Visual aids and structured criteria for improving visual inspection and interpretation of single-case designs
Open accessAbstract
Because behavior analysis is a data-driven process, a critical skill for behavior analysts is accurate visual inspection and interpretation of single-case data. Study 1 was a basic study in which we increased the accuracy of visual inspection methods for A-B designs through two refinements of the split-middle (SM) method called the dual-criteria (DC) and conservative dual-criteria (CDC) methods. The accuracy of these visual inspection methods was compared with one another and with two statistical methods (Allison & Gorman, 1993; Gottman, 1981) using a computer-simulated Monte Carlo study. Results indicated that the DC and CDC methods controlled Type I error rates much better than the SM method and had considerably higher power (to detect real treatment effects) than the two statistical methods. In Study 2, brief verbal and written instructions with modeling were used to train 5 staff members to use the DC method, and in Study 3, these training methods were incorporated into a slide presentation and were used to rapidly (i.e., 15 min) train a large group of individuals (N = 87). Interpretation accuracy increased from a baseline mean of 55% to a treatment mean of 94% in Study 2 and from a baseline mean of 71% to a treatment mean of 95% in Study 3. Thus, Study 1 answered basic questions about the accuracy of several methods of interpreting A-B designs; Study 2 showed how that information could be used to increase the accuracy of human visual inspectors; and Study 3 showed how the training procedures from Study 2 could be modified into a format that would facilitate rapid training of large groups of individuals to interpret single-case designs.
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Conservative dual-criterion (CDC) analyses were conducted to increase reliability of visual inspection.
“Conservative dual-criterion (CDC; Fisher et al., 2003; Swoboda et al., 2010) analyses were also conducted to increase reliability of visual inspection.”
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“However, it is important to acknowledge that research on methods and protocols for improving agreement across visual analysts have shown considerable promise and represent an avenue deserving of investment and continued development (e.g., Fisher et al., 2003; Wolfe et al., 2019).”
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“This criterion also relates to the need for easily trainable procedures (Fisher et al., 2003).”
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“For between-phases comparison, a well-known tool, highlighted by Kratochwill, Levin, Horner, and Swoboda (2014), is the Conservative Dual Criteria (CDC; Fisher, Kelley, & Lomas, 2003).”
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“Finally, our guidelines are based on the premise that SCEDs are best at identifying moderate-to-large improvements (Fisher et al., 2003; Kazdin, 2011).”
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“In addition, we have included the conservative dual criterion (Fisher, Kelley, & Lomas, 2003), which is a visual aid for which there has already been evidence that it improves visual analysis (Stewart, Carr, Brandt, & McHenry, 2007; Wolfe & Slocum, 2015; Young & Daly, 2016) and that it performs…”
BackgroundMethodInfluentialSemantic feature analysis: Application to confrontation naming of actions in aphasia
Wambaugh, J. L., Mauszycki, S., & Wright, S. (2014) · Aphasiology · doi:10.1080/02687038.2013.845739 · Cited by 44 · see citing works
“The lines were adjusted upwards in the direction of the expected treatment effect by 0.25 standard deviations and extended into each corresponding treatment phase (Fisher et al., 2003).”
BackgroundMethodInfluentialFactors Affecting Visual Inference in Single-Case Designs
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“One possibility is to incorporate visual aids, since there is some evidence that regression or trend lines can increase inter-rater agreement, reliability and decision accuracy (Bailey, 1984; Fisher et al., 2003; Hagopian et al., 1997; Hojem & Ottenbacher, 1988; Skiba et al., 1989).”
BackgroundA comparison of two approaches to training visual analysis of AB graphs
Wolfe, K., & Slocum, T. A. (2015) · Journal of Applied Behavior Analysis · doi:10.1002/jaba.212 · Cited by 43 · see citing works
Williamson, P. S., Carnahan, C. R., Birri, N. L., & Swoboda, C. M. (2014) · The Journal of Special Education · doi:10.1177/0022466914521301 · Cited by 43 · see citing works
“Figure 3 contains the multiple baseline graph with intervention phase visual aides added using the CDC method (Fisher et al., 2003; Swoboda et al., 2010).”
