EBP THERAPY ANALYSIS for
Single Subject Designs
Note: The summary of the intervention procedure(s) can be viewed by scrolling about two-thirds of the way down on this page.
ASD = autism spectrum disorders
C = Clinician
CA = chronological age
CARS = Childhood Autism Rating Scale
EBP = evidence-based practice
MA = mental age
MTS = matching to sample
NA = not applicable
P = Patient or Participant
pmh = Patricia Hargrove, blog developer
SLP = speech–language pathologist
SOURCE: Matsuda, S., & Yamamoto, J. (2013). Intervention for increasing comprehension of affective prosody in children with autism spectrum disorders. Research in Autism Spectrum Disorders, 7, 938-946.
DATE: January 26, 2015
ASSIGNED OVERALL GRADE: B (The highest possible grade was A-.)
TAKE AWAY: The investigators used 4 single-subject experimental design (multiple baseline across participants) studies to explore the effectiveness of a cross-modal matching to sample (MTS) intervention designed to improve the comprehension of affective prosody of Japanese children diagnosed with autism spectrum disorders (ASD.) The results indicate that the children improved their rate of correct responses to an adult’s direction to indicate which picture represented a targeted emotion produced using a single word.
- What was the focus of the research? Clinical Research
- What type of evidence was identified?
- What type of single subject design was used? Single Subject Experimental Design with Specific Clients – Multiple Baseline—across participants
- What was the level of support associated with the type of evidence? Level = A-
- Was phase of treatment concealed?
- from participants? No
- from clinicians? No
- from data analyzers? No
- Were the participants adequately described? Yes
– How many participants were involved in the study? 4
– The following characteristics/variables were described:
- age: 3 to 7 years (mean = 5 years, 6 months)
- gender: all male
- cognitive skills: on the Kyoto Scale of Psychological Development
– Ken (Chronological Age, CA, = 4-10) Mental Age (MA) = 2-11
– Taro (CA = 7-0) MA = 6-7
– Jiro (CA = 7-3) MA = 6-8
– Kazu (CA 3-7) MA = 2-11
- level of severity of autism: on the Childhood Autism Rating Scale (CARS)
– Ken: severe
– Taro: mild/moderate
– Jiro: severe
– Kazu: mild/moderate
- educational level of participant:
– Ken: regular kindergarten
– Taro: in regular class in elementary school
– Jiro: in regular class in elementary school
– Kazu: regular kindergarten
– Were the communication problems adequately described? No
- The communication disorder type was not provided.
- Was membership in treatment maintained throughout the study? Yes
- If there was more than one participant, did at least 80% of the participants remain in the study? Yes
- Were any data removed from the study? No
- Did the design include appropriate controls? Yes
- Were baseline/preintervention data collected on all behaviors? Yes
- Did probes/intervention data include untrained data? No
- Did probes/intervention data include trained data? Yes
- Was the data collection continuous? Yes
- Were different treatment counterbalanced or randomized? Not Applicable
- Was the outcome measure appropriate and meaningful? Yes
- List the outcome was
OUTCOME: Percentage of correct responses to request to match affective prosody (happy, angry, surprised, sad) to pictures depicting emotions
- The outcome was subjective.
- The outcome was not objective.
- The following reliability data were reported:
OUTCOME: Percentage of correct responses to request to match affective prosody (happy, angry, surprised, sad) to pictures depicting emotions using a single Japanese word using a single Japanese word
– Individual interobserver reliability for each participant (P): percentage of agreement ranged from 95% to 100%; Kendall’s W ranged from 0.99 to 1.00
- Did the target behavior improve when it was treated? Yes
- For each of the Ps, the overall quality of improvement was
OUTCOME: Percentage of correct responses to request to match affective prosody (happy, angry, surprised, sad) to pictures depicting emotions using a single Japanese word—
– Ken: strong
– Taro: moderate
– Jiro: strong
– Kazu: moderate
- Description of baseline:
- Were baseline data provided? Yes, the number of baseline session for each P were
– Ken: 3
– Taro: 5
– Jiro: 6
– Kazu: 7
- Was baseline low (or high, as appropriate) and stable?
– Ken: low, stable
– Taro: moderate, stable
– Jiro: low-moderate, variable
– Kazu: moderate, variable
(continue numbering as needed)
- What was the percentage of nonoverlapping data (PND)?
NOTE: The PND was calculated by the reviewer, not the investigators. It should be considered to be an approximation because it was derived from Figure 1.
– Ken: 100%– highly effective
– Taro: 100%– highly effective
– Jiro: 92%– highly effective
– Kazu: 100%– highly effective
- What was the magnitude of the treatment effect? NA
- Was information about treatment fidelity adequate? Not Provided. However, because the prosody was presented live by a Japanese speaking male, measures of the accuracy of portrayal of the emotion in the picture cards can be found in the appendix. Overall, productions were moderately accurate.
