Types of ABA Study Designs

Table Of Content

• Multiple-Treatment Designs
• Alternating treatments design: one strategy for comparing the effects of two treatments in a single subject.
• What is the evidence that ABA works?
• Quantitative Techniques and Graphical Representations for Interpreting Results from Alternating Treatment Design
• The Role of SSEDs in Evidence-Based Practice

Steadily increasing trends were observed in both of the directed rehearsal conditions beginning in the fifth session, whereas responding remained at zero in the control condition. The rate of acquisition in the directed rehearsal plus positive reinforcement condition was higher than in directed rehearsal alone throughout the alternating treatments phase. The latency in correct responding observed during the initial sessions of the alternating treatments was a demonstration of noneffect. The fact that no change in responding was observed in the control condition, however, is evidence that the changes were due to the intervention rather than a result of some factor outside of the study. As further demonstration of the experimental effect of directed rehearsal plus reinforcement, a final condition was implemented in which the treatment package was used to teach the phrases from the other two conditions.

Multiple-Treatment Designs

A number of important studies dating back to the 1960s and 1970s investigated fluency treatments using SSED approaches (e.g., Hanson, 1978; Haroldson, Martin, & Starr, 1968; Martin & Siegel, 1966; Reed & Godden, 1977). Several reviews, tutorials, and textbooks describing and promoting the use of SSEDs in CSD were published subsequently in the 1980s and 1990s (e.g., Connell, & Thompson, 1986; Fukkink, 1996; Kearns, 1986; McReynolds & Kearns, 1983; McReynolds & Thompson, 1986; Robey, Schultz, Crawford, & Sinner, 1999). Despite their history of use within CSD, SSEDs are sometimes overlooked in contemporary discussions of evidence-based practice. This article provides a comprehensive overview of SSEDs specific to evidence-based practice issues in CSD that, in turn, could be used to inform disciplinary research as well as clinical practice.

Alternating treatments design: one strategy for comparing the effects of two treatments in a single subject.

With LTM prompting, often the least intrusive prompt was ineffective and a few prompts were delivered before the child responded correctly, leading to more time between the discriminative stimulus and correct response and reinforcement. If trials were terminated upon the delivery of an incorrect response at a given prompt level and followed by a new trial where a more or less intrusive prompt was delivered with 0 time delay, both MTL and LTM prompting would be equated in terms of reinforcement immediacy. This study identified effective prompt topographies during the prompt topography assessment and then compared prompt hierarchies using only effective prompt topographies. Under these conditions, all three preschool-aged children diagnosed with ASD mastered target responses with the MTL prompting hierarchy and did not master target responses with the LTM hierarchy, even with 20 % additional sessions. Among the Between-Groups Comparisons (see Appendix 5, Table S9), the ABA coding category was the most often improved, showing improvement over the comparison group at least 36% of the time across all outcomes. I-ABA showed improvement over the comparison 18%–30% of the time among cognitive, language, social/communication, adaptive behavior, and autism symptom outcomes.

What is the evidence that ABA works?

Nonparametric statistical tests for single-case systematic and randomized ABAB…AB and alternating treatment ... - ScienceDirect.com

Nonparametric statistical tests for single-case systematic and randomized ABAB…AB and alternating treatment ....

Posted: Wed, 27 Dec 2017 00:58:04 GMT [source]

Alternating Treatment Design in ABA is a therapy method that helps kids with special needs learn new skills. This helps parents and therapists determine the most effective methods for their child. All Medicaid plans must cover treatments that are medically necessary for children under the age of 21. If a doctor prescribes ABA and says it is medically necessary for your child, Medicaid must cover the cost. “Evidence based” means that ABA has passed scientific tests of its usefulness, quality, and effectiveness. All of these techniques focus on antecedents (what happens before a behavior occurs) and on consequences (what happens after the behavior).

Search

The change in reinforcers was applied to all prompting conditions at the same point in time for this participant. Research has demonstrated that most-to-least (MTL) and least-to-most (LTM) prompting are effective in helping children with Autism Spectrum Disorders acquire a variety of new skills. However, when directly compared to one another, the efficiency and efficacy of the prompting procedures have been variable. The inconsistencies in the literature could be due to selecting prompt topographies that do not promote correct responding. To address this, the present study began by assessing different prompt topographies and then compared most-to-least (MTL) and least-to-most (LTM) prompt-fading with only prompt topographies that were potent enough to promote correct responding.

