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Examining Procedural Variations of Delivering Competing Stimuli in the Treatment of Stereotypy. 研究在治疗刻板印象中传递竞争性刺激的程序变异。
IF 2.3 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2024-07-01 Epub Date: 2024-02-23 DOI: 10.1177/01454455241232574
Julia L Rosenzweig, Catlyn A Li Volsi, Tiago de Man, William H Ahearn

Competing stimulus assessments (CSA) are effective tools for identifying stimuli that compete with automatically reinforced behavior. However, Jennett et al. suggests there are cases for which non-contingent access to competing stimuli are insufficient at decreasing target responding and additional treatment components may be necessary. The purpose of the current study was to examine procedural variations (i.e., rotating competing items and prompted engagement) when presenting competing stimuli on increasing functional engagement and decreasing stereotypy. Following a functional analysis, a CSA was conducted to identify competing stimuli for four individuals with autism. Items identified were then used with two procedural variations. Levels of stereotypy, functional engagement, and item contact were measured. Results showed that for two participants both treatments were effective, while for the other two participants prompting functional engagement was more effective. Prompting functional engagement is likely a productive strategy for enhancing engagement with competing stimuli for automatically reinforced problem behavior as it may result in functional engagement becoming reinforcing in and of itself.

竞争刺激评估(CSA)是识别与自动强化行为竞争的刺激物的有效工具。然而,Jennett 等人认为,在某些情况下,非条件性地获得竞争性刺激不足以减少目标反应,可能需要额外的治疗成分。本研究的目的是考察在呈现竞争刺激时程序的变化(即旋转竞争项目和提示参与)对增加功能性参与和减少刻板行为的作用。在进行功能分析后,研究人员对四名自闭症患者进行了CSA,以确定竞争刺激物。确定的项目在使用时有两种程序变化。对刻板印象、功能参与和项目接触水平进行了测量。结果表明,对两名参与者来说,两种处理方法都有效,而对另外两名参与者来说,提示功能参与更为有效。提示功能性参与很可能是一种有效的策略,可以提高自动强化问题行为的竞争性刺激的参与度,因为它可能导致功能性参与本身成为强化行为。
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引用次数: 0
Perceived Negative Effects of Tic Management Strategies in Adults With Tic Disorders. 成人抽搐症患者对抽搐管理策略负面影响的认知。
IF 2 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2024-07-01 Epub Date: 2024-04-01 DOI: 10.1177/01454455241236446
Kathryn E Barber, Brandon X Pitts, Jordan T Stiede, Flint M Espil, Douglas W Woods, Matthew W Specht, Shannon M Bennett, John T Walkup, Emily J Ricketts, Joseph F McGuire, Alan L Peterson, Scott N Compton, Sabine Wilhelm, Lawrence Scahill, John C Piacentini

Behavior therapy is a well-established and empirically supported treatment for tic disorders (TDs). However, concerns have been expressed about the negative effects of behavioral interventions, such as tic worsening, tic substitution, and excessive effort. This study explored perceived negative effects of tic management strategies in adults with TDs and predictors of these experiences. Participants (N = 72) completed semi-structured interviews 11 years after receiving behavior therapy or supportive therapy in a randomized clinical trial. We examined responses to interview questions about managing tics and predictors of reported negative effects. Most participants did not experience tic worsening (84%) or tic substitution (75%) from tic management strategies. The majority felt they could manage tics while participating in their environment (87%) and did not report life interference from tic management (77%). About half (45%) felt less present when managing tics. Treatment non-responders in the original trial were more likely to report negative effects of tic management strategies. No differences in reported negative consequences were found between those who received behavior therapy versus supportive therapy, suggesting that behavior therapy specifically does not lead to such adverse effects. These findings could reduce misconceptions about behavior therapy for TDs and enhance its acceptability and utilization.

