Sequential Multiple-Assignment Randomized Trials: Developing and Evaluating Adaptive Interventions in Special Education

2018 ◽  
Vol 40 (5) ◽  
pp. 267-276 ◽  
Author(s):  
Jason C. Chow ◽  
Lauren H. Hampton
Keyword(s):  
Special Education ◽  
Individual Differences ◽  
Educational Outcomes ◽  
Randomized Trials ◽  
Sufficient Evidence ◽  
Adaptive Intervention ◽  
Meaningful Information ◽  
Adaptive Interventions ◽  
Multiple Assignment ◽  
Individual Variables

Interventions often require multiple decisions to improve outcomes for every student. Whether the decision to implement a practice, tailor an existing protocol, or change approaches, these decisions should be based on individual variables and outcomes via a sequence of treatment. To develop adaptive interventions that have sufficient evidence to support decisions, components, and sequences, they must be evaluated as they operate. The sequential multiple-assignment randomized trial is a design that experimentally assesses the efficacy of the decisions, components, and sequence of an adaptive intervention. The purpose of this article is to provide an overview of this novel methodology and describe how this design can provide meaningful information about components and sequence based on individual differences and response to maximize educational outcomes in special education.

scholarly journals Adaptive intervention designs in pediatric psychology: The promise of sequential multiple assignment randomized trials of pediatric interventions.

2017 ◽  
Vol 5 (2) ◽  
pp. 170-179 ◽  
Author(s):  
Amy E. Noser ◽  
Christopher C. Cushing ◽  
Meghan E. McGrady ◽  
Christina M. Amaro ◽  
Lindsay P. Huffhines
Keyword(s):  
Randomized Trials ◽  
Pediatric Psychology ◽  
Adaptive Intervention ◽  
Multiple Assignment ◽  
Pediatric Interventions

Accommodations for Individual Differences without Classroom Ability Groups: An Experiment in School Restructuring

1994 ◽  
Vol 60 (4) ◽  
pp. 344-358 ◽  
Author(s):  
Joseph R. Jenkins ◽  
Mark Jewell ◽  
Norma Leicester ◽  
Rollanda E. O'Connor ◽  
Linda M. Jenkins ◽  
...  
Keyword(s):  
Special Education ◽  
Individual Differences ◽  
Special Education Teachers ◽  
Reading Ability ◽  
School Restructuring ◽  
Control School ◽  
Reading Vocabulary ◽  
Language Arts Instruction ◽  
Ability Groups ◽  
Based Instruction

This study examined an alternative approach for organizing reading and language arts instruction to accommodate individual differences in reading ability. The approach featured Cooperative Integrated Reading and Composition (CIRC), conducted without ability groups, with cross-age and peer tutoring, supplementary phonics instruction for some students, and classroom-based instruction from compensatory and special education teachers. Students in regular, remedial, and special education were included in an experimental and a control school. We found significant effects on reading vocabulary, total reading, and language scores in favor of the experimental school; but on several other measures, including behavior ratings, we did not detect treatment effects.

scholarly journals Comparing cluster-level dynamic treatment regimens using sequential, multiple assignment, randomized trials: Regression estimation and sample size considerations

2017 ◽  
Vol 26 (4) ◽  
pp. 1572-1589 ◽  
Author(s):  
Timothy NeCamp ◽  
Amy Kilbourne ◽  
Daniel Almirall
Keyword(s):  
Randomized Trial ◽  
Randomized Trials ◽  
Treatment Regimens ◽  
Patient Level ◽  
Multiple Assignment ◽  
Dynamic Treatment ◽  
The Mean ◽  
Cluster Randomized ◽  
The Individual ◽  
Cluster Level

Cluster-level dynamic treatment regimens can be used to guide sequential treatment decision-making at the cluster level in order to improve outcomes at the individual or patient-level. In a cluster-level dynamic treatment regimen, the treatment is potentially adapted and re-adapted over time based on changes in the cluster that could be impacted by prior intervention, including aggregate measures of the individuals or patients that compose it. Cluster-randomized sequential multiple assignment randomized trials can be used to answer multiple open questions preventing scientists from developing high-quality cluster-level dynamic treatment regimens. In a cluster-randomized sequential multiple assignment randomized trial, sequential randomizations occur at the cluster level and outcomes are observed at the individual level. This manuscript makes two contributions to the design and analysis of cluster-randomized sequential multiple assignment randomized trials. First, a weighted least squares regression approach is proposed for comparing the mean of a patient-level outcome between the cluster-level dynamic treatment regimens embedded in a sequential multiple assignment randomized trial. The regression approach facilitates the use of baseline covariates which is often critical in the analysis of cluster-level trials. Second, sample size calculators are derived for two common cluster-randomized sequential multiple assignment randomized trial designs for use when the primary aim is a between-dynamic treatment regimen comparison of the mean of a continuous patient-level outcome. The methods are motivated by the Adaptive Implementation of Effective Programs Trial which is, to our knowledge, the first-ever cluster-randomized sequential multiple assignment randomized trial in psychiatry.

