Evidence-Based Diagnostic Treatment and Treatment Planning for Adult Stuttering: A Case Study

2012 ◽  
Vol 22 (2) ◽  
pp. 70-87
Author(s):  
Lee W. Ellis ◽  
Svetlana A. Beltyukova
Keyword(s):  
Treatment Planning ◽  
Treatment Process ◽  
Self Management ◽  
Single Subject ◽  
Evidence Based ◽  
Single Subject Design ◽  
Self Evaluation ◽  
Time Out ◽  
Treatment Procedures

This case study describes and evaluates an approach to diagnostic treatment and treatment planning that incorporates principles of evidence-based practice and findings from recent research on efficacious treatments of stuttering. A 22-year-old woman with severe stuttering participated in eight diagnostic treatment sessions in which experts used a simplified ABA single-subject design to assess effects of treatment procedures on her stuttering. Professionals selected treatment procedures based on available evidence regarding the procedures, the clinician’s experience with the procedures, and the client’s preferences. They assessed treatment procedures such as prolonged speech, smooth speech, regulated breathing, self-imposed time out, cancellation and speech using the SpeechEasy. Researchers measured the patient’s outcomes using a measure of stuttering frequency, client self-ratings of stuttering severity, naturalness, rate and effectiveness, and the client’s summary of her overall impressions about the procedures. Researchers analyzed stuttering frequency and client self-ratings using visual inspection and Rasch analysis. Analyzing results, researchers found major differences in the client’s responsiveness to the various treatment procedures. The diagnostic treatment process, which emphasized aspects of client self-evaluation and self-management, helped the client reach conclusions about treatment on her own. The client report measures and simplified ABA format in this study seemed adequate for helping to document differential effects of the treatment procedures and to facilitate treatment planning. Findings support further clinical application and research using this evidence-based approach to diagnostic treatment and treatment planning.

PENERAPAN TEKNIK SELF MANAGEMENT TERHADAP KEPATUHAN BEROBAT PENDERITA HIV DI YOGYAKARTA

2017 ◽  
Vol 16 (1) ◽  
Author(s):  
Yuliati Hasanah
Keyword(s):  
Medication Adherence ◽  
Behavioral Approach ◽  
Self Management ◽  
Single Subject ◽  
Single Subject Design ◽  
Self Monitoring ◽  
Self Evaluation ◽  
Subject Design ◽  
Management Techniques ◽  
The Subject

Abstract Self management is a strategy in which the cognitive behavioral approach in the application, subject to the expected full attendance during the intervention process. NAP is an HIV patient and had undergone antiretroviral therapy. Saturation, fatigue experienced by NAP during the ARV therapy, so found some times subject medical leave provisions. Healthy behavior in a sick person (in this case a person suffering from HIV) one of which is adherent to treatment that must be endured. This research aims to gain result the applying of self management techniques against medication adherence of NAP patient with HIV in the Balai Rehabilitasi Sosial Pamardi PutraYogyakarta. This study focuses on the application of self-management techniques that include self-monitoring, self reinforcement and self evaluation of medication adherence that includes aspects of belief, accept and act on the subject. Researchers used quantitative approach by using the method of single subject design N = 1 model A-B-A now where the measurements and observations made in each phase. The subject in this study as many as one person with initials NAP. The purpose of this study is to look at the effect of applying the self management technique against NAP’s medication adherence. The results of this study indicate that the application of self-management techniques have a positive effect in improving NAP’s medication adherence with skor of 2SD smaller than skor of the mean phase difference A2 and A1. Stages through the application of this technique is extracting and determining value, set goals, formulate an action plan, the implementation of self-monitoring, self reinforcement and self evaluation. Based on the analysis of the results of the study concluded that the motivation, participation and discipline will determine the effectiveness of the intervention. Support of family members is also important to support the commitment of the subjects in this therapy.Keywords: behavior modification, HIV, medication adherence, self-management AbstrakManusia dapat memutuskan dan menentukan dirinya sendiri. Berdasarkan asumsi tersebut teknik self management merupakan salah satu teknik modifikasi perilaku yang memfokuskan pada regulasi diri. Self management merupakan salah satu strategi dalam pendekatan perilaku kognitif dimana dalam penerapannya, subjek diharapkan kehadiran penuh selama proses intervensi. NAP adalah seorang penderita HIV dan telah menjalani terapi ARV. Kejenuhan, kelelahan dialami NAP selama mengikuti terapi ARV, sehingga ditemukan beberapa kali subjek meninggalkan ketentuan-ketentuan medis. Perilaku sehat pada orang sakit (dalam kasus ini seseorang yang menderita HIV) salah satunya adalah patuh terhadap pengobatan yang harus dijalani. Penelitian ini bertujuan untuk memperoleh hasil dari penerapan teknik self management terhadap kepatuhan berobat subjek NAP sebagai penderita HIV di Balai Rehabilitasi Sosial Pamardi Putra Yogyakarta. Penelitian ini menitikberatkan pada penerapan teknik self management yang mencakup self monitoring, self reinforcement dan self evaluation terhadap kepatuhan berobat yang mencakup aspek mempercayai (belief), menerima (accept) dan tindakan (act) pada subjek. Peneliti menggunakan pendekatan kuantitatif dengan menggunakan metode single subject design N=1 dengan model A-B-A dinama pengukuran dan pengamatan dilakukan di setiap fase. Subjek dalam penelitian ini sebanyak satu orang dengan inisial NAP. Tujuan penelitian ini adalah untuk melihat pengaruh penerapan teknik self management terhadap kepatuhan berobat subjek NAP. Hasil penelitian ini menunjukkan bahwa penerapan teknik self management mempunyai pengaruh positif dalam meningkatkan kepatuhan berobat subjek NAP dengan nilai 2SD lebih kecil dari selisih mean fase A2 dan A1. Tahapan yang dilalui dalam penerapan teknik ini adalah penggalian dan penentuan value, menetapkan goals, merumuskan rencana tindakan, pelaksanaan self monitoring, self reinforcement dan self evaluation. Berdasarkan analisa hasil penelitian disimpulkan bahwa motivasi, peran serta dan kedisiplinan akan menentukan efektifitas intervensi. Dukungan anggota keluarga juga penting untuk mendukung komitmen subjek dalam terapi ini.Kata kunci:  HIV, kepatuhan berobat, modifikasi perilaku, self management

