs can increase the chance of finding an intervention to be statistically better than a control when compared to interventions applied to a selected subpopulation such as all children of divorce. Selection based on poor mediational variable scores creates a high expectation that many subjects will benefit because it matches a population to a given intervention strategy. It does not permit examination of the impact on other subjects nor the possibility of interventions that may be tuned to the specific needs of different subpopulations. A sequence of trials each built on the results of previous ones has the potential for extending the results obtained from a mediational selection design.