Changing-Criterion Designs: An Alternate Applied Behavior Analysis Pro

Table Of Content

• CCD Design Characteristics
• Some methodological considerations in the design and implementation of behavior therapy research
• Who provides ABA services?
• Single case design: A critique of methodology and analysis of recent trends
• Some current dimensions of applied behavior analysis.
• What is Applied Behavior Analysis?

Phase magnitude was varied in just under half of the studies (45.7 %) and less than half of those varied magnitude two or more times between criterions (22.1 %). Approximately 85 studies (31.8 %) varied both phase length and magnitude once or more, 101 (37.8 %) varied either length or magnitude at least once, and 15 (5.6 %) did not vary either. The majority of studies used a simple AB design (63.0 %) with a small percentage using a baseline only (4.9 %), a reversal ABAB (8.3 %), a withdrawal ABA (3.4 %), or another design (21.0 %). A combination utilizing the multiple baseline design across behaviors was the most frequently encountered. Approximately 414 participants were children (45.7 %), 63 were adults (6.9 %), 3 studies with 169 participants had both child and adult age ranges (18.7 %), and 4 studies with 260 participants did not report age (28.7 %).

CCD Design Characteristics

It is vital that parents or guardians of children suspected of having an ASD seek early diagnosis and care for the child to increase any potential benefits of treatment. The recommendations for evaluation and assessment of ASD as published by the American Academy of Pediatrics (Zwaigenbaum, 2015b), and the American Academy of Child and Adolescent Psychiatry (Volkmar, 2014) are resources that can be utilized. Remember that you play an important role in making choices about the setting or provider from which your child receives services.

Some methodological considerations in the design and implementation of behavior therapy research

The magnitude of each phase should be based on responding in the previous sub-phase and professional judgment. Thus, when restricted responding is in place it is not representative of the individual’s ability and does not lead the experimenter or therapist to an appropriate criterion shift. If a criterion is shifted five data points up to increase a behavior, experimental control is demonstrated when responding increases. If the individual meets their desired outcome almost immediately after intervention implementation and is able to maintain that goal, the inappropriate intervention was used and a poor assessment of the individual’s capability and or motivation was conducted. Thus, improvements in areas such as cognition may be misleading, because both improvements on specific tasks and improvements on full-scale cognitive assessments were scored as improvements in the cognitive outcome category (Grow et al., 2011; Howard et al., 2005). In addition, some of the outcome measures had considerable overlap in definitions, such as the cognition, language, social/communication, and adaptive behavior categories, thus potentially resulting in the coding of multiple outcome measures for a similar task.

Who provides ABA services?

The effect of ABA is defined as the measurable changes in a participant's various outcomes as a result of receiving ABA intervention. The review comprised a database search, as well as a reference search of selected reviews. A second phase of the literature search was conducted to update the sample to reflect more recent literature. A guiding document by Tricco et al. (2016) was used for direction and as a reference for conducting this review. The ensuing amount of scientific evidence has resulted in ABA being considered a “best practice” and thus endorsed by the governments of Canada and the United States for the treatment of children and youth with ASD (Government of Canada, 2018; U.S. Department of Health & Human Services, 1999).

Single case design: A critique of methodology and analysis of recent trends

Seventy-six percent of study records had participants with only ASD, and 24% had participants in the mixed-diagnoses category. The database searches yielded a total of 2,074 entries after import to Mendeley®, and 874 entries from selected reviews and secondary reviews. Ten systematic reviews were identified and investigated for the literature search (Brunner & Seung, 2009; Dawson & Bernier, 2013; Makrygianni et al., 2018; Mohammadzaheri et al., 2015; Reichow et al., 2014, 2018; Rodgers et al., 2020; Shabani & Lam, 2013; Spreckley & Boyd, 2009; Virués-Ortega, 2010).

Some current dimensions of applied behavior analysis.