Evaluating Behavioral Skills Training as an Evidence-Based Practice When Training Parents to Intervene with Their Children

2020 ◽  
pp. 014544552092399 ◽  
Author(s):  
John M. Schaefer ◽  
Natalie R. Andzik
Keyword(s):  
Design Research ◽  
Behavioral Skills Training ◽  
Skills Training ◽  
Single Subject ◽  
Evidence Based ◽  
Single Subject Design ◽  
Behavioral Skills ◽  
Evidence Based Practices ◽  
Behavior Skills ◽  
What Works Clearinghouse

The authors of this systematic review identified 20 individual single-subject studies examining the efficacy of Behavior Skills Training (BST) implemented with parents. Findings indicate that researchers have used BST to successfully train parents to implement a range of evidence-based practices (EBP) with their own children. Parents of children with autism or intellectual disability made up the large majority of participants in these studies. Applying the methodological quality standards set by What Works Clearinghouse (WWC), the authors detail the evidence from 67 individual cases provided by single-subject design research. Practitioners looking to train parents of children with disabilities to implement EBPs can be confident that BST is an effective training practice.

Reducing Aphasic Perseverations: A Case Study

2011 ◽  
Vol 21 (4) ◽  
pp. 176-183 ◽  
Author(s):  
Maria L. Muñoz
Keyword(s):  
Single Subject ◽  
Single Subject Design ◽  
Target Response ◽  
Subject Design ◽  
Perseverative Response ◽  
Semantic Feature Analysis ◽  
Verbal Output ◽  
Systematic Reduction

The purpose of this study was to measure outcomes resulting from a treatment designed to reduce aphasic perseverations by decreasing activation of the perseverative response and increasing activation of the target response. A single-subject design was used. A Spanish-speaking male with moderate-to-severe receptive-expressive aphasia participated in this study. Treatment involved the use of systematic reduction of interstimulus interval paired with semantic feature analysis. The treatment resulted in a decrease in perseveration, but only minor increases in naming accuracy on trained and untrained stimuli. In addition, an increase in overall verbal output was observed. Decreased perseveration was maintained during follow-up. Outcomes suggest the treatment successfully reduces perseveration and increases verbal output. Additional research is needed to evaluate the effectiveness of this treatment.

Using Single Subject Methodology To Improve Decision-Making in Stuttering Treatment

2012 ◽  
Vol 22 (1) ◽  
pp. 16-21
Author(s):  
Sheryl R. Gottwald ◽  
Bryan Ness
Keyword(s):  
Decision Making ◽  
Down Syndrome ◽  
Systematic Approach ◽  
Evidence Based Practice ◽  
Single Subject ◽  
Evidence Based ◽  
Speech Language Pathologists ◽  
Fluent Speech ◽  
The Subject

With the proliferation of evidence-based practice and the need to quantify therapy effects, it is imperative for speech-language pathologists to adapt a systematic approach when planning therapy. In this tutorial, we describe a 5-step decision making sequence that permitted us to systematically assess our clinical assumptions about the most effective treatments for eliciting perceptually fluent speech for a client with Down syndrome. We used single subject methodology to compare the effects of 3 intervention protocols—scripting, pacing board, and intonation training—on the fluency of an adult client with Down syndrome. This case study demonstrated that scripting allowed the subject to produce the largest number of normally fluent sentences with the least amount of clinician prompting.

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