Single-Case Research: Documenting Evidence-based Practice Rob Horner University of Oregon

Main Message  For Applied Behavior Analysis to achieve wide spread adoption we need clear procedures by which single-case research can be used to document “evidence-based practices.”  Acknowledgements:  Dr. Edward Carr  Dr. James Halle  Dr. Gail McGee  Dr. Sam Odom  Dr. Mark Wolery “The use of single-subject research to identify evidence-based practices in special education” 2005 Exceptional Children, 71 (2)

The roles of Single-case research  Using Single-case research to examine behavioral principles  Using Single-case research to document effective interventions.  Using Single-case research to document evidence-based practices

A Challenge  Federal and state governments are being required/encouraged to allocate funding only for practices that are “evidence-based.”  The current standards for documenting a practice as “evidence-based”:  Are being managed by people who do not have experience with Single-case technology  Require use of a randomized control trials (RCT)

The Need  Build a set of unified, professional standards Clarity in defining a “practice” Criteria for documenting experimental control Criteria for designating a practice as “evidence- based” Meta-analysis technology  Collectively promote those standards

Clarity in defining a “Practice”  A “practice” is a procedure, or set of procedures, designed for use in a specific context, by individuals with certain skills/features, to produce specific outcomes for specific individuals.

Clarity in defining a “Practice”  Define a Practice by stipulating:  Procedures  Who uses the procedures  Contexts where procedures are appropriate  Population(s) for whom the procedures are intended  Specific outcomes expected

Clarity in defining a “Practice”  Issue  Size of practice (principle; single-component intervention; multi- component intervention)  ABA Practices (?):  Precision TeachingSelf-delivered reinforcement  Time OutPeer tutoring  Toilet trainingDiscrete Trial Training  Non-contingent reinfDirect Instruction  Positive reinforcementTime-Delay  Functional Communication Training  Acceptance and Commitment Therapy  Applied Behavior AnalysisPositive Behavior Support

Criteria for documenting experimental control within Single-case designs  To assess an “effect” between two phases compare:  Level, Trend, Variability, Overlap, Immediacy of effect, similarity of effect for similar phases.  -- Parsonson & Baer (1978)  To assess if “effects” constitutes experimental control  Three demonstrations of the effect at three points in time  Need for Training Materials  Wayne Fisher (Munroe-Meyer Institute) Fisher Model Examples Training Graphs

Criteria for Defining a “Practice” as Evidence-based  At least 5 peer-reviewed studies  Practice is defined  Fidelity is documented  Experimental control is documented  Replication of experimental control across at least three contexts/researchers  At least 20 participants documenting effect

Example of using Single-Case Research to document Evidence-based Practice  Functional Communication Training Procedure Functional behavioral assessment/ functional analysis Instruction on a functionally equivalent skill Used in schools/home/community Used by teachers, psychologists, interventionists Used with individuals with typical abilities to severe disabilities who engage in problem behavior Outcomes: Reduction in problem behavior and increase in use of functionally equivalent skill.

Example of using Single-Case Research to document Evidence-based Practice  Functional Communication Training At least Five Studies Bird, Dores, Moniz & Robinson (1989) Brown et al., (2000) Carr & Durand (1985) Durand & Carr (1987) Hagopian, Fisher, Sullivan, Acquisto & LeBlanc (1998) Mildon, Moore, & Dixon (2004) Wacker et al., (1990) At least three locations/scholars Six locations, Research Groups At least 20 participants 42 different participants document effect

Adequacy of Proposed Criteria  Identify a “practice” that you believe meets these criteria?  To what extent do these criteria meet the needs of the field?

Standards for Statistical Analysis  Analysis of Individual Studies  Time series models, HLM/SEM, non-parametric models  Statistical models exist for assessing if there is an effect between two phases  Current statistical models DO NOT account for whole design  Similarity of effect in similar phases  Three demonstrations of effect at three points in time  Meta-Analysis of Multiple Single-Case Studies  Documentation of effect size  HLM  Janet Marquis  Will Shadish  Tom Kratochwill

Summary  Single-case designs will not be used to document evidence- based practices unless Behavior Analysts propose a set of “accepted professional standards”  We need professional agreement  We need to promote the standards across non-ABA audiences  Federal agencies  Mental Health, Psychology, Education  Slides available at