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Single-case designs: Methodology and data analysis

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1 Single-case designs: Methodology and data analysis
Analyses via web-based applications

2 Outline Visual analysis: 6 aspects & visual aids Mean difference:
Within-case standardized Log response ration Percentage change Slope and level change Mean phase difference

3 Outline Nonoverlap indices: Percentage of Nonoverlapping Data
Percentage of data points Exceeding the Median Nonoverlap of all pairs Improvement Rate Difference Tau: without and with trend correction Baseline corrected Tau: conditional PEM-Trend PNCorrectedD

4 Outline Regression analyses Ordinary least squares
Generalized least squares Piecewise regression

5 Outline Several comparisons Slope and level change
Mean phase difference Two-level models: (HLM / Multilevel / Mixed effects) Between-cases standardized mean difference Multiple-baseline design Reversal design

6 Outline Alternating treatments design Mean difference
Quantifications of variability NAP PND according to Wolery et al. (2010) ADISO ALIV

7 Outline: R-Cmdr plug-in
Randomization tests Using R, R-Commander, plug-ins AB design Multiple-baseline design Alternating treatments design

8

9

10 Example: Baldwin & Powell (2015)
Protocol design Multiple baseline across behaviors (not staggered) preferred over ABAB due to ethical reasons Baseline (A) compared with Google Calendar text alerts delivered to a mobile phone as a memory aid 1 patients with traumatic brain injury + severe problems in memory and executive functioning Outcome: number of events forgotten + a subjective measure (Everyday Memory Questionnaire) Original analysis: Nonoverlap of all pairs

11 Example: Baldwin & Powell (2015)

12

13 Web-based Visual aids: Loading & summarizing the data

14 Web-based Visual aids: WWC Standards

15 Web-based Visual aids: WWC Standards consistency

16 Web-based Visual aids: (Conservative) Dual Criterion

17 Web-based Visual aids: Trend stability envelope

18 Web-based Visual aids: Standard deviation bands

19 Web-based Visual aids: Split-middle trend & Md-envelope

20 Web-based Visual aids: Split-middle trend & IQR-interval

21

22 Web-based Within-case SMD (/SA)

23 Web-based Within-case SMD (/Spooled)

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25 Web-based Log response ratio

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27 Web-based Percentage change: Loading & summarizing the data

28 Web-based Percentage change: Percentage change index

29 Web-based Percentage change: Percentage zero data

30

31 Web-based Slope & Level Change

32 Web-based Slope & Level Change

33 Web-based Mean phase difference

34

35 Web-based Nonoverlap indices : Percentage of nonoverlapping data

36 Web-based Nonoverlap indices : Percentage of nonoverlapping data

37 Web-based Nonoverlap indices : % data points exceeding the Md

38 Web-based Nonoverlap indices : Nonoverlap of all pairs

39 Web-based Nonoverlap indices : Improvement rate difference

40

41 Web-based Nonoverlap indices : Tau without trend correction

42 Web-based Nonoverlap indices : Tau-U with trend correction

43 Web-based Nonoverlap indices : Baseline corrected Tau

44 Web-based Nonoverlap indices: Loading & summarizing the data

45 Web-based Nonoverlap indices: Baseline corrected Tau

46 Web-based Nonoverlap indices: % data points exceeding median trend

47 Web-based Nonoverlap indices: PNCorrectedD

48

49 Web-based Regression-based ES: Loading & summarizing the data
Web-based Regression-based ES: Loading & summarizing the data

50 Web-based Regression-based ES: Ordinary least squares
Web-based Regression-based ES: Ordinary least squares 𝑑= 𝛽 0𝐵 − 𝛽 0𝐴 + 𝛽 1𝐵 − 𝛽 1𝐴 2 𝑛 𝐴 + 𝑛 𝐵 +1 /2, 𝑛 𝐴 −1 𝑠 2 𝑒𝑟𝑟𝑜𝑟𝐴 + 𝑛 𝐵 −1 𝑠 2 𝑒𝑟𝑟𝑜𝑟𝐵 ( 𝑛 𝐴 + 𝑛 𝐵 −2)

51 Web-based Regression-based ES: Generalized least squares (“directly”)
Web-based Regression-based ES: Generalized least squares (“directly”) 𝑑= 𝛽 0𝐵 − 𝛽 0𝐴 + 𝛽 1𝐵 − 𝛽 1𝐴 2 𝑛 𝐴 + 𝑛 𝐵 +1 /2, 𝑛 𝐴 −1 𝑠 2 𝑒𝑟𝑟𝑜𝑟𝐴 + 𝑛 𝐵 −1 𝑠 2 𝑒𝑟𝑟𝑜𝑟𝐵 ( 𝑛 𝐴 + 𝑛 𝐵 −2)

52 Web-based Regression-based ES: Piecewise regression
Web-based Regression-based ES: Piecewise regression

53

54 Example: Baldwin & Powell (2014)

55 Web-based SLC & MPD for multiple baseline: Loading & summarizing the data

56 Web-based SLC for multiple baseline: Graphing the data
Web-based SLC for multiple baseline: Graphing the data

57 Web-based SLC for multiple baseline: Graphing the differences
Web-based SLC for multiple baseline: Graphing the differences