- Were maintenance data reported? Yes
- 3Ps maintained gains at the first one-week follow up. One P initially did not and was administered a second round of intervention. After the second round of intervention, that P maintained his progress.
- All 4 Ps maintained gains following the termination of therapy.
- Were generalization data reported? Yes
- Generalization was measured after the successful completion of all post testing (post-training probes, one week follow up, one month follow up). The generalization consisted of changing of the speaker from male to female.
- A male speaker administered (live) all pretests, treatment sessions, and post tests.
- A female speaker (live) administered the generalization tests.
- All the Ps maintained a high percentage of correct responses during generalization.
- Brief description of the design:
- This investigation consisted of 4 single subject experimental design studies (multiple baseline across participants.)
- Prior to the experimental procedures, the investigators administered procedures to insure that the Ps could (1) follow intervention procedure (i.e., cross modal matching procedures and (2) match pictures of facial expressions to other pictures representing the same expressions.
- Four prosodic affects/facial expressions were targeted in intervention: happy, surprised, angry, and sad.
- During baseline, the male clinician (C) placed all 4 pictures of facial expression on the table. He then produced the targeted Japanese word using one of the 4 prosodic affects.
- Data from the baseline was used as pretesting scores and to guide the selection of training pairs. During training only 2 cards were placed in front of the child: the card representing the emotion that had the highest percentage of correct responses and another emotion.
- Following the achievement of the criterion for intervention, C administered post-test probes. If P reached the post-testing criteria, intervention was terminated.
- If a P did not reach criterion, he received additional therapy. One P did not reach criterion at the first post-test probe. He did, however, achieve criterion on the second round of post-test probes.
- After post-test probes, C administered 2 rounds of follow-up post tests. Three of the 4 Ps achieved criterion on the first follow-up post-test which was administered one week after the termination of intervention. The P who did not reach criterion was administered another round of intervention. (Following that additional round, the P passed criteria for post-test probes and a subsequent one-week follow-up.)
- One month after the termination of intervention, C administered a one-month follow up post-test. All Ps achieved criterion.
- Following the passing of the one-month follow-up post test, a female speaker administered a generalization tests across 2 sessions.
OVERALL RATING OF THE QUALITY OF SUPPORT FOR THE INTERVENTION: ___B______
SUMMARY OF INTERVENTION
PURPOSE: To determine if cross modal matching to sample intervention can improve the receptive prosody of Japanese children diagnosed with ASD.
POPULATION: Autism Spectrum Disorders
MODALITY TARGETED: Receptive
ELEMENTS/FUNCTIONS OF PROSODY TARGETED: prosodic affect
ADMINISTRATOR: probably a psychologist
STIMULI: auditory, visual
- Four emotions/affects were treated: happy, surprised, angry, and sad.
- The investigators employed a cross-model matching-to-sample two-choice training procedure.
- The cross-modal portion of the procedure involved using auditory (the C’s production of a single Japanese word using a targeted prosodic affect) and visual (pictures depicting facial expressions signaling the targeted affect) stimuli.
- The matching-to-sample portion of the procedure involved requiring the P to point to or hand to the C the picture representing the affect the C has just produced.
- The two-choice portion of the procedure involved selected only 2 emotions to train at a time. Because up to four emotions were treated for each P, the investigators developed a strategy for pairing emotions/affects.
- Overall there were 5 major portions of the experiments: pre-assessment, baseline, two-choice intervention, post –tests, and generalization tests.
- During baseline, the investigators identified the strongest (highest percentage of correct comprehension responses) and the weakest (lowest percentage of correct comprehension responses) emotions/affects. In the pairings, the strong emotions were paired with weak emotions. Each of the different pairings of emotions was considered a “Phase” of treatment. Only one pairing was worked on in a Phase.
- Criterion for moving from one Phase to the next was 100% correct responding for 2 treatment sessions in a row.
- Criterion for termination of treatment was an average of 90% correct responding for each of the post-tests (post-test probes, 1-week generalization, and 3-week generalization).
- C placed two cards depicting 2 emotions in front of P.
- C directed P to select the card that represents (says) the targeted emotion/affect.
- C produced the single Japanese target word using the targeted emotion/affect.
- During the first Phase of this training, C was allowed to show his face to P while he was producing the targeted word and prosodic emotion/affect. This was not permitted for subsequent Phases.
- If P responded to the direction, C enthusiastically provided positive feedback verbally and gesturally (i.e., high-fives, handshaking.)
- If P failed to respond, C waited 5 seconds and readministered the direction.
- If P responded incorrectly to the direction or failed to respond a second time, C pointed to the correct card, said “This is the correct one”, and prompted P to hand him the card.