scholarly journals Teachers’ awareness of differentiated learning dimensions for students with special educational needs in Kuwait: مدى وعي معلمي برامج التربية الخاصة في دولة الكويت بمبدأ وأبعاد تفريد التعليم للطلبة من ذوي الاحتياجات الخاصة

2020 ◽  
Vol 4 (17) ◽  
Author(s):  
Bader Jassim Alqallaf, Hamed Jassim Alsahou, Hashemiah Moham
Keyword(s):  
Special Education ◽  
Individual Differences ◽  
Learning Environment ◽  
Learning Strategies ◽  
School Level ◽  
Special Educational Needs ◽  
Education Programs ◽  
Special Education Programs ◽  
The State Of Kuwait ◽  
Differentiated Learning

The current study aims to identify the awareness of teachers of special education programs in the state of Kuwait of differentiated learning or what is known as “pedagogical difference” based on four components. The four components are the foundation of individual differences, planning and preparation, instructional strategies, and learning environment. A questionnaire was developed and distributed in 18 schools that provide special education programs (9 male schools and 9 female schools) in which 158 respondents completed the questionnaire. The study concluded the following results: The teachers have a high level of awareness of differentiated learning and its components. The dimension of learning environment was the highest mean (M =4.39), followed by the dimension of learning strategies (M= 4.37) then the dimension of individual differences (M= 4.22) and the dimension of planning and preparation (M =4.03). Also, statistical differences were emerged according to some demographic variables such as years of experience, academic qualifications, taught course, type of disability. No statistical differences were found based on gender and school level. These findings are discussed according to the previous empirical works and literature review followed by some implications and suggestions.

BestFIT Sequential Multiple Assignment Randomized Trial Results: A SMART Approach to Developing Individualized Weight Loss Treatment Sequences

2021 ◽  
Author(s):  
Nancy E Sherwood ◽  
A Lauren Crain ◽  
Elisabeth M Seburg ◽  
Meghan L Butryn ◽  
Evan M Forman ◽  
...  
Keyword(s):  
Weight Loss ◽  
Randomized Trial ◽  
Controlled Trial ◽  
Response Assessment ◽  
Optimal Time ◽  
Behavioral Weight Loss ◽  
Weight Loss Treatment ◽  
Adaptive Intervention ◽  
Weight Losses ◽  
Multiple Assignment

Abstract Background State-of-the-art behavioral weight loss treatment (SBT) can lead to clinically meaningful weight loss, but only 30–60% achieve this goal. Developing adaptive interventions that change based on individual progress could increase the number of people who benefit. Purpose Conduct a Sequential Multiple Assignment Randomized Trial (SMART) to determine the optimal time to identify SBT suboptimal responders and whether it is better to switch to portion-controlled meals (PCM) or acceptance-based treatment (ABT). Method The BestFIT trial enrolled 468 adults with obesity who started SBT and were randomized to treatment response assessment at Session 3 (Early TRA) or 7 (Late TRA). Suboptimal responders were re-randomized to PCM or ABT. Responders continued SBT. Primary outcomes were weight change at 6 and 18 months. Results PCM participants lost more weight at 6 months (−18.4 lbs, 95% CI −20.5, −16.2) than ABT participants (−15.7 lbs, 95% CI: −18.0, −13.4), but this difference was not statistically significant (−2.7 lbs, 95% CI: −5.8, 0.5, p = .09). PCM and ABT participant 18 month weight loss did not differ. Early and Late TRA participants had similar weight losses (p = .96), however, Early TRA PCM participants lost more weight than Late TRA PCM participants (p = .03). Conclusions Results suggest adaptive intervention sequences that warrant further research (e.g., identify suboptimal responders at Session 3, use PCMs as second-stage treatment). Utilizing the SMART methodology to develop an adaptive weight loss intervention that would outperform gold standard SBT in a randomized controlled trial is an important next step, but may require additional optimization work. Clinical Trial information ClinicalTrials.gov identifier; NCT02368002

scholarly journals Adaptive interventions for optimizing malaria control: an implementation study protocol for a block-cluster randomized, sequential multiple assignment trial

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Guofa Zhou ◽  
Ming-chieh Lee ◽  
Harrysone E. Atieli ◽  
John I. Githure ◽  
Andrew K. Githeko ◽  
...  
Keyword(s):  
Study Protocol ◽  
Malaria Control ◽  
Implementation Study ◽  
Adaptive Interventions ◽  
Multiple Assignment ◽  
Cluster Randomized
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