58 Web-based SLC for multiple baseline: Numerical results
Web-based SLC for multiple baseline: Numerical results

59 Web-based MPD for multiple baseline: Graphing the differences
Web-based MPD for multiple baseline: Graphing the differences

60 Web-based MPD for multiple baseline: Numerical results
Web-based MPD for multiple baseline: Numerical results

61

62 Web-based Two-level HLM: Loading & summarizing the data
Web-based Two-level HLM: Loading & summarizing the data

63 Web-based Two-level HLM: Graphical results
Web-based Two-level HLM: Graphical results

64 Web-based Two-level HLM: Numerical results
Web-based Two-level HLM: Numerical results

65

66 Web-based Between-cases SMD

67 Web-based Between-cases SMD

68 Web-based Between-cases SMD

69

70

71 Example: Coker et al. (2009) Protocol design ABAB design
Intervention: mCIMT (1 hour /day) Participant: One child aged 5 months in the beginning; 9 months at B1; 18 months at follow up Outcome mesures: video analysis of affected limb use for: Reaching an object Stabilizing weight Approaching midline

72 Example: Coker et al. (2009) What did the authors do?
Reported graphically observed affected limb use from videotapes. No visual aids provided. No statistics. Simple description of graphs in results section. Peabody developmental motor scale: percentile & age normative groups - comparison Is it appropriate? Yes, but insufficient. Only 2 A1 points, due to “no improvement” (ethics, clinical) Great variability in each phase Difficult to conclude whether intervention is effective

73 Example: Coker et al. (2009) What are we doing? Apply the d-statistic by Hedges, Pustejovsky, and Shadish (2012). Why? Obtain a summary quantification; SCED-specific; applicable to ABAB designs replicated across participants or behaviors; get an overall summary, given that visual inspection is unclear. What more can be done? Not much, too short baseline data. Maybe, nonoverlap indices.

74 Web-based Between-cases SMD
Web-based Between-cases SMD

75 Web-based Between-cases SMD

76 Web-based Between-cases SMD

77

78

79 Example: Kirsch et al. (2004)
Protocol design ABA desgin (Study 1); Alternating treatments design (Study 2) Intervention: Assistive technology for cognition Participants: Study 1: 19-year-old man, with topographical disorientation after traumatic brain injury (TBI). Study 2: 71-year-old woman with cognitive declines associated with TBI and a pre-injury history of chronic ischemic changes. Outcome mesures: recorded Navigation task: average number of errors per route (Study 1) Setting an alarm clock: Average number of errors per task substep (Study 2) Setting an alarm clock: number of substeps attempted (Study 2)

80 Example: Kirsch et al. (2004)
Specific characteristics of the Alternating treatments design Referred to as “modified ABAB” by Kirsch et al. (2004) «One or two trials were conducted each day, depending on the participant’s availability. However, time of day and order of conditions within and across days were counterbalanced.» Other possibilities for designs in which frequent alternation of conditions is possible: Completely randomized sequence of conditions (limiting nA=nB) Randomized block design: for each pair of measurement occasions, decide at random whether A or B is taking place «ATD»: random sequence of conditions with a restriction of a maximum of two consecutive administrations of the same conditions.

81 Web-based ATD data analysis: Basic quantifications

82 Web-based ATD data analysis: PND as a quantification of superiority

83 Web-based ATD data analysis: Regression analyses

84 Web-based ATD data analysis: Regression analyses

85 Web-based ATD data analysis: Regression analyses

86 Web-based ATD data analysis: Average DIfference between Successive Observations

87 Web-based ATD data analysis: Actual and Linearly Interpolated Values: Difference

88

89 References for the examples
Baldwin, V. N., & Powell, T. (2015): Google Calendar: A single case experimental design study of a man with severe memory problems. Neuropsychological Rehabilitation, 25, Coker, P., Lebkicher, C., Harris, L., & Snape, J. (2009). The effects of constraint-induced movement therapy for a child less than one year of age. NeuroRehabilitation, 24, 199–208. Kirsch, N. L., Shenton, M., Spirl, E., Rowan, J., Simpson, R., Schreckenghost, D., & LoPresti, E. F. (2004). Web-Based assistive technology interventions for cognitive impairments after traumatic brain injury: A selective review and two case studies. Rehabilitation Psychology, 49,

90 References for the analyses
Nonoverlap indices Parker, R. I., Vannest, K. J., & Davis, J. L. (2011). Effect size in single-case research: A review of nine nonoverlap techniques. Behavior Modification, 35, Tarlow, K. (2016, November 8). An improved rank correlation effect size statistic for single-case designs: Baseline corrected Tau. Behavior Modification. Advance online publication. doi: / Tarlow, K. R., & Penland, A. (2016, September 26). Outcome assessment and inference with the Percentage of Nonoverlapping Data (PND) single-case statistic. Practice Innovations. Advance online publication. doi: /pri Vannest, K. J., & Ninci, J. (2015). Evaluating intervention effects in single-case research designs. Journal of Counseling & Development, 93,

