Master of Science

thesisThe current study compared the efficacy of video-based social skills instruction for children with autism to traditional didactic instruction of social skills. The study consisted of two separate social skills groups. Two children with Autism Spectrum Disorder (ASD) and two typically developing same-aged peers were included in an experimental group that received video-based social skills instruction. Two other children with ASD and 2 additional typically developing same-aged peers were included in the group that received traditional didactic social skills instruction. The social skills lessons were taught twice per week for 8 weeks. Generalization probes of social interaction during free play time were conducted during analog free time intervals for each child with autism. At the end the program, effect sizes and PND were calculated to examine differences in the amount of social interaction during free time periods for the two groups, and pre- and postmeasures of social responsiveness were compared

An Evaluation of a Teaching Interaction Procedure Implemented in a Recess Setting

The teaching interaction procedure (TIP) is a strategy that has been demonstrated as effective in promoting social skill acquisition in school settings for young students with social communication deficits (Leaf et al., 2009; Leaf et al., 2010). However, a frequently cited criticism of social skills training is the lack of generalizability of target skills to novel contexts (Bellini et al., 2007). The purpose of the study was to evaluate a TIP-based social skills intervention conducted on the playground, intended to promote generalizability through training in naturalistic settings and to evaluate generalizability of skill acquisition to the classroom. Eight students 5-8 years old with an educational classification of autism or developmental delay participated in the study. The primary dependent variable was skill acquisition in the playground setting, and a secondary measure was generalized skill acquisition to the classroom setting. Target skills included appropriate body language, participation, and responding to initiations. A multi-probe design embedded within a multiple baseline design across target skills with concurrent replication across participants was used to evaluate the primary and secondary measures. Overall, results suggest that increases in skill acquisition were observed during implementation of the TIP across most participants and skills in both training and generalization phases. However, substantial variability was noted across participants related to maintaining skill acquisition during maintenance and follow-up phases in both the training and generalization settings. Limitations of these results are discussed as well as implications for school practitioners

Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial

Background: The EMPA KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. Methods: EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. Findings: Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5–2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62–0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16–1·59), representing a 50% (42–58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). Interpretation: In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. Funding: Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council

Antecedent Strategies to Promote Children\u27s and Adolescents\u27 Compliance with Adult Requests: A Review of the Literature

Compliance with adult requests and directives has often been described as a keystone behavior in children, meaning it is associated with engagement in other desirable and socially appropriate behaviors. As such, a great deal of research has been directed toward identifying strategies that increase compliance in children. Antecedent strategies, which focus on increasing the probability of compliance prior to or during the delivery of the directive or request, are popular because they have the potential to prevent noncompliance; however, it is not clear which of the numerous antecedent strategies are effective or for whom. Therefore, a systematic review of the antecedent strategies for compliance was completed. Forty-two studies were identified evaluating eight different antecedent strategies for children aged 1-19. It was determined that high-probability command sequences, effective instruction delivery, and errorless compliance training may all be considered evidence-based antecedent strategies to increase children\u27s compliance with adult requests

Toward a Standard Assembly of Linear Graphs

© 2017 American Psychological Association. Single-case data are frequently used in school psychology. In research, single-case designs allow experimenters to provide rigorous demonstrations of treatment effects on a smaller scale and with more precise measurement than traditional group experimental design. In practice, single-case data are used to evaluate the effects of school-based services to make decisions at the individual level within a multitiered system of support (MTSS). School psychology and related fields (e.g., special education) have worked to increase the rigor of single-case data by developing standards for single-case experimental design and developing robust single-case effect size statistics; however, in practice, single-case data are often collected with less experimental rigor and evaluated using visual analysis of a linear graph as opposed to quantitative effect sizes. This is concerning, as an emerging body of literature suggests that simple elements of the graphical display (e.g., ordinate axis scaling, ratio of X to Y axis length) can have a profound impact on effect size judgments made by visual analysts. Currently, there are no standards guiding the construction of linear graphs used to display single-case data. The purpose of this paper is to advance the perspective that our field must develop and adopt standards of linear graph construction or risk inaccurate decisions within a MTSS framework

The Impact of Ordinate Scaling On the Visual Analysis of Single-Case Data

Visual analysis is the primary method for detecting the presence of treatment effects in graphically displayed single-case data and it is often referred to as the “gold standard.” Although researchers have developed standards for the application of visual analysis (e.g., Horner et al., 2005), over- and underestimation of effect size magnitude is not uncommon among analysts. Several characteristics have been identified as potential contributors to these errors; however, researchers have largely focused on characteristics of the data itself (e.g., autocorrelation), paying less attention to characteristics of the graphic display which are largely in control of the analyst (e.g., ordinate scaling). The current study investigated the impact that differences in ordinate scaling, a graphic display characteristic, had on experts\u27 accuracy in judgments regarding the magnitude of effect present in single-case percentage data. 32 participants were asked to evaluate eight ABAB data sets (2 each presenting null, small, moderate, and large effects) along with three iterations of each (32 graphs in total) in which only the ordinate scale was manipulated. Results suggest that raters are less accurate in their detection of treatment effects as the ordinate scale is constricted. Additionally, raters were more likely to overestimate the size of a treatment effect when the ordinate scale was constricted

School-Based Social Skills Training for Preschool-Age Children with Autism Spectrum Disorder

Individuals with autism spectrum disorder display impairments in social interactions and communication that appear at early ages and result in short- and long-term negative outcomes. As such, there is a need for effective social skills training programs for young children with autism spectrum disorder—particularly interventions capable of being delivered in educational settings. The study evaluated the effects of the Superheroes Social Skills program on accurate demonstration of social skills in young children with autism spectrum disorder. Two preschool-age children with autism spectrum disorder participated in a weekly social skills intervention. A multiple probe design across skills was used to determine the effects of the intervention. Both participants demonstrated substantial improvements in skill accuracy. Social skills checklists also indicated improvements in social functioning over baseline levels

Utilization of Superheroes Social Skills To Reduce Disruptive and Aggressive Behavior

The current pilot study investigated the effectiveness of the Superheroes Social Skills program in decreasing disruptive and aggressive behavior of elementary-age students with high-incidence disabilities. Six students in a self-contained classroom, identified as displaying high rates of disruptive and aggressive behavior toward peers, were included in the study. Social skills training was presented over 10 lessons that targeted instructional control and turn taking skills. Results indicate immediate improvements in disruptive and aggressive behavior. Additionally, follow-up observations revealed maintenance of intervention effects. Sociometric data were collected, with all participants increasing in social network salience. Although use of an ABC design resulted in limited experimental control, preliminary results indicate that the Superheroes Social Skills program may be useful for addressing disruptive and aggressive behaviors