Evidence-Based Practice using a Single-Subject Experimental Design Contact Information Susie Bartolome Peterson, CScD., CCC-SLP Doctor of Clinical Science Susie Bartolome Peterson, CScD., CCC-SLP Certified Speech-Language Pathologist Parker Adventist Hospital ••• Rocky Mountain University of Health Professions [email protected]

Introduction Components Types of SSED SSED Example of SSED Research studies involving single-subject experimental designs (SSED) have an • important role in the pursuit of evidence-based practice and are an important resource Identify the behavior in clinical practice. Although randomized controlled trials (RCTs) may hold the “gold to be changed standard”, they may not be feasible, available, or timely. Unlike large-scale studies • Identify the variables that may exclude patient conditions, SSED can be individualized and include patients - independent variable with multiple issues. Thus research using SSEDs can be found in many disciplines (IV), the intervention & such as psychology, speech-language pathology, physical therapy, nursing and occupational therapy. - dependent variable (DV), the behavior to be Objectives: measured.
To familiarize clinicians with single-subject experimental designs (SSEDs). •
To provide a research example to demonstrate how SSEDs can be conducted in a Select design/type clinical setting to contribute towards evidence-based practice. • Repeated measures: collect continuous data before (baseline A), What is SSED? during (intervention B) and after treatment (A) There are two approaches to experimental research: • Data analysis FIG. 1: 6 Types of SSED (Byiers, Reichle & Symons, 2012). Experimental Research Advantages of SSED

 experimental design to identify the effectiveness of specific treatments or the Group Designs Single-Subject Experimental Design viability of treatments in real-life settings  can be individualized and include patients with multiple issues making them  Ideally n = >12 participants per group  n = 1 participant to 6+ participants ideal for clinical applications Group Designs Single-Subject Experimental Design (SSED)  can be easily incorporated into clinical practice  two groups - control group and  the research participant serves as own control  can be conducted during scheduled therapy sessions in the clinic experimental group; such as RCT  variables are manipulated and the effect of  does not need a large number of participants to conduct.  a group with a random selection of the independent variable (IV) on the participants from a larger population dependent variable (DV) is measured. Discussion and Conclusions What SSED is Not SSED is also known as: Evidence-based research should drive clinical practice. However, research is not commonly being conducted in the clinical settings, • Literature Is not one of the following single-subject Time Series Design despite the fact that research studies can benefit from the descriptive designs: • Within-Subject Design Barlow, D. H., & Hersen, M. (1973). Single case experimental designs: Uses in applied clinical research. Archives of General Psychiatry , 29, 319–325. • Diary study (only has A phase = baseline) • participation of clinicians and draw from their clinical experiences and Byiers, B., Reichle, J., & Symons, F. (2012). Single-subject experimental design for evidence-based practice. American Journal of Speech-Language Pathology , 21, 397–414 Small N Research Design Gast, D. L., & Ledford, J. R., (2014). Single case research methodology: Applications in special education and behavioral sciences (2nd ed.). New York, NY: Routledge. • Treatment-only Case study (has B phase) • insight. With clinical research support and the use of single-subject • Case study with baseline and treatment, Single-Case Experimental Design Peterson, S. B., Simpson, K. O. & Lucker, J. R. (2016). Effect of Interactive Metronome on understanding spoken language in adults with auditory comprehension impairments. but no control (A- B phases) • Experimental Analysis of Behavior experimental designs (SSEDs), clinicians in non-research or non- Unpublished Capstone, Rocky Mountain University of Health Professions. Provo, Utah. • Pre-experimental design (A – B phases) • Single-Subject Repeated Measures Design academic settings can participate and conduct research. Portney, L. & Watkins, M. (2009 ). Foundations of clinical research: Applications to practice (3rd ed.). Upper Saddle River, NJ: Pearson Prentice Hall. Ward-Horner, J., & Sturmey, P. (2010). Component analyses using single-subject experimental designs: A review. Journal of Applied Behavior Analysis , 43, 685–704.