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Cited by 20Statistical Methods in Clinical TrialsBehavioral and Psychological StudiesHealth Policy Implementation Science

Single‐case experimental designs for child neurological rehabilitation and developmental disability research

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Krasny‐Pacini, Agata·2023·Developmental Medicine & Child Neurology
DOI 10.1111/dmcn.15513
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Abstract

Single‐case experimental designs (SCEDs) are a group of methodologies of growing interest, aiming to test the effectiveness of an intervention at the single‐participant level, using a rigorous and prospective methodology. SCEDs may promote flexibility on how we design research protocols and inform clinical decision‐making, especially for personalized outcome measures, inclusion of families with challenging needs, measurement of children's progress in relation to parental implementation of interventions, and focus on personal goals. Design options for SCEDs are discussed in relation to an expected on/off effect of the intervention (e.g. school/environmental adaptation, assistive technology devices) or, alternatively, on an expected carry‐on/maintenance of effects (interventions aiming to develop or restore a function). Randomization in multiple‐baseline designs and ‘power’ calculations are explained. The most frequent reasons for not detecting an intervention effect in SCEDs are also presented, especially in relation to baseline length, trend, and instability. The use of SCEDs on the front and back ends of randomized controlled trials is discussed. What this paper adds: Single‐case experimental designs (SCEDs) may promote flexibility on how we design research protocols. Randomization in multiple‐baseline designs allows ‘power’ calculations based on randomization tests. Whenever feasible, N‐of‐1 trials should be preferred to other SCEDs and to group randomized controlled trials.

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Research works printed but not linked: 47