Improvement was recorded 85% and 67% of the time, respectively, for these outcomes. Among records looking at only males, language was the most studied outcome at 26%, followed by cognitive and social/communication at 21% each. Among publications with mixed sexes, the most studied outcome measures were language (25%), cognitive (22%), and social/communication (21%). Pilot data revealed articles varied in the use of the changing criterion as a level of performance expected and or level of performance given differing tasks or materials. Level of performance expected refers to direct calculations of the behavior (e.g., number of cigarettes smoked per day, percent of questions completed) whereas in cases where differing tasks or materials were present for criterions the level of performance expected did not necessarily vary. To clarify, in a study conducted by Schleien et al. (1981), two adults with severe handicaps were part of a procedure to hit the dartboard with darts.

In 24.0 % of studies, an intervention that utilized neither reinforcement nor punishment contingencies was used. No range-bound and distributed-criterion design data were observed, and articles describing those variations (McDougall 2005, 2006) referenced research not yet published. Federal and State law, as well as contract language, and Medical Policy take precedence over Clinical UM Guidelines. We reserve the right to review and update Clinical UM Guidelines periodically.

The current scoping review spanning 770 study records showed positive and beneficial effects of ABA for children with ASD across seven outcome measures. However, only 32 (4%) assessed ABA impact, had a comparison group, and did not rely on mastery of specific skills to mark improvement. The entire cohort of records explored had few occurrences of RCTs, the “gold standard” of research. In the interest of identifying a subset of more rigorous records, a three-step filter was conducted (Fig. ​(Fig.5).5). This was not a formal assessment of study quality, but rather a way to identify the proportion of investigated studies with several specific characteristics. After removing the section of studies looking at Comparisons of ABA Techniques, as well as any studies assessing mastery or criterion, and following with a filter for any inclusion of a comparison to control or other intervention, 32 study records (4%) remained out of 770.

What is Applied Behavior Analysis?

The changing criterion design (CCD) has been a recognized format of single-case research for four decades. Published examples of the CCD have been limited and the structure of the design used in the literature has varied to a degree that might engender confusion. This review examines the structure of CCD studies published to date to identify prior implementation practices and identify best practices for future use. The DSM-5-TR (2022) describes the essential diagnostic features of ASD as both a persistent impairment in reciprocal social communication and restricted and repetitive pattern of behavior, interest or activities. These attributes are present from early childhood and limit or impair everyday functioning. Parents may note symptoms as early as infancy, and the typical age of onset is before 3 years of age.

This guideline is to be applied to the extent there is a state mandate or specific benefit coverage for an Adaptive Behavioral Treatment (ABT) such as Intensive Behavioral Intervention (IBI) or Applied Behavioral Analysis (ABA). Essentially, the approach is based on the scientific finding that behaviors that are reinforced will increase, while those not reinforced will decrease and eventually disappear. Treatment, then, becomes about identifying and reinforcing helpful behaviors—and not reinforcing those that cause harm. Please see our insurance resources for more information about insurance and coverage for autism services. The learner receives no reinforcement for behaviors that pose harm or prevent learning.

The Between-Groups Comparisons section had the highest median number of participants at 34, and the largest variation in the number of samples with an interquartile range (IQR) of 37. The entire cohort, ABA Impact section and Comparisons of ABA Techniques section each had a median number of 3 and an IQR of 1, respectively. The earliest publication reviewed was from 1977 and the most recent from 2020. When the diagnostic criteria were narrowed to focus primarily on ASD, articles that contained only non-ASD diagnoses were excluded.

When observing outcome measures by age group (see Appendix 5, Table S4), among study records conducted with participants between ages 0–5 years, cognitive, language, and social/communication were the most commonly studied outcomes, at 22%, 23%, and 23% respectively. Meanwhile, for ages 6–12, problem behavior and language were the most commonly studied outcomes at 25% each. For ages 13–18, the most commonly studied outcome was cognitive (26%), followed by adaptive behavior (20%).