Synthesizing single-case studies: A Monte Carlo examination of a three-level meta-analytic model

Numerous ways to meta-analyze single-case data have been proposed in the literature; however, consensus has not been reached on the most appropriate method. One method that has been proposed involves multilevel modeling. For this study, we used Monte Carlo methods to examine the appropriateness of Van den Noortgate and Onghena's (2008) raw-data multilevel modeling approach for the meta-analysis of single-case data. Specifically, we examined the fixed effects (e.g., the overall average treatment effect) and the variance components (e.g., the between-person within-study variance in the treatment effect) in a three-level multilevel model (repeated observations nested within individuals, nested within studies). More specifically, bias of the point estimates, confidence interval coverage rates, and interval widths were examined as a function of the number of primary studies per meta-analysis, the modal number of participants per primary study, the modal series length per primary study, the level of autocorrelation, and the variances of the error terms. The degree to which the findings of this study are supportive of using Van den Noortgate and Onghena's (2008) raw-data multilevel modeling approach to meta-analyzing single-case data depends on the particular parameter of interest. Estimates of the average treatment effect tended to be unbiased and produced confidence intervals that tended to overcover, but did come close to the nominal level as Level-3 sample size increased. Conversely, estimates of the variance in the treatment effect tended to be biased, and the confidence intervals for those estimates were inaccurate.     

Concurrent-chains schedules as a method to study choice between alcohol-associated conditioned reinforcers

An extensive body of research using concurrent-chains schedules of reinforcement has shown that choice for one of two differentially valued food-associated stimuli is dependent upon the overall temporal context in which those stimuli are embedded. The present experiments examined whether the concurrent chains procedure was useful for the study of behavior maintained by alcohol and alcohol-associated stimuli. In Experiment 1, rats responded on concurrent-chains schedules with equal variable-interval (VI) 10-s schedules in the initial links. Across conditions, fixed-interval schedules in the terminal links were varied to yield 1∶1, 9∶1, and 1∶9 ratios of alcohol delivery. Initial-link response rates reflected changes in terminal-link schedules, with greater relative responding in the rich terminal link. In Experiment 2, terminal-link schedules remained constant with a 9∶1 ratio of alcohol delivery rates while the length of two equal duration initial-link schedules was varied. Preference for the rich terminal link was less extreme when initial links were longer (i.e., the initial-link effect), as has been previously reported with food reinforcers. This result suggests that the conditioned reinforcing value of an alcohol-associated stimulus depends on the temporal context in which it is embedded. The concurrent-chains procedure and quantitative models of concurrent chains performance may provide a useful framework within which to study how contextual variables modulate preference for drug-associated conditioned reinforcers.     

Dissociating linguistic and non-linguistic gesture processing: electrophysiological evidence from American Sign Language

A fundamental advance in our understanding of human language would come from a detailed account of how non-linguistic and linguistic manual actions are differentiated in real time by language users. To explore this issue, we targeted the N400, an ERP component known to be sensitive to semantic context. Deaf signers saw 120 American Sign Language sentences, each consisting of a “frame” (a sentence without the last word; e.g. BOY SLEEP IN HIS) followed by a “last item” belonging to one of four categories: a high-close-probability sign (a “semantically reasonable” completion to the sentence; e.g. BED), a low-close-probability sign (a real sign that is nonetheless a “semantically odd” completion to the sentence; e.g. LEMON), a pseudo-sign (phonologically legal but non-lexical form), or a non-linguistic grooming gesture (e.g. the performer scratching her face). We found significant N400-like responses in the incongruent and pseudo-sign contexts, while the gestures elicited a large positivity.     

Deaf readers’ response to syntactic complexity: Evidence from self-paced reading

This study was designed to determine the feasibility of using self-paced reading methods to study deaf readers and to assess how deaf readers respond to two syntactic manipulations. Three groups of participants read the test sentences: deaf readers, hearing monolingual English readers, and hearing bilingual readers whose second language was English. In Experiment 1, the participants read sentences containing subject-relative or object-relative clauses. The test sentences contained semantic information that would influence online processing outcomes (Traxler, Morris, & Seely Journal of Memory and Language 47: 69–90, 2002; Traxler, Williams, Blozis, & Morris Journal of Memory and Language 53: 204–224, 2005). All of the participant groups had greater difficulty processing sentences containing object-relative clauses. This difficulty was reduced when helpful semantic cues were present. In Experiment 2, participants read active-voice and passive-voice sentences. The sentences were processed similarly by all three groups. Comprehension accuracy was higher in hearing readers than in deaf readers. Within deaf readers, native signers read the sentences faster and comprehended them to a higher degree than did nonnative signers. These results indicate that self-paced reading is a useful method for studying sentence interpretation among deaf readers.     