  1. Graham JE, Karmarkar AM, Ottenbacher KJ. Small Sample Research Designs for Evidence-Based Rehabilitation: Issues and Methods. Arch Phys Med Rehabil. 2012 Aug;93(8):S111-6.
  2. Tate RL, Perdices M, Rosenkoetter U, Shadish W, Vohra S, Barlow DH, et al. The Single-Case Reporting Guideline In BEhavioural Interventions (SCRIBE) 2016 Statement. Neuropsychol Rehabil. 2017; 27:1-15.
  3. Lanovaz MJ, Turgeon S. How Many Tiers Do We Need? Type I Errors and Power in Multiple Baseline Designs. Perspect Behav Sci. 2020 Sep 1;43(3):605-16.
  4. Tate RL, Perdices M, Rosenkoetter U, McDonald S, Togher L, Shadish W, et al. The Single-Case Reporting Guideline In BEhavioural Interventions (SCRIBE) 2016: Explanation and elaboration. Arch Sci Psychol. 2016;4(1):10-31.
  5. Byiers BJ, Reichle J, Symons FJ. Single-subject experimental de- sign for evidence-based practice. Am J Speech Lang Pathol. 2012 Nov;21(4):397-414.
  6. Krasny-Pacini A, Evans J. Single-case experimental designs (SCEDs) to assess intervention effectiveness in rehabilitation: A practical guide. Ann Phys Rehabil Med. 2018;61:164-79.
  7. Tanious R, Onghena P. Randomized Single-Case Experimental Designs in Healthcare Research: What, Why, and How? Healthcare. 2019 Nov 13;7(4):143.
  8. OCEBM Levels of Evidence Table. "The Oxford 2011 Levels of Evidence". [Internet]. Oxford Centre for Evidence-Based Medicine.; Available from: http://www.cebm.net/index.aspx?o=5653
  9. Mitchell G. Aggregated N-of-1 Trials. In Nikles J, Mitchell G (eds). The Essential Guide to N-of-1 Trials in Health. Springer Netherlands, 2015; 57-66.
  10. Nikles J, Mitchell G. The Essential Guide to N-of-1 Trials in Health. Springer Netherlands, 2015.
  11. Kratochwill TR, Levin JR. Enhancing the scientific credibility of single-case intervention research: randomization to the rescue. Psychol Methods. 2010 Jun;15(2):124-44.
  12. Craig AR, Fisher WW. Randomization tests as alternative anal- ysis methods for behavior-analytic data. J Exp Anal Behav. 2019 Mar;111(2):309-28.
  13. Heyvaert M, Onghena P. Randomization tests for single-case experi- ments: State of the art, state of the science, and state of the application. J Context Behav Sci. 2014 Jan 1;3(1):51-64.
  14. Levin JR, Ferron JM, Gafurov BS. Comparison of randomization- test procedures for single-case multiple-baseline designs. Dev Neurorehabilitation. 2018;21:290-311.
  15. Lane JD, Gast DL. Visual analysis in single case experimental de- sign studies: brief review and guidelines. Neuropsychol Rehabil. 2014;24(3-4):445-63.
  16. Colquhoun D. An investigation of the false discovery rate and the misinterpretation of p -values. R Soc Open Sci. 2014 Nov;1(3):140216.
  17. Slocum TA, Pinkelman SE, Joslyn PR, Nichols B. Threats to Internal Validity in Multiple-Baseline Design Variations. Perspect Behav Sci. 2022;45:619-38. Available from: https://doi.org/10.1007/s4061 4-022- 00326 -1 · DOI
  18. Ledford JR. Concurrence on Nonconcurrence in Multiple-Baseline Designs: A Commentary on Slocum et al. (2022). Perspect Behav Sci. 2022 Sep 1;45(3):661-6.
  19. Bulté I, Onghena P. Randomization tests for multiple-baseline de- signs: An extension of the SCRT-R package. Behav Res Methods. 2009 May 1;41(2):477-85.
  20. Bulté I, Onghena P. An R package for single-case randomization tests. Behav Res Methods. 2008 May 1;40(2):467-78.
  21. Bulté I, Onghena P. The Single-Case Data Analysis Package: Analysing Single-Case Experiments with R Software. J Mod Appl Stat Methods. 2013 Nov 1;12(2):450-78.
  22. Vibrac C, Avias A, François PO, Isner-Horobeti ME, Krasny-Pacini A. Charlie Chaplin and gesture training in severe aphasia: A con- trolled double-blind single-case experimental design. Ann Phys Rehabil Med. 2021 Jan;64(1):101356.
  23. Ferron J, Jones PK. Tests for the Visual Analysis of Response-Guided Multiple-Baseline Data. J Exp Educ. 2006;75(1):66-81.
  24. Lanovaz MJ, Primiani R. Waiting for baseline stability in single-case designs: Is it worth the time and effort? Behav Res Methods 2022 Apr 25. doi: https://doi.org/10.3758/s1342 8-022-01858 -9. Online ahead of print. · DOI
  25. Nikles J, Mitchell G, McKinlay L, Waugh MC, Epps A, Carmont SA, et al. A series of n-of-1 trials of stimulants in brain injured children. NeuroRehabilitation. 2017;40(1):11-21.
  26. Lui M, Falk TH, Chau T. Development and evaluation of a dual- output vocal cord vibration switch for persons with multiple disabili- ties. Disabil Rehabil Assist Technol. 2012 Jan;7(1):82-8.
  27. Ten Berge SR, Boonstra AM, Dijkstra PU, Hadders-Algra M, Haga N, Maathuis CGB. A systematic evaluation of the effect of thumb op- ponens splints on hand function in children with unilateral spastic cerebral palsy. Clin Rehabil. 2012 Apr;26(4):362-71.