91 References for the analyses
Within-case standardized mean difference (SMD) Beretvas, S. N., & Chung, H. (2008). A review of meta-analyses of single-subject experimental designs: Methodological issues and practice. Evidence-Based Communication Assessment and Intervention, 2, Between-cases standardized mean difference (SMD) Shadish, W. R., Hedges, L. V., Horner, R. H., & Odom, S. L. (2015). The role of between-case effect size in conducting, interpreting, and summarizing single-case research (NCER ). Washington, DC: National Center for Education Research, Institute of Education Sciences, U.S. Department of Education. Retrieved on October 12, 2016 from Slope and level change (SLC) and Mean phase difference (MPD) Manolov, R., & Rochat, L. (2015). Further developments in summarising and meta-analysing single-case data: An illustration with neurobehavioural interventions in acquired brain injury. Neuropsychological Rehabilitation, 25,

92 References for the analyses
Alternating treatments designs Jacoby, W. G. (2000). Loess: A nonparametric, graphical tool for depicting relationships between variables. Electoral Studies, 19, 577–613. Manolov, R., & Onghena, P. (in press). Analyzing data from single-case alternating treatments designs. Psychological Methods. Moeyaert, M., Ugille, M., Ferron, J., Beretvas, S. N., & Van Den Noortgate, W. (2014). The influence of the design matrix on treatment effect estimates in the quantitative analyses of single-case experimental designs research. Behavior Modification, 38, 665–704. Solmi, F., Onghena, P., Salmaso, L., & Bulté, I. (2014). A permutation solution to test for treatment effects in alternation design single-case experiments. Communications in Statistics - Simulation and Computation, 43, 1094–1111. Wolery, M., Gast, D. L., & Hammond, D. (2010). Comparative intervention designs. In D. L. Gast (Ed.), Single subject research methodology in behavioral sciences (pp. 329–381). London, UK: Routledge.

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94

95 Example: Winkens et al. (2014)
Protocol design AB design. The moment of change in phase determined at random Baseline (A) compared with the ABC method: a simplified form of behavioural modification therapy especially designed for nursing staff (B) 1 patients with acquired brain injury: olivo-pontocerebellar ataxia Outcome: daily score on verbal aggressiveness (2x 0: not at all to 2x 4: continuous yelling, screaming, cursing, or threatening) Original analysis: Randomization test + NAP

96 Example: Winkens et al. (2014)

97 R-Commander data analysis: Websites

98 R-Commander data analysis: Installing the package once

99 R-Commander data analysis: Loading the package every time

100 R-Commander data analysis: Using the package for design

101 R-Commander data analysis: Using the package for design

102 R-Commander data analysis: Using the package for analysis

103 R-Commander data analysis: Using the package for analysis

104 R-Commander data analysis: Using the package for analysis

105 R-Commander data analysis: Using the package for analysis

106

107 Example: Fictitious

108 R-Commander data analysis: Using the package for analysis

109 R-Commander data analysis: Using the package for analysis

110 R-Commander data analysis: Using the package for analysis

111

112 Example: Sil et al. (2013)

113 Example: Sil et al. (2013) Protocol design
Several Alternating treatments designs with initial baseline. Alternation determined at random with a maximum of 2 consecutive per condition (restricted randomization; semi-random) Baseline (A) compared with passive distraction (B) and interactive distraction (C) 4-year-old girl receiving repeated burn dressing changes Outcome: child cooperation (to increase) and distress (to reduce) as reported by a parent and a nurse Original analysis: Randomization test

114 Example: Sil et al. (2013)

115 R-Commander data analysis: Using the package for analysis

116 R-Commander data analysis: Using the package for analysis

117 R-Commander data analysis: Using the package for analysis

118 R-Commander data analysis: Using the package for analysis

119 Additional references
Heyvaert, M., & Onghena, P. (2014). Analysis of single-case data: Randomisation tests for measures of effect size. Neuropsychological Rehabilitation, 24, Heyvaert, M., & Onghena, P. (2014). Randomization tests for single-case experiments: State of the art, state of the science, and state of the application. Journal of Contextual Behavioral Science, 3, 51–64. Levin, J. R., Ferron, J. M., & Gafurov, B. S. (2016, July 1). Comparison of randomization-test procedures for single-case multiple-baseline designs. Developmental Neurorehabilitation. Advance online publication. doi: / Sil, S., Dahlquist, L. M., & Burns, A. J. (2013). Case study: videogame distraction reduces behavioral distress in a preschool-aged child undergoing repeated burn dressing changes: A single-subject design. Journal of Pediatric Psychology, 38, 330–341. Winkens, I., Ponds, R., Pouwels-van den Nieuwenhof, C., Eilander, H., & van Heugten, C. (2014). Using single-case experimental design methodology to evaluate the effects of the ABC method for nursing staff on verbal aggressive behaviour after acquired brain injury. Neuropsychological Rehabilitation, 24,


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