行为疗法是治疗抽搐症(TDs)的一种行之有效且得到经验支持的治疗方法。然而,也有人对行为干预的负面影响表示担忧,如抽搐恶化、抽搐替代和过度努力。本研究探讨了成人抽搐症患者对抽搐管理策略的负面影响的感知及其预测因素。参与者(N = 72)在随机临床试验中接受行为疗法或支持疗法 11 年后完成了半结构化访谈。我们研究了他们对有关控制抽搐的访谈问题的回答,以及报告的负面影响的预测因素。大多数参与者在采取抽搐管理策略后没有出现抽搐恶化(84%)或抽搐替代(75%)。大多数人认为他们可以在参与环境活动的同时控制抽搐(87%),并且没有报告抽搐控制对生活造成的干扰(77%)。约有一半(45%)的患者在控制抽搐时感觉不到自己的存在。在最初的试验中,对治疗无反应者更有可能报告抽搐控制策略的负面影响。接受行为疗法和支持疗法的患者在报告的负面影响方面没有发现差异,这表明行为疗法不会导致此类不良影响。这些发现可以减少人们对行为疗法治疗抽动障碍的误解,提高行为疗法的可接受性和利用率。
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引用次数: 0
A Comparison of Single-Case Effect Measures Using Check-In Check-Out Data. 使用签到签出数据的单个案例效果测量比较。
IF 2.3 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2024-05-01 Epub Date: 2024-02-23 DOI: 10.1177/01454455241233738
Allison M Peart, Daniel D Drevon, Andrea D Jasper

There are numerous effect measures researchers can select when conducting a meta-analysis of single-case experimental design research. These effect measures model different characteristics of the data, so it is possible that a researcher's choice of an effect measure could lead to different conclusions about the same intervention. The current study investigated the impact of effect measure selection on conclusions about the effectiveness of check-in check-out (CICO), a commonly used intervention within School-Wide Positive Behavior Interventions and Supports. Using a multilevel meta-analysis of seven different effect measures across 95 cases in 22 studies, findings suggested that all effect measures indicated statistically significant results of CICO in improving student behavior. However, the magnitude of the effects varied when comparing the results to interpretive guidelines, suggesting that the selection of effect measures may impact conclusions regarding the extent to which an intervention is effective. Implications, limitations, and future directions are discussed.

在对单例实验设计研究进行荟萃分析时,研究人员可以选择多种效应测量方法。这些效应指标可以模拟数据的不同特征,因此研究人员对效应指标的选择有可能导致对同一干预措施得出不同的结论。本研究调查了效果测量选择对签入签出(CICO)有效性结论的影响,签入签出是全校积极行为干预与支持中常用的干预措施。通过对 22 项研究中 95 个案例的七种不同效果测量方法进行多层次荟萃分析,研究结果表明,所有效果测量方法都表明,CICO 在改善学生行为方面具有显著的统计意义。然而,在将结果与解释性指南进行比较时,效果的大小各不相同,这表明效果测量的选择可能会影响有关干预措施有效程度的结论。本文讨论了影响、局限性和未来发展方向。
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引用次数: 0
Investigation of Two Preliminary Analysis-Altering Elements: Ordinate Scaling and DPPXYR. 两个初步分析改变元素的调查:正交缩放和 DPPXYR。
IF 2.3 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2024-05-01 Epub Date: 2024-01-11 DOI: 10.1177/01454455231221289
Corey Peltier, John William McKenna, Wilhelmina van Dijk

The purpose of this pre-registered study (Peltier & McKenna) was to conceptually replicate if the truncation of the ordinate and DPPXYR increased analysts' estimation of a functional relation and magnitude of treatment effect. Visual analysts (n = 27) evaluated eight data sets reporting null (n = 2), small (n = 2), moderate (n = 2), and large (n = 2) effects. Each data set was graphed six times with manipulations of the ordinate and DPPXYR, resulting in 48 ABAB graphs. We estimated two separate three-level mixed effect models with variations nested in datasets and nested in participants to evaluate the impact of graph characteristics for (1) confidence in determining a functional relation and (2) the estimated magnitude of the treatment effect. We included ordinate scaling and DPPXYR at level 1 and graph effect size at level 2, including all interactions. Overall, graph manipulation consistently did not impact confidence in a functional relation. Results suggest mixed findings for graph manipulation on the estimated magnitude of the treatment effect. Findings will be couched in current literature and recommendations for graph construction and future research will be discussed.