MethodThe effects of rate control treatment on consonant production accuracy in mild apraxia of speech
Mauszycki, S. C., & Wambaugh, J. (2008) · Aphasiology · doi:10.1080/02687030701800818 · Cited by 45 · see citing works
“In order to assist in visual inspection of these data, the conservative dual‐criterion method (CDC) described by Fisher, Kelly, and Lomas ( 2003 ) was utilised.”
MethodSaini, V., Fisher, W. W., & Retzlaff, B. J. (2018) · Journal of Applied Behavior Analysis · doi:10.1002/jaba.450 · Cited by 42 · see citing works
Self-citationSelf-Empowerment of Immigrant Latina Survivors of Domestic Violence
Serrata, J. V., Hernández‐Martínez, M., & Macias, R. L. (2016) · Hispanic Health Care International · doi:10.1177/1540415316629681 · Cited by 39 · see citing works
Machine Learning to Analyze Single-Case Data: A Proof of Concept
Lanovaz, M. J., Giannakakos, A. R., & Destras, O. (2020) · Perspectives on Behavior Science · doi:10.1007/s40614-020-00244-0 · Cited by 40 · see citing works
“Three common aids that can be used with AB designs are the split-middle line for identifying trend (White & Haring, 1980), the dual-criteria method (DC) and the conservative dual-criteria method (CDC; Fisher et al., 2003).”
BackgroundMethodInfluentialIt has been said that, “There are three degrees of falsehoods: Lies, damn lies, and statistics”
Fisher, W. W., & Lerman, D. C. (2014) · Journal of School Psychology · doi:10.1016/j.jsp.2014.01.001 · Cited by 40 · see citing works
Self-citationCattivelli, R., Castelnuovo, G., Musetti, A., Varallo, G., Spatola, C. A. M., Riboni, F. V., Usubini, A. G., Tosolin, F., Manzoni, G. M., Capodaglio, P., et al. (2018) · Trials · doi:10.1186/s13063-018-2968-x · Cited by 41 · see citing works
“Detailed visual inspection and graphical analysis will be use, followed by a randomization test to ensure statistical power to the visual analysis [37, 38].”
MethodUsing the dual-criteria methods to supplement visual inspection: An analysis of nonsimulated data
Lanovaz, M. J., Huxley, S. C., & Dufour, M. (2017) · Journal of Applied Behavior Analysis · doi:10.1002/jaba.394 · Cited by 39 · see citing works
“Even though the DC method produces slightly more false positives than the CDC method, it is more powerful and thus produces fewer false negatives (Fisher et al., 2003).”
InfluentialEvaluating single-case research data for systematic review: A commentary for the special issue
Maggin, D. M., & Odom, S. L. (2014) · Journal of School Psychology · doi:10.1016/j.jsp.2014.01.002 · Cited by 38 · see citing works
Wolfe, K., Seaman, M. A., Drasgow, E., & Sherlock, P. (2018) · Journal of Applied Behavior Analysis · doi:10.1002/jaba.453 · Cited by 37 · see citing works
Lundgren, K., Brownell, H., Cayer-Meade, C., Milione, J., & Kearns, K. P. (2010) · Aphasiology · doi:10.1080/02687038.2010.500809 · Cited by 37 · see citing works
A Behavioral Manipulation Engages Right Frontal Cortex During Aphasia Therapy
Benjamin, M. L., Towler, S., Garcia, A., Park, H., Sudhyadhom, A., Harnish, S. M., McGregor, K., Zlatar, Z. Z., Reilly, J. J., Rosenbek, J. C., et al. (2014) · Neurorehabilitation and neural repair · doi:10.1177/1545968313517754 · Cited by 37 · see citing works
Using Single-Case Designs in Practical Settings: Is Within-Subject Replication Always Necessary?