Participants

The database searches yielded a total of 2,074 entries after import to Mendeley®, and 874 entries from selected reviews and secondary reviews. Ten systematic reviews were identified and investigated for the literature search (Brunner & Seung, 2009; Dawson & Bernier, 2013; Makrygianni et al., 2018; Mohammadzaheri et al., 2015; Reichow et al., 2014, 2018; Rodgers et al., 2020; Shabani & Lam, 2013; Spreckley & Boyd, 2009; Virués-Ortega, 2010). After pulling references from the first five (Brunner & Seung, 2009; Dawson & Bernier, 2013; Makrygianni et al., 2018; Rodgers et al., 2020; Shabani & Lam, 2013), it was found that the references in the remaining five reviews were duplicates of previously identified references. Records from Brunner and Seung (2009) that were categorized into treatment models that did not fulfill the definition of ABA as per the current review were not considered. In addition, the secondary review by Vismara and Rogers (2010) was not considered because it was a narrative review.

Purpose of Review

One commonly used alternative to the ATD is called the adapted alternating treatments design (AATD; Sindelar, Rosenburg, & Wilson, 1985). Whereas the traditional ATD assesses the effects of different interventions or independent variables on a single outcome variable, in the AATD, a different set of responses is assigned to each intervention or independent variable. The resulting design is similar to a multiple-baseline, across-behaviors design with concurrent training for all behaviors. For example, Conaghan, Singh, Moe, Landrum, and Ellis (1992) assigned a different set of 10 phrases to each of three conditions (directed rehearsal, directed rehearsal plus positive reinforcement, and control).

Quantitative Techniques and Graphical Representations for Interpreting Results from Alternating Treatment Design

One argument against the exclusive reliance on visual inspection is that it is prone to Type 1 errors (inferring an effect when there is none), particularly if the effects are small to medium (Franklin, Gorman, Beasley, & Allison, 1996; Todman & Dugard, 2001). Evidence for experimental control is not always as compelling from a visual analysis perspective. In many cases, the clinical significance of behavior change between conditions is less clear and, therefore, is open to interpretation. The logic of the ATD is similar to that of multiple-treatment designs, and the types of research questions that it can address are also comparable.

This occurs when the same participant receives two or more treatments whose effects may not be independent. As a result, it is possible that the order in which the interventions are given will affect the results. For example, the effects of two interventions may be additive, so that the effects of Intervention 2 are enhanced beyond what they should be because Intervention 2 followed Intervention 1. Alternatively, Intervention 1 may have measurable but delayed effects on the dependent variable, making it appear that Intervention 2 is effective when the results should be attributed to Intervention 1. Such possibilities should be considered when multi-treatment studies are being planned (see Hains & Baer, 1989, for a comprehensive discussion of multiple-treatment interference).

One of the tools used to help answer the question of “what works” that forms the basis for the evidence in evidence-based practice is meta-analysis—the quantitative synthesis of studies from which standardized and weighted effect sizes can be derived. Meta-analysis methodology provides an objective estimate of the magnitude of an intervention's effect. One of the main problems of SSEDs is that the evidence generated is not always included in meta-analyses. Alternatively, if studies based on SSEDs are used in meta-analysis, there is no agreement on the correct metric to estimate and quantify the effect size.

Sean did not master targets assigned to the LTM training procedure in 42 sessions, and his performance was between 30 and 50 % correct prior to terminating this prompt-fading procedure. During the prompt hierarchy comparison, Sean’s responding in the control condition was variable, with scores ranging from 0 to 50 % correct. As ever in the scientific process, interventions and treatments need consistent and replicative investigations under stringent protocols to ensure the continued efficacy and generalizability of a given intervention. Department of Health and Human Services (1999), ABA is the gold standard treatment for ASD, and is funded almost exclusively across North America.

The issues related to multiple-treatment interference are also relevant with the ATD because the dependent variable is exposed to each of the independent variables, thus making it impossible to disentangle their independent effects. To ensure that the selected treatment remains effective when implemented alone, a final phase demonstrating the effects of the best treatment is recommended (Holcombe & Wolery, 1994), as was done in the study by Conaghan et al., 1992. Many researchers pair an independent but salient stimulus with each treatment (i.e., room, color of clothing, etc.) to ensure that the participants are able to discriminate which intervention is in effect during each session (McGonigle, Rojahn, Dixon, & Strain, 1987). Nevertheless, outcome behaviors must be readily reversible if differentiation between conditions is to be demonstrated. During the initial four sessions of the alternating treatments phase, responding remained at zero for all three word sets.

Prior to coding, researchers categorized outcome measures, measurement scales or strategies, and intervention categories observed during the extraction process into tables in an effort to mitigate potential inconsistencies in coding. For example, in the Comparisons of ABA Techniques section, categories were broadly defined as Teaching, Stimulus Characteristics, Reinforcement, Subject/Setting Characteristics, and Comparisons of ABA Interventions. The learner receives an abundance of positive reinforcement for demonstrating useful skills and socially appropriate behaviors. Challenges regarding appropriate research methods to evaluate the effectiveness of individualised interventions contribute to disagreements about what counts as evidence.

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