  28. Gharebaghy S, Rassafiani M, Cameron D. Effect of Cognitive Intervention on Children with ADHD. Phys Occup Ther Pediatr. 2015 Jan 2;35(1):13-23.
  29. Diamond MF, Ottenbacher KJ. Effect of a tone-inhibiting dynamic ankle-foot orthosis on stride characteristics of an adult with hemipa- resis. Phys Ther. 1990;70(7):423-30.
  30. Logan KR, Jacobs HA, Gast DL, Murray AS, Daino K, Skala C. The Impact of Typical Peers on the Perceived Happiness of Students with Profound Multiple Disabilities. Res Pract Pers Sev Disabil. 1998 Dec 1;23(4):309-18.
  31. Feeney TJ. Structured flexibility: the use of context-sensitive self- regulatory scripts to support young persons with acquired brain injury and behavioral difficulties. J Head Trauma Rehabil. 2010 Dec;25(6):416-25.
  32. Kirby MS, Spencer TD, Ferron J. How to Be RAD: Repeated Acquisition Design Features that Enhance Internal and External Validity. Perspect Behav Sci. 2021 Sep 1;44(2):389-416.
  33. Feeney TJ, Ylvisaker M. Context-Sensitive Cognitive-Behavioral Supports for Young Children with TBI: A Second Replication Study. J Posit Behav Interv. 2008;10(2):115-28.
  34. Kiresuk TJ, Sherman R. Goal Attainment Scaling: A general method for evaluating comprehensive community mental health programs. Comm Mental Health J. 1968;4(6):443-53.
  35. Tennant A. Goal attainment scaling: current methodological chal- lenges. Disabil Rehabil. 2007 Nov 30;29(20-21):1583-8.
  36. Cosbey J, Muldoon D. EAT-UPTM Family-Centered Feeding Intervention to Promote Food Acceptance and Decrease Challenging Behaviors: A Single-Case Experimental Design Replicated Across Three Families of Children with Autism Spectrum Disorder. J Autism Dev Disord. 2017 Mar 1;47(3):564-78.
  37. Gabler NB, Duan N, Vohra S, Kravitz RL. N-of-1 trials in the medical literature: a systematic review. Med Care. 2011 Aug;49(8):761-8.
  38. Guyatt GH, Keller JL, Jaeschke R, Rosenbloom D, Adachi JD, Newhouse MT. The n-of-1 Randomized Controlled Trial: Clinical Usefulness. Ann Intern Med. 1990 Feb 15;112(4):293-9.
  39. Larson EB, Ellsworth AJ, Oas J. Randomized Clinical Trials in Single Patients During a 2-Year Period. JAMA. 1993 Dec 8;270(22): 2708-12.
  40. Romeiser Logan L, Hickman RR, Harris SR, Heriza CB. Single- subject research design: recommendations for levels of evidence and quality rating. Dev Med Child Neurol. 2008 Feb;50(2):99-103.
  41. Tarlow KR. An Improved Rank Correlation Effect Size Statistic for Single-Case Designs: Baseline Corrected Tau. Behav Modif. 2017 Jul 1;41(4):427-67.
  42. Parker RI, Vannest KJ, Davis JL. Effect size in single-case re- search: a review of nine nonoverlap techniques. Behav Modif. 2011 Jul;35(4):303-22.
  43. Pustejovsky JE, Hedges LV, Shadish WR. Design-Comparable Effect Sizes in Multiple Baseline Designs: A General Modeling Framework. J Educ Behav Stat. 2014 Oct;39(5):368-93.
  44. Declercq L, Cools W, Beretvas SN, Moeyaert M, Ferron J, Noortgate W. MultiSCED: A tool for (meta-)analyzing single-case experimental data with multilevel modeling. Behav Res Methods. 2020;52:177-92.
  45. Blampied NM. Analyzing Therapeutic Change Using Modified Brinley Plots: History, Construction, and Interpretation. Behav Ther. 2017 Jan;48(1):115-27.
  46. Manolov R, Moeyaert M. How can single-case data be analyzed? Software resources, tutorial, and reflections on analysis. Behav Modif. 2017;41(2):179-228.
  47. Manolov R, Moeyaert M. Recommendations for choosing single-case data analytical techniques. Behav Ther. 2017;48(1):97-114.

Cited by

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Authors
Krasny‐Pacini, A.
Affiliations
Inserm (FR)
Corresponding author
Krasny‐Pacini, Agata
ORCID
Krasny‐Pacini, Agata
Venue
Developmental Medicine & Child Neurology
Publisher
Wiley
Published
2023-01-31
Volume
65
Issue
5
Pages
611-624
ISSN
  • 0012-1622 (ISSN-L)
  • 1469-8749
DOI
10.1111/dmcn.15513
OpenAlex
W4318755014
Cited by
20
References
5
Citations by year
2026: 2 · 2025: 5 · 2024: 6 · 2023: 7
FWCI
0.76
Type
journal article
Language
en
Open access
Licence
Locations
  • Developmental Medicine & Child Neurology (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • HAL (submittedVersion, cc-by)
Topics
  • Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Clinical Trials
  • Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Keywords
single-case experimental design, developmental disabilities, multiple baseline design, N-of-1 trials, randomization, power analysis, permutation tests, assistive technology, family involvement, randomized controlled trials
MeSH terms
Child, Developmental Disabilities, Humans, Prospective Studies, Research Design

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