Lanovaz, M. J., Turgeon, S., Cardinal, P., & Wheatley, T. L. (2018) · Perspectives on Behavior Science · doi:10.1007/s40614-018-0138-9 · Cited by 36 · see citing works
“To examine the probability of replication, we applied the dual-criteria method of analysis (Fisher et al., 2003) to the three phase changes in each dataset (i.e., A1 to B1, B1 to A2, and A2 to B2). We selected the dual-criteria method because (a) visual structured criteria are more reliable and objective than visual a…”
BackgroundMethodResultInfluentialA Decade of Evidence-Based Education
Detrich, R., & Lewis, T. (2012) · Journal of Positive Behavior Interventions · doi:10.1177/1098300712460278 · Cited by 36 · see citing works
“Judgments about visually displayed data improved when visual aids were made a part of the data presentation (Fisher et al., 2003).”
BackgroundA systematic review of functional analysis in pediatric feeding disorders
Saini, V., Kadey, H. J., Paszek, K. J., & Roane, H. S. (2019) · Journal of Applied Behavior Analysis · doi:10.1002/jaba.637 · Cited by 35 · see citing works
Sound Production Treatment: Effects of Blocked and Random Practice
Wambaugh, J. L., Nessler, C., Wright, S., & Mauszycki, S. C. (2014) · American Journal of Speech-Language Pathology · doi:10.1044/2014_ajslp-13-0072 · Cited by 35 · see citing works
Sound Production Treatment: Application with severe apraxia of speech
Wambaugh, J. L., & Mauszycki, S. C. (2010) · Aphasiology · doi:10.1080/02687030903422494 · Cited by 35 · see citing works
“Additionally, the conservative dual-criteria (CDC; Fisher, Kelley, & Lomas, 2003 ) method was used as an aid to visual inspection to make a determination of treatment effects.”
The Application of Single-Case Research Designs to Study Elite Athletes’ Conditioning: An Update
Kinugasa, T. (2012) · Journal of Applied Sport Psychology · doi:10.1080/10413200.2012.709578 · Cited by 34 · see citing works
“Furthermore, visual analysis using a validated method has shown to possess better statistical power to detect intervention effects than the ITSE method (Fisher, Kelley, & Lomas, 2003 ).”
MethodHow Many Tiers Do We Need? Type I Errors and Power in Multiple Baseline Designs
Lanovaz, M. J., & Turgeon, S. (2020) · Perspectives on Behavior Science · doi:10.1007/s40614-020-00263-x · Cited by 34 · see citing works
“Given that our concern involved power and that the dual-criteria method is more powerful than the conservative dual-criteria method (Fisher et al., 2003), our study only applied the dual-criteria method.”
BackgroundMethodResultInfluentialCombined Aphasia and Apraxia of Speech Treatment (CAAST): effects of a novel therapy.
Wambaugh, J., Wright, S., Nessler, C., & Mauszycki, S. C. (2014) · Journal of Speech, Language and Hearing Research · doi:10.1044/2014_jslhr-l-14-0004 · Cited by 27 · see citing works
Ward, R., Leitão, S., & Strauss, G. (2014) · International Journal of Speech-Language Pathology · doi:10.3109/17549507.2013.876662 · Cited by 32 · see citing works
Machine learning to analyze single‐case graphs: A comparison to visual inspection
Lanovaz, M. J., & Hranchuk, K. S. (2021) · Journal of Applied Behavior Analysis · doi:10.1002/jaba.863 · Cited by 31 · see citing works
Dowdy, A., Jessel, J., Saini, V., & Peltier, C. J. (2021) · Journal of Applied Behavior Analysis · doi:10.1002/jaba.899 · Cited by 31 · see citing works
A Simple Method to Control Positive Baseline Trend Within Data Nonoverlap
Parker, R. I., Vannest, K. J., & Davis, J. L. (2012) · The Journal of Special Education · doi:10.1177/0022466912456430 · Cited by 31 · see citing works
“Over the past few decades, there has been ongoing research on the training and supports that would enhance reliability of visual judgments from graphs (Ferron & Jones, 2006; Fisher, Kelley, & Lomas, 2003; Ximenes, Manolov, Solanas, & Quera, 2009).”
