Evidence-based practice (EBP) is a model of professional decision-making in which practitioners integrate the best available evidence with client values/context and clinical expertise in order to provide services for their clients. This framework provides behavior analysts with a structure for pervasive use of the best available evidence in the complex settings in which they work. This structure recognizes the need for clear and explicit understanding of the strength of evidence supporting intervention options, the important contextual factors including client values that contribute to decision making, and the key role of clinical expertise in the conceptualization, intervention, and evaluation of cases. Opening the discussion of EBP in this journal, Smith (The Behavior Analyst, 36, 7-33, 2013) raised several key issues related to EBP and applied behavior analysis (ABA). The purpose of this paper is to respond to Smith's arguments and extend the discussion of the relevant issues. Although we support many of Smith's (The Behavior Analyst, 36, 7-33, 2013) points, we contend that Smith's definition of EBP is significantly narrower than definitions that are used in professions with long histories of EBP and that this narrowness conflicts with the principles that drive applied behavior analytic practice. We offer a definition and framework for EBP that aligns with the foundations of ABA and is consistent with well-established definitions of EBP in medicine, psychology, and other professions. In addition to supporting the systematic use of research evidence in behavior analytic decision making, this definition can promote clear communication about treatment decisions across disciplines and with important outside institutions such as insurance companies and granting agencies.
Tier 2 interventions play an important role within the Positive Behavioral Interventions and Supports framework, bridging the gap between schoolwide Tier 1 interventions and individualized Tier 3 supports. Check-in Check-out (CICO) is a promising Tier 2 intervention for addressing mild problem behavior and potentially preventing the need for more intensive supports. In this systematic review, we synthesize the characteristics, methodological quality, and outcomes of 15 single-subject studies and one group design study examining CICO. The results suggest that CICO can be considered an evidence-based practice for students with problem behavior maintained by adult attention. Versions of CICO that were modified to address other functions (e.g., obtain peer attention, escape from tasks) demonstrated strong effects, but there were not a sufficient number of studies for modified CICO to qualify as an evidence-based practice. We discuss the implications of this review for practitioners as well as future research on CICO.
Researchers in applied behavior analysis and related fields such as special education and school psychology use single-case designs to evaluate causal relations between variables and to evaluate the effectiveness of interventions. Visual analysis is the primary method by which single-case research data are analyzed; however, research suggests that visual analysis may be unreliable. In the absence of specific guidelines to operationalize the process of visual analysis, it is likely to be influenced by idiosyncratic factors and individual variability. To address this gap, we developed systematic, responsive protocols for the visual analysis of A-B-A-B and multiple-baseline designs. The protocols guide the analyst through the process of visual analysis and synthesize responses into a numeric score. In this paper, we describe the content of the protocols, illustrate their application to 2 graphs, and describe a small-scale evaluation study. We also describe considerations and future directions for the development and evaluation of the protocols.
Previous research on visual analysis has reported low levels of interrater agreement. However, many of these studies have methodological limitations (e.g., use of AB designs, undefined judgment task) that may have negatively influenced agreement. Our primary purpose was to evaluate whether agreement would be higher than previously reported if we addressed these weaknesses. Our secondary purposes were to investigate agreement at the tier level (i.e., the AB comparison) and at the functional relation level in multiple baseline designs and to examine the relationship between raters' decisions at each of these levels. We asked experts (N = 52) to make judgments about changes in the dependent variable in individual tiers and about the presence of an overall functional relation in 31 multiple baseline graphs. Our results indicate that interrater agreement was just at or just below minimally adequate levels for both types of decisions and that agreement at the individual tier level often resulted in agreement about the overall functional relation. We report additional findings and discuss implications for practice and future research.
Repetitive behavior is a hallmark feature of autism spectrum disorders (ASD), and can have adverse consequences related to social stigma and low rates of skill acquisition. Basic research suggests that variability, or the extent to which one response differs from previous responses, is amenable to antecedent and consequence manipulations. This article describes the concept of variability, synthesizes the findings of 14 recent studies on interventions to increase the variability of behavior in individuals with ASD, and proposes preliminary guidelines for practitioners that focus on building response repertoires, implementing contingencies to produce and maintain variability, and incorporating prompts to vary responding.
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