这项预先登记的研究(Peltier 和 McKenna)旨在从概念上复制截断纵坐标和 DPPXYR 是否会增加分析师对功能关系和治疗效果大小的估计。视觉分析师(n = 27)评估了报告无效(n = 2)、较小(n = 2)、中等(n = 2)和较大(n = 2)效应的八个数据集。对每个数据集都绘制了六次图表,并对其序数和 DPPXYR 进行了处理,最终绘制出 48 幅 ABAB 图表。我们估算了两个独立的三水平混合效应模型,分别采用数据集嵌套变化和参与者嵌套变化,以评估图形特征对(1)确定功能关系的信心和(2)治疗效果估计值的影响。我们在第 1 层纳入了纵坐标缩放和 DPPXYR,在第 2 层纳入了图形效应大小,包括所有交互作用。总体而言,图形处理始终不会影响对功能关系的信心。结果表明,图形处理对估计治疗效果的大小影响不一。研究结果将根据当前的文献进行阐述,并讨论对图表构建和未来研究的建议。
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引用次数: 0
A Description of Missing Data in Single-Case Experimental Designs Studies and an Evaluation of Single Imputation Methods. 描述单例实验设计研究中的缺失数据并评估单一估算方法。
IF 2.3 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2024-05-01 Epub Date: 2024-02-19 DOI: 10.1177/01454455241226879
Orhan Aydin

Missing data is inevitable in single-case experimental designs (SCEDs) studies due to repeated measures over a period of time. Despite this fact, SCEDs implementers such as researchers, teachers, clinicians, and school psychologists usually ignore missing data in their studies. Performing analyses without considering missing data in an intervention study using SCEDs or a meta-analysis study including SCEDs studies in a topic can lead to biased results and affect the validity of individual or overall results. In addition, missingness can undermine the generalizability of SCEDs studies. Considering these drawbacks, this study aims to give descriptive and advisory information to SCEDs practitioners and researchers about missing data in single-case data. To accomplish this task, the study presents information about missing data mechanisms, item level and unit level missing data, planned missing data designs, drawbacks of ignoring missing data in SCEDs, and missing data handling methods. Since single imputation methods among missing data handling methods do not require complicated statistical knowledge, are easy to use, and hence are more likely to be used by practitioners and researchers, the present study evaluates single imputation methods in terms of intervention effect sizes and missing data rates by using a real and hypothetical data sample. This study encourages SCEDs implementers, and also meta-analysts to use some of the single imputation methods to increase the generalizability and validity of the study results in case they encounter missing data in their studies.

在单例实验设计(SCEDs)研究中,由于在一段时间内重复测量,缺失数据是不可避免的。尽管如此,SCEDs 的实施者,如研究人员、教师、临床医生和学校心理学家,通常会在研究中忽略缺失数据。在使用SCEDs的干预研究中,或在包含SCEDs研究的专题荟萃分析研究中,如果不考虑缺失数据而进行分析,可能会导致结果偏差,影响个别或整体结果的有效性。此外,缺失也会影响 SCEDs 研究的可推广性。考虑到这些弊端,本研究旨在为 SCEDs 从业人员和研究人员提供有关单例数据缺失的描述性和咨询性信息。为了完成这项任务,本研究介绍了有关缺失数据机制、项目级和单位级缺失数据、计划缺失数据设计、SCEDs 中忽略缺失数据的弊端以及缺失数据处理方法的信息。由于缺失数据处理方法中的单一估算法不需要复杂的统计知识,易于使用,因此更容易被实践者和研究者使用,本研究通过使用真实和假设的数据样本,从干预效果大小和缺失数据率的角度对单一估算法进行了评估。本研究鼓励 SCEDs 实施者以及元分析人员在研究中遇到数据缺失时使用一些单一估算方法,以提高研究结果的可推广性和有效性。
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引用次数: 0
Functional Analysis of Contextually Inappropriate Social Behavior in Children With Down Syndrome. 唐氏综合症儿童不恰当社交行为的功能分析。
IF 2.3 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2024-05-01 Epub Date: 2024-01-18 DOI: 10.1177/01454455231222912
Sally M Izquierdo, Joshua Jessel, Theresa Fiani, Emily A Jones

Background: Children with Down syndrome often engage in contextually inappropriate social behavior, which researchers suggest may function to escape from difficult activities to preferred social interactions. Caregivers may reinforce the behavior, perceiving it only as evidence of the child's social strength, when, in fact, the pattern may also prevent or slow the development of critical skills. Unlike overt forms of challenging behavior, contextually inappropriate social behavior had never been subjected to experimental analysis.

Aims: The purpose of the current study was to identify and demonstrate functional control of contextually inappropriate social behavior to caregiver-informed contingencies.