Resurgence is greater following a return to the training context than remaining in the extinction context

The present study examined whether resurgence of a previously reinforced target response upon removing alternative reinforcement would be greater when (1) returning to the original training context (ABA context changes) versus (2) remaining in the analogue treatment context in which the alternative response was differentially reinforced (ABB context changes). Experiment 1 arranged reinforcement of button pressing with points exchangeable for money in university students. Experiment 2 arranged reinforcement of lever pressing with food for rats. Experiment 3 arranged reinforcement of responses to a touchscreen with small bites of food with children diagnosed with ASD. Overall, resurgence of target responding tended to be greater when returning to the original training context (A) than when remaining in the analogue treatment context (B). These findings suggest context changes with differential reinforcement treatments could exacerbate the recurrence of problem behavior resulting from reductions in treatment integrity through failure to reinforce appropriate behavior.     

Facial gender confirmation surgery—review of the literature and recommendations for Version 8 of the WPATH Standards of Care

Facial gender confirmation surgery (FGCS), also popularly known and referred to in the scientific literature as facial feminization surgery (FFS), was previously treated as a collection of aesthetic procedures complementing other aspects of gender-confirming surgery. Recent literature on quality-of-life outcomes following FGCS has supported the substantial impact these procedures have on overall well-being and reduction of psychosocial sequelae in patients. The World Professional Association for Transgender Health Standards of Care, Version 7 (WPATH SOC 7), did not deem FGCS a medical necessity. Based on these new studies, increasing evidence points to the need to include FGCS among medically necessary gender-confirming surgeries, though more-prospective studies are needed. Updates to the WPATH SOC 8 are proposed based on available quality of life studies.     

Renewed behavior produced by context change and its implications for treatment maintenance: A review

Behavioral treatment gains established in one setting do not always maintain in other settings. The present review examines the relevance of basic and translational research to understanding failures to maintain treatment gains across settings. Specifically, studies of the renewal effect examine how transitioning away from a treatment setting could evoke a return of undesirable behavior, rather than newly trained appropriate behavior. Studies of renewal typically arrange three phases, with a response trained and reinforced under a particular set of contextual stimuli in the first phase. Next, that response is extinguished, often under a different set of contextual stimuli. Finally, that response returns despite extinction remaining in effect upon returning to the original training context or transitioning to a novel context. Thus, removing the extinction context is sufficient to produce a recurrence of the response. The findings suggest treatment effects can become specific to the context in which the treatment was delivered. This literature offers promising methods for systematically assessing the factors contributing to treatment maintenance and improving generalization of treatment gains across contexts. Therefore, the present review suggests basic and translational research on renewal provides an empirical literature to bring greater conceptual systematization to understanding generalization and maintenance of behavioral treatment.     

Estimating individual treatment effects from multiple-baseline data: A Monte Carlo study of multilevel-modeling approaches

While conducting intervention research, researchers and practitioners are often interested in how the intervention functions not only at the group level, but also at the individual level. One way to examine individual treatment effects is through multiple-baseline studies analyzed with multilevel modeling. This analysis allows for the construction of confidence intervals, which are strongly recommended in the reporting guidelines of the American Psychological Association. The purpose of this study was to examine the accuracy of confidence intervals of individual treatment effects obtained from multilevel modeling of multiple-baseline data. Monte Carlo methods were used to examine performance across conditions varying in the number of participants, the number of observations per participant, and the dependency of errors. The accuracy of the confidence intervals depended on the method used, with the greatest accuracy being obtained when multilevel modeling was coupled with the Kenward—Roger method of estimating degrees of freedom.     

Dissociation between linguistic and nonlinguistic gestural systems: a case for compositionality.

This paper addresses the issue of the separability of disorders of sign language from disorders of gesture and pantomime. The study of a left-lesioned deaf signer presents one of the most striking examples to date of the cleavage between linguistic signs and manual pantomime. The left-hemisphere lesion produced a marked sign language aphasia disrupting both the production and the comprehension of sign language. However, in sharp contrast to the breakdown of sign language, the ability to communicate in nonlinguistic gesture was remarkably spared. This case has important implications for our understanding of the neural mediation of language and gesture. We argue that the differences observed in the fractionation of linguistic versus nonlinguistic gesture reflect differing degrees of compositionality of systems underlying language and gesture. The compositionality hypothesis receives support for the existence of phonemic paraphasias in sign language production, illustrating structural dissolution which is absent in the production of pantomimic gesture. Understanding the neural encoding of compositional motoric systems may lead to a principled anatomical account of the neural separability of language and gesture. This case provides a powerful indication of the left hemisphere's specialization for language-specific functions.