etadd_46(4) - Division on Autism and Developmental Disabilities
etadd_46(4) - Division on Autism and Developmental Disabilities
etadd_46(4) - Division on Autism and Developmental Disabilities
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2008), <strong>and</strong> increasing adaptive behavior (e.g.,<br />
Cannella-Mal<strong>on</strong>e et al., 2009; Harding et al.).<br />
Third, a functi<strong>on</strong>al relati<strong>on</strong> is dem<strong>on</strong>strated<br />
between the treatment <strong>and</strong> resulting change<br />
in the target behavior. Thirteen studies <strong>on</strong> the<br />
effects of choice interventi<strong>on</strong>s <strong>on</strong> behavior are<br />
present across the current review (Cannella et<br />
al., 2005; Lanci<strong>on</strong>i et al., 1996) with positive<br />
results. Positive in all three reviews indicated<br />
that the provisi<strong>on</strong> of choice led to a change in<br />
behavior indicating a functi<strong>on</strong>al relati<strong>on</strong>. In<br />
the current review, 12 out of 13 studies implemented<br />
a single subject experimental design<br />
that dem<strong>on</strong>strated a functi<strong>on</strong>al relati<strong>on</strong>.<br />
Three studies implemented a multiple baseline<br />
design (Cannella-Mal<strong>on</strong>e et al., 2009;<br />
Carls<strong>on</strong> et al., 2008; Sigafoos et al., 2005)<br />
where experimental c<strong>on</strong>trol is dem<strong>on</strong>strated<br />
when <strong>and</strong> <strong>on</strong>ly when the interventi<strong>on</strong> is implemented.<br />
Four studies implemented a reversal<br />
design (Harding et al., 2005; Harding et<br />
al., 2009; Humenik et al., 2008; Tasky et al.,<br />
2008) in which experimental c<strong>on</strong>trol is dem<strong>on</strong>strated<br />
when a behavior change is observed<br />
when <strong>and</strong> <strong>on</strong>ly when the interventi<strong>on</strong> is implemented,<br />
<strong>and</strong> when the interventi<strong>on</strong> is withdrawn,<br />
the target behavior returns to previously<br />
observed levels without treatment. Two<br />
studies implemented an alternating treatments<br />
design (S<strong>on</strong> et al., 2006; Spevack et al.,<br />
2005) <strong>and</strong> <strong>on</strong>e implemented a multielement<br />
design (Reed et al., 2009). In these designs,<br />
experimental c<strong>on</strong>trol is dem<strong>on</strong>strated when<br />
<strong>on</strong>e data path increases or decreases to a<br />
greater degree than the other independent<br />
variables tested. Finally, two used multiple experimental<br />
designs (Hoch et al., 2002; Sigafoos<br />
et al., 2009) to dem<strong>on</strong>strate experimental<br />
c<strong>on</strong>trol.<br />
Fourth, experimental c<strong>on</strong>trol was dem<strong>on</strong>strated<br />
across a sufficient range of studies,<br />
researchers, <strong>and</strong> participants. In the current<br />
review, nine of the thirteen studies focusing<br />
<strong>on</strong> choice interventi<strong>on</strong>s did not have overlapping<br />
first authors. That is, the first author of a<br />
study did not appear again in the literature<br />
search as first author <strong>on</strong> another study. Of<br />
these nine studies, results were positive for<br />
eight <strong>and</strong> negative for <strong>on</strong>e. The eight studies<br />
with positive results included a total of 16<br />
individuals with various severe to profound<br />
disabilities, including traumatic brain injury<br />
(Tasky et al., 2008), autism (Carls<strong>on</strong> et al.,<br />
2008), <strong>and</strong> developmental disabilities (Sigafoos<br />
et al., 2009).<br />
Lastly, practices were not implemented with<br />
documented fidelity. Studies included in the<br />
current review did not include data <strong>on</strong> treatment<br />
integrity, limiting support for choice interventi<strong>on</strong>s<br />
to be c<strong>on</strong>sidered an evidencebased<br />
practice. Although a functi<strong>on</strong>al relati<strong>on</strong><br />
was dem<strong>on</strong>strated in the majority of studies—<br />
indicating the treatment was resp<strong>on</strong>sible for<br />
the behavior change—the extent to which the<br />
treatment was implemented as it was outlined<br />
should be viewed with some cauti<strong>on</strong>.<br />
Horner et al. (2005) suggested a criteri<strong>on</strong><br />
of five single-subject studies with acceptable<br />
experimental c<strong>on</strong>trol, across at least three different<br />
researchers, <strong>and</strong> at least 20 participants<br />
across the five studies. Although treatment<br />
integrity data is lacking, the four other criteria<br />
have clearly been met, suggesting that choice<br />
interventi<strong>on</strong>s can be c<strong>on</strong>sidered an evidencebased<br />
practice for individuals with severe to<br />
profound disabilities as defined by Horner et<br />
al.<br />
In additi<strong>on</strong> to the support for choice interventi<strong>on</strong>s<br />
to be c<strong>on</strong>sidered an evidence-based<br />
practice, the findings <strong>on</strong> preference assessments<br />
also have practical implicati<strong>on</strong>s for the<br />
assessment of preferred stimuli <strong>and</strong> the guidance<br />
of interventi<strong>on</strong>s to encourage more independence<br />
<strong>and</strong> involve the individual in<br />
treatment implementati<strong>on</strong>. For example,<br />
Hanley et al. (2005) assessed preference for<br />
treatment comp<strong>on</strong>ents in a functi<strong>on</strong>al communicati<strong>on</strong><br />
training (FCT) package using a<br />
c<strong>on</strong>current chains procedure. Participants<br />
dem<strong>on</strong>strated a clear preference for the treatment<br />
package that included FCT <strong>and</strong> punishment<br />
over the package that c<strong>on</strong>sisted of FCT<br />
<strong>and</strong> extincti<strong>on</strong>. These data indicated that<br />
treatment selecti<strong>on</strong> may be guided empirically<br />
while still taking the individual’s treatment<br />
preference into account.<br />
One of the most significant areas where<br />
preference assessments <strong>and</strong> choice interventi<strong>on</strong>s<br />
may be useful is in implementing quality<br />
services for individuals with severe to profound<br />
disabilities. Cannella et al. (2005) suggested<br />
the use of preference assessments <strong>and</strong><br />
choice interventi<strong>on</strong>s as an aid to guide the IEP<br />
process <strong>and</strong> enhance pers<strong>on</strong>-centered planning.<br />
Current research, though still applicable<br />
to a younger student populati<strong>on</strong>, may also<br />
588 / Educati<strong>on</strong> <strong>and</strong> Training in <strong>Autism</strong> <strong>and</strong> <strong>Developmental</strong> <strong>Disabilities</strong>-December 2011