Method and procedures: We interviewed caregivers and subjected contextually inappropriate social behavior to functional analyses for nine young children with Down syndrome.

Outcomes and results: We found sensitivity to the caregiver-informed contingencies for all nine participants with strong functional control and large effect sizes for most.

Conclusions and implications: Caregivers may not perceive contextually inappropriate social behavior as problematic, yet patterns of contextually inappropriate and other problem behaviors suggest decreased engagement and poor task persistence. Assessments that lead to intervention decisions may be more informative when they include questions about social topographies of behavior not typically considered as problematic. Once caregivers are aware of the pattern, they may be better prepared to intervene.

背景:研究人员认为,唐氏综合症患儿经常会做出与环境不相称的社交行为,这种行为可能是为了逃避困难的活动,而更喜欢社交互动。照顾者可能会强化这种行为,将其视为儿童社交能力的证明,而事实上,这种模式也可能会阻碍或减缓关键技能的发展。与公开形式的挑战行为不同,不适宜情境的社交行为从未接受过实验分析。研究目的:本研究的目的是识别并证明不适宜情境的社交行为对照顾者告知的应急措施的功能控制:我们采访了照顾者,并对九名患有唐氏综合症的幼儿的不恰当社交行为进行了功能分析:我们发现,所有九名参与者都对照顾者提供的应急措施很敏感,而且大多数人都有很强的功能控制能力和较大的效应大小:照顾者可能并不认为情境不恰当的社交行为是有问题的,但情境不恰当行为和其他问题行为的模式表明,参与度降低,任务持续性差。如果评估中包含有关通常不被视为有问题的行为的社会拓扑图的问题,则可为干预决策提供更多信息。一旦照护者意识到这种行为模式,他们就可以更好地进行干预。
{"title":"Functional Analysis of Contextually Inappropriate Social Behavior in Children With Down Syndrome.","authors":"Sally M Izquierdo, Joshua Jessel, Theresa Fiani, Emily A Jones","doi":"10.1177/01454455231222912","DOIUrl":"10.1177/01454455231222912","url":null,"abstract":"<p><strong>Background: </strong>Children with Down syndrome often engage in contextually inappropriate social behavior, which researchers suggest may function to escape from difficult activities to preferred social interactions. Caregivers may reinforce the behavior, perceiving it only as evidence of the child's social strength, when, in fact, the pattern may also prevent or slow the development of critical skills. Unlike overt forms of challenging behavior, contextually inappropriate social behavior had never been subjected to experimental analysis.</p><p><strong>Aims: </strong>The purpose of the current study was to identify and demonstrate functional control of contextually inappropriate social behavior to caregiver-informed contingencies.</p><p><strong>Method and procedures: </strong>We interviewed caregivers and subjected contextually inappropriate social behavior to functional analyses for nine young children with Down syndrome.</p><p><strong>Outcomes and results: </strong>We found sensitivity to the caregiver-informed contingencies for all nine participants with strong functional control and large effect sizes for most.</p><p><strong>Conclusions and implications: </strong>Caregivers may not perceive contextually inappropriate social behavior as problematic, yet patterns of contextually inappropriate and other problem behaviors suggest decreased engagement and poor task persistence. Assessments that lead to intervention decisions may be more informative when they include questions about social topographies of behavior not typically considered as problematic. Once caregivers are aware of the pattern, they may be better prepared to intervene.</p>","PeriodicalId":48037,"journal":{"name":"Behavior Modification","volume":" ","pages":"285-311"},"PeriodicalIF":2.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139486635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Characteristics of Missing Data in Single-Case Experimental Designs: An Investigation of Published Data. 单例实验设计中缺失数据的特征:对已发表数据的调查。
IF 2.3 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2024-03-01 Epub Date: 2023-11-17 DOI: 10.1177/01454455231212265
Orhan Aydin

Single-case experimental designs (SCEDs) have grown in popularity in the fields such as education, psychology, medicine, and rehabilitation. Although SCEDs are valid experimental designs for determining evidence-based practices, they encounter some challenges in analyses of data. One of these challenges, missing data, is likely to be occurred frequently in SCEDs research due to repeated measurements over time. Since missing data is a critical factor that can weaken the validity and generalizability of a study, it is important to determine the characteristics of missing data in SCEDs, which are especially conducted with a small number of participants. In this regard, this study aimed to describe missing data features in SCEDs studies in detail. To accomplish this goal, 465 published SCEDs studies within the recent 5 years in six journals were included in the investigation. The overall results showed that the prevalence of missing data among SCEDs articles in at least one phase, as at least one data point, was approximately 30%. In addition, the results indicated that the missing data rates were above 10% within most studies where missing data occurred. Although missing data is so common in SCEDs research, only a handful of studies (5%) have handled missing data; however, their methods are traditional. In analyzing SCEDs data, several methods are proposed considering missing data ratios in the literature. Therefore, missing data rates determined in this study results can shed light on the analyses of SCEDs data with proper methods by improving the validity and generalizability of study results.