BackgroundTraining Front-Line Employees to Conduct Visual Analysis Using a Clinical Decision-Making Model
Kipfmiller, K. J., Brodhead, M. T., Wolfe, K., LaLonde, K. B., Sipila‐Thomas, E. S., Bak, M. Y. S., & Fisher, M. H. (2019) · Journal of Behavioral Education · doi:10.1007/s10864-018-09318-1 · Cited by 31 · see citing works
“First, we used an autoregressive formula (Fisher et al. 2003; Wolfe and Slocum 2015; Young and Daly 2016) to generate graphs based on hypothetical rather than actual student data.”
MethodReporting Results of Single‐Case Studies
Hott, B. L., Limberg, D., Ohrt, J. H., & Schmit, M. K. (2015) · Journal of Counseling & Development · doi:10.1002/jcad.12039 · Cited by 30 · see citing works
Nonverbal Working Memory as a Predictor of Anomia Treatment Success
Harnish, S. M., & Lundine, J. P. (2015) · American Journal of Speech-Language Pathology · doi:10.1044/2015_ajslp-14-0153 · Cited by 30 · see citing works
“The mean and trend lines were then adjusted in the direction of predicted treatment effect by 0.25 SD as a “reasonable compromise between Type I and Type II errors” (Fisher et al., 2003, p. 387).”
MethodInfluentialUsing behavior contracts to improve behavior of children and adolescents in multiple settings
Edgemon, A. K., Rapp, J. T., Coon, J. C., Cruz‐Khalili, A., Brogan, K. M., & Richling, S. M. (2020) · Behavioral Interventions · doi:10.1002/bin.1757 · Cited by 28 · see citing works
Semantic Feature Analysis: Further Examination of Outcomes
DeLong, C., Nessler, C., Wright, S., & Wambaugh, J. L. (2015) · American Journal of Speech-Language Pathology · doi:10.1044/2015_ajslp-14-0155 · Cited by 28 · see citing works
EEG Theta/Beta Ratio Neurofeedback Training in Healthy Females
Son, D. V., van der Does, W. A. J., Band, G. P. H., & Putman, P. (2020) · Applied Psychophysiology and Biofeedback · doi:10.1007/s10484-020-09472-1 · Cited by 28 · see citing works
Falligant, J. M., Hagopian, L. P., Kranak, M. P., & Kurtz, P. F. (2022) · Journal of the Experimental Analysis of Behavior · doi:10.1002/jeab.769 · Cited by 27 · see citing works
The Impact of Baseline Trend Control on Visual Analysis of Single-Case Data
Mercer, S. H., & Sterling, H. E. (2011) · Journal of School Psychology · doi:10.1016/j.jsp.2011.11.004 · Cited by 27 · see citing works
The Use of Behavioral Skills Training to Teach Graph Analysis to Community Based Teachers
Maffei‐Almodovar, L., Feliciano, G., Fienup, D. M., & Sturmey, P. (2017) · Behavior Analysis in Practice · doi:10.1007/s40617-017-0199-3 · Cited by 25 · see citing works
“Finally, Fisher, Kelley, and Lomas (2003) conducted three studies to increase the accuracy of visual inspection methods in detecting treatment effects in A–”
BackgroundUsing dual‐criteria methods to supplement visual inspection: Replication and extension
Falligant, J. M., McNulty, M. K., Hausman, N. L., & Rooker, G. W. (2019) · Journal of Applied Behavior Analysis · doi:10.1002/jaba.665 · Cited by 25 · see citing works
Modified Response Elaboration Training: Application to Procedural Discourse and Personal Recounts
Wambaugh, J. L., Nessler, C., & Wright, S. (2013) · American Journal of Speech-Language Pathology · doi:10.1044/1058-0360(2013/12-0063 · Cited by 25 · see citing works
Detecting False Positives in Multielement Designs
Bartlett, S. M., Rapp, J. T., & Henrickson, M. L. (2011) · Behavior Modification · doi:10.1177/0145445511415396 · Cited by 25 · see citing works
Martin, N., & Kalinyak-Fliszar, M. (2014) · Aphasiology · doi:10.1080/02687038.2014.987049 · Cited by 7 · see citing works
“These shortcomings have been recognised and efforts to address them have been offered by Fisher et al. (2003) and others (e.g., Robey et al., 1999; Swoboda, Kratochwill, & Levin, 2010). Shewhart (1931) trend lines advocated by Robey et al. (1999) set criterion for a significant effect as two consecutive treatment prob…”
BackgroundMethodInfluentialAssessing Nonoverlap in Single-Case Data: Strengths, Challenges, and Recommendations
Manolov, R., & Tanious, R. (2024) · Journal of Behavioral Education · doi:10.1007/s10864-024-09552-w · Cited by 24 · see citing works
“The current double focus on visualization and quantification is well-aligned with previous recommendations (Fisher et al., 2003; Harrington & Velicer, 2015; Houle, 2009) and with recent texts on representing quantifications of effect (Ferron et al., 2024; Verboon & Peters, 2020).”
