A wide variety of media can be used in learning, including distance learning, such as print, lectures, conference sections, tutors, pictures, video, sound, and computers. Any one instance of distance learning will make choices among these media, perhaps using several.

Multimedia in Learning

This article systematically reviews the research design and methodological characteristics of single-case experimental design (SCED) research published in peer-reviewed journals between 2000 and 2010. SCEDs provide researchers with a flexible and viable alternative to group designs with large sample sizes. However, methodological challenges have precluded widespread implementation and acceptance of the SCED as a viable complementary methodology to the predominant group design. This article includes a description of the research design, measurement, and analysis domains distinctive to the SCED; a discussion of the results within the framework of contemporary standards and guidelines in the field; and a presentation of updated benchmarks for key characteristics (e.g., baseline sampling, method of analysis), and overall, it provides researchers and reviewers with a resource for conducting and evaluating SCED research. The results of the systematic review of 409 studies suggest that recently published SCED research is largely in accordance with contemporary criteria for experimental quality. Analytic method emerged as an area of discord. Comparison of the findings of this review with historical estimates of the use of statistical analysis indicates an upward trend, but visual analysis remains the most common analytic method and also garners the most support among those entities providing SCED standards. Although consensus exists along key dimensions of single-case research design, and researchers appear to be practicing within these parameters, there remains a need for further evaluation of assessment and sampling techniques and data analytic methods.

Single-case experimental designs: a systematic review of published research and current standards.

Objective: To evaluate the effectiveness of any psychosocial plus any agonist maintenance treatment versus standard agonist treatment for opiate dependence in respect of retention in treatment, use of substances, health and social status. The abuse of opioid drugs and drug dependency are major health and social issues. Maintenance treatments with pharmacological agents can help to reduce the risks associated with the use of street drugs for drug addicts who are unable to abstain from drug use. Methadone is effective in retaining patients in treatment and reducing heroin use but re-addiction remains as a substantial challenge. Opiate addicts often have psychiatric problems such as anxiety and depression and may not be able to cope with stress. Psychosocial interventions including psychiatric care, psychotherapy, counselling, and social work services are commonly offered as part of the maintenance programs. Psychological support varies from structured psychotherapies such as cognitive behavioural therapy and supportive-expressive therapy to behavioural interventions and contingency management. This review addressed whether a specific psychosocial intervention provides any additional benefit to pharmacological maintenance treatment. The control intervention was a maintenance program, which routinely offers counselling sessions in addition to pharmacological treatment. Present evidence suggests that adding psychosocial support does not change the effectiveness of retention in treatment and opiate use during treatment. Findings on retention in treatment were for 12 different psychosocial interventions including contingency management. These conclusions are based on 34 randomised trials involving 3777 opiate addicts, some 73% of whom were male. All but three studies were conducted in the USA. The previous version of this review showed a reduction in opiate use during treatment that was no longer the case with the addition of new studies and the same is for the number of participants abstinent at the end of follow up. The psychosocial interventions are likely to require rigorous assessment of any changes in emotional, interpersonal, vocational and physical health areas of life functioning that may indirectly reduce drug use over longer periods of time.

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Psychosocial combined with agonist maintenance treatments versus agonist maintenance treatments alone for treatment of opioid