单例实验设计(SCEDs)在教育、心理学、医学和康复等领域越来越受欢迎。尽管SCEDs是确定循证实践的有效实验设计,但它们在数据分析中遇到了一些挑战。其中一个挑战,数据丢失,可能经常发生在SCEDs研究中,因为随着时间的推移重复测量。由于缺失数据是削弱研究有效性和普遍性的关键因素,因此确定sced中缺失数据的特征非常重要,特别是在参与者较少的情况下进行的sced。在这方面,本研究旨在详细描述SCEDs研究中缺失的数据特征。为了实现这一目标,调查纳入了近5年来在6种期刊上发表的465篇SCEDs研究。总体结果显示,SCEDs文章中至少一个阶段(至少一个数据点)缺失数据的发生率约为30%。此外,结果表明,在大多数发生数据缺失的研究中,数据缺失率都在10%以上。虽然数据缺失在SCEDs研究中很常见,但只有少数研究(5%)处理了数据缺失;然而,他们的方法是传统的。在分析SCEDs数据时,提出了几种考虑文献中缺失数据比率的方法。因此,本研究结果确定的缺失数据率可以通过提高研究结果的有效性和可推广性,为采用合适的方法分析SCEDs数据提供启发。
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引用次数: 0
Individualized Parent-Mediated Behavioral Treatment for Challenging Behavior: A Program Description. 针对挑战行为的个性化父母中介行为治疗:项目描述。
IF 2.3 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2024-03-01 Epub Date: 2023-10-20 DOI: 10.1177/01454455231201957
Nadrat N Nuhu, Colin Muething, Scott E Gillespie, Joanna Lomas Mevers, Mindy Scheithauer

Past research suggests behavioral treatments are effective for challenging behavior in children and young adults with neurodevelopmental disorders, such as autism spectrum disorder (ASD). However, access to these services can be limited and require substantial resources. To address this issue, the current study provides a programmatic description of an individualized parent-mediated service model targeting moderate challenging behavior. In the program, therapists coached parents to implement functional analyses and individualized function-based treatment packages. Forty-one families of children and young adults with neurodevelopmental disorders participated. Most clients (75.6%) met all admission treatment goals and parents reported significant decreases in frequency and severity of challenging behaviors at discharge. Parents also reported less stress at discharge. Outcomes of the study suggest this parent-mediated treatment model is a viable option to treating moderate challenging behavior in children and young adults with intellectual and developmental disorders.

过去的研究表明,行为治疗对患有神经发育障碍(如自闭症谱系障碍)的儿童和年轻人的挑战性行为有效。然而,获得这些服务的机会可能有限,需要大量资源。为了解决这个问题,目前的研究提供了一个针对中度挑战行为的个性化父母中介服务模型的程序描述。在该项目中,治疗师指导家长进行功能分析和个性化的基于功能的治疗包。41个患有神经发育障碍的儿童和年轻人家庭参加了活动。大多数客户(75.6%)达到了所有入院治疗目标,家长报告出院时挑战性行为的频率和严重程度显著降低。家长们也报告说,出院时压力较小。研究结果表明,这种父母介导的治疗模式是治疗患有智力和发育障碍的儿童和年轻人的中度挑战性行为的可行选择。
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引用次数: 0
Consistent Visual Analysis of Multielement Data: A Preliminary Evaluation. 多元素数据的一致视觉分析:初步评估
IF 2.3 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2024-03-01 Epub Date: 2024-01-11 DOI: 10.1177/01454455231212263
Margaret R Gifford, Jeffrey H Tiger, Michael J Harman, Kendall M Kastner

Experimenters provided 33 graphical displays of hypothetical data depicted in a multielement experimental design to editorial board members of prominent, applied, behavior-analytic journals via an online survey. For each display, participants indicated (a) the presence or absence of experimental control and (b) the degree of experimental control (rated on a 1-100 scale). Each depiction varied systematically in (a) the number of data paths, (b) the number of data paths elevated above the control, (c) the mean difference between affected data paths and control conditions, and (d) the degree of variability within conditions. Correspondence among experts' ratings of experimental control was high across all presented graphical displays, supporting the reliability of visual analysis as an evaluative tool for these designs.