Blake, M., Tompkins, C., Scharp, V. L., Meigh, K. M., & Wambaugh, J. (2014) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2014.932290 · Cited by 20 · see citing works
“Fisher et al. (2003) provide criteria for the number of data points that must fall above both lines in order to conclude that positive change on the probe items is systematic and associated with the treatment.”
Intensive treatment of dysarthria in two adults with Down syndrome
Mahler, L. A., & Jones, H. N. (2012) · Developmental Neurorehabilitation · doi:10.3109/17518423.2011.632784 · Cited by 26 · see citing works
PELATIHAN REGULASI EMOSI UNTUK MENURUNKAN PERILAKU AGRESIF PADA ANAK
Syahadat, Y. M. (2013) · Humanitas Indonesian Psychological Journal · doi:10.26555/humanitas.v10i1.326 · Cited by 24 · see citing works
Wambaugh, J. L., Nessler, C., Wright, S., Mauszycki, S. C., & DeLong, C. (2015) · International Journal of Speech-Language Pathology · doi:10.3109/17549507.2015.1101161 · Cited by 24 · see citing works
Using a Visual Structured Criterion for the Analysis of Alternating-Treatment Designs
Lanovaz, M. J., Cardinal, P., & Francis, M. (2017) · Behavior Modification · doi:10.1177/0145445517739278 · Cited by 24 · see citing works
Extrapolating baseline trend in single-case data: Problems and tentative solutions
Manolov, R., Solanas, A., & Sierra, V. (2018) · Behavior Research Methods · doi:10.3758/s13428-018-1165-x · Cited by 23 · see citing works
Rvachew, S., & Matthews, T. (2017) · Journal of Communication Disorders · doi:10.1016/j.jcomdis.2017.04.003 · Cited by 23 · see citing works
- Authors
- Fisher, W. W., Kelley, M. E., & Lomas, J. E.
- Affiliations
- Louisiana State University (US)
- Corresponding author
- Fisher, Wayne W.
- Venue
- Journal of Applied Behavior Analysis
- Publisher
- Wiley
- Published
- 2003-09
- Volume
- 36
- Issue
- 3
- Pages
- 387-406
- ISSN
- 0021-8855 (ISSN-L)
- 1938-3703
- PMC
- PMC1284456
- OpenAlex
- W2048320738
- Cited by
- 351
- References
- 28
- Citations by year
- 2026: 19 · 2025: 11 · 2024: 15 · 2023: 25 · 2022: 29 · 2021: 33 · 2020: 32 · 2019: 16 · 2018: 14 · 2017: 22 · 2016: 13 · 2015: 21 · 2014: 22 · 2013: 16 · 2012: 14
- FWCI
- 3.65
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Applied Behavior Analysis (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Health and Human Services (5 R01 HD37837-03)
- National Institutes of Health (5r01hd037837-03)
- National Institute of Child Health and Human Development
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (5 R01 HD37837-03)
- Topics
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Data Visualization and Analytics
- Social Sciences › Psychology › Applied Psychology › Human Resource Development and Performance Evaluation
- Keywords
- visual inspection, single-case experimental design, type I error control, statistical power, interpreting accuracy, employee training, modeling, behavior analysis
- MeSH terms
- Audiovisual Aids, Behavior Therapy, Computer Graphics, Computer Simulation, Humans, Mathematical Computing, Monte Carlo Method, Outcome and Process Assessment, Health Care, Regression Analysis, Software, Reproducibility of Results, Observer Variation
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