1. Visually Interpreting Your Client’s Progress

2. Visual Analysis
Systematic process for interpreting results of single-case design data
Visual examination of graphed data within and between different conditions (e.g., baseline, intervention)
Allows you to analyze your client’s progress in real time and use this practice-based evidence to make the right decisions to help your clients in a dynamic process

3. Dimensions of Change Is change occurring?
Is change for the better or worse?
Is the pace of change sufficient?
Is the change large
enough—is it meaningful
and sufficient to the
client?

4. When Change is Off Track
Try a different intervention or modify the current intervention
Check the status of the “helping alliance,” “client motivation to change,” environmental and biological factors in the client’s life including social support, etc.
Extend the date for goal achievement

5. When Change is Off Track (cont’d)
Revise the goal or objective
Refocus your efforts on other problems
Collect more information
Return to the assessment/case conceptualization phase
Refer to another social worker or other professional

6. Figure 6.2.

7. Data Pattern
Particular arrangement of data in terms of in terms of level, trend, variability, cyclicity, overlap, immediacy, permanency, and practical significance

8. Within Phase Data Patterns
Level
Trend
Variability

9. Level
Value on the vertical axis around which a series of outcome data converge
Last two or three data points in a phase are especially important indicators of level if they are higher or lower than the overall level

10. Figure 6.3.

11. Median
Measure of central tendency which divides a distribution of values in half when the values are arranged in numerical order (or the average of the middle two values in a set with an even Number of values)

12. Trend
Overall direction of a data path within a phase or across phases of a single-system design line graph:
No trend
Negative trend (also referred to as a “descending” or “decelerating” trend because values are decreasing over time)
Positive trend (also referred to as an “ascending” or “accelerating” trend because values are increasing over time)

13. Figure 6.4.

14. Improving Trend
Overall direction of a data path within a phase is moving in the desired direction (e.g., descending if lower values of the outcome are desirable, and ascending if higher values of the outcome are desirable)

15. Deteriorating Trend
Overall direction of a data path within a phase is moving in an undesirable direction (e.g., descending if higher values of the outcome are desirable, and ascending if lower values of the outcome are desirable)

16. Slope
Typical amount of change in an outcome from day-to-day, week-to-week, or whatever unit is involved

17. Variability
Degree to which data points deviate from the overall trend

18. Figure 6.5.

19. Stable Baseline
Pattern of baseline data that exhibits relatively little variability over time and little or no trend

20. Variable Baseline
Pattern of baseline outcome data that do not fall within a relatively small range of values (i.e., they are variable)

21. Baselines Revisited
Period of time during which an outcome is measured repeatedly in the absence of an intervention
Confirm or disconfirm that the problem exists
Establish the extent of the problem
Develop and explore hypotheses useful for case conceptualization and intervention planning
Determine whether the problem is getting better or worse and the pace of change
Estimate what would happen to the client’s outcome without intervention

22. Figure 6.6.

23. Between Condition Data Patterns
Level
Trend
Variability
Immediacy of change
Overlap

24. Figure 6.7.

25. Figure 6.8.

26. Figure 6.9.

27. Figure 6.10.

28. Figure 6.11.

29. Figure 6.12.

30. Figure 6.13.

31. Figure 6.14.

32. Figure 6.15.

33. Figure 6.16.

34. Figure 6.17.

35. Figure 6.18.

36. Immediacy of Change
Amount of time it takes for a change in level, trend, or variability to occur after a condition change (e.g., baseline to intervention)

37. Figure 6.19.

38. Overlap
Degree to which data in adjacent phases share similar quantitative values—the more the overlap the less the difference between adjacent phases, and the less the overlap the greater the difference

39. Figure 6.20.

40. Figure 6.21.

41. Figure 6.22.

42. Change Without a Pre-Intervention Baseline
B-only design
Design consisting of an intervention phase (B) during which the outcome is measured repeatedly
B+ design
Design consisting of one pre-intervention outcome measurement followed by an intervention phase (B) during which the outcome is measured repeatedly

43. Figure 6.23.

44. Figure 6.24.

45. Figure 6.25.

46. Figure 6.26.

47. Number of Observations
More information—more accurate decisions
When in doubt, if practical and ethical, continue to collect information
More within-phase variability, more observations necessary
During intervention--enough observations to make sure problem is resolved sufficiently
After intervention—monitor outcome long enough to ensure that change is lasting

48. Number of Observations (cont’d)
Baseline
Enough to establish the presence and extent of the problem
Enough to identify environmental influences on the problem to use in case conceptualization and intervention planning
Unnecessary if outcome never occurs
Unethical with outcomes such as self-injurious behaviors

49. Potential Limitations of Visual Analysis
Under some circumstances different people, experts and novices alike, draw different conclusions from the same data
Decision errors possible

50. Decisions Regarding Change

51. Increasing the Validity of Decisions Regarding Change
Increase number of observations
Reduce within-phase variability
Measure outcomes accurately
Use intervention appropriate to the problem
Implement intervention with fidelity
Use intervention with larger effect