实验人员通过在线调查向著名应用行为分析期刊的编委提供了 33 幅多元素实验设计中的假设数据图表。对于每幅图,参与者都要指出:(a) 是否存在实验控制;(b) 实验控制的程度(按 1-100 分制评分)。每种描述都在以下方面存在系统性差异:(a) 数据路径的数量,(b) 高于对照的数据路径的数量,(c) 受影响数据路径与对照条件之间的平均差异,以及 (d) 条件内的可变性程度。在所有显示的图形中,专家们对实验控制的评分对应性都很高,这支持了视觉分析作为这些设计的评估工具的可靠性。
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引用次数: 0
A Meta-Analysis of Treatment for Self-Injurious Behavior in Children and Adolescents With Intellectual and Developmental Disabilities. 智力和发育障碍儿童和青少年自伤行为治疗的元分析》(Meta-Analysis of Treatment for Self-Injurious Behavior in Children and Adolescents With Intellectual and Developmental Disabilities)。
IF 2.3 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2024-03-01 Epub Date: 2024-01-10 DOI: 10.1177/01454455231218742
Timothy R Moore, Seunghee Lee, Rachel Freeman, Maryam Mahmoundi, Adele Dimian, Amy Riegelman, Jessica J Simacek

Self-injurious behavior (SIB) among children and youth with developmental disabilities has not diminished in prevalence despite the availability of effective interventions, and the impact on quality of life for people and their families is devastating. The current meta-analysis reviews SIB intervention research between 2011 and 2021 using single-case experimental designs with children and youth up to 21 years old and provides a quantitative synthesis of data from high-quality studies including moderator analyses to determine effects of participant and study characteristics on intervention outcomes. Encouraging findings include a high level of effectiveness across studies in the decrease of SIB (Tau-U = -0.90) and increase of positive behavior (Tau-U = 0.73), as well as an increase in studies (relative to prior reviews) reporting intervention fidelity, generalization, maintenance, and social validity. However, our findings shed limited light on potential moderating variables in the development of interventions for children and youth who exhibit SIB. Of the potential moderators of intervention effects, only implementer (researcher/therapist vs. parent/caregiver) and setting (clinic vs. home) were significantly associated with improved outcomes. We discuss the need for more robust involvement of natural communities of implementers in SIB intervention research to better equip them to effectively and sustainably meet the needs of people they care for. We also discuss the importance of creating systems enabling broad access for children with SIB to effective interventions in service of reducing burden for people, families, and society over time.

尽管存在有效的干预措施,但发育障碍儿童和青少年的自伤行为(SIB)发生率并没有降低,这对患者及其家人的生活质量造成了毁灭性的影响。当前的荟萃分析回顾了 2011 年至 2021 年间针对 21 岁以下儿童和青少年的单案例实验设计的 SIB 干预研究,并对高质量研究的数据进行了定量综合,包括确定参与者和研究特征对干预结果影响的调节分析。令人鼓舞的发现包括:在减少 SIB(Tau-U = -0.90)和增加积极行为(Tau-U = 0.73)方面,各项研究的有效性都很高,而且(相对于之前的综述)报告干预忠实性、普遍性、维持性和社会有效性的研究有所增加。然而,我们的研究结果对针对表现出 SIB 的儿童和青少年制定干预措施的潜在调节变量的启示有限。在干预效果的潜在调节因素中,只有实施者(研究人员/治疗师与家长/照顾者)和环境(诊所与家庭)与干预效果的改善显著相关。我们讨论了让自然社区的实施者更积极地参与到 SIB 干预研究中的必要性,以使他们能够更好地有效、可持续地满足他们所照顾的人的需求。我们还讨论了建立相关系统的重要性,这些系统可使SIB患儿广泛获得有效的干预措施,从而长期减轻患者、家庭和社会的负担。
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引用次数: 0
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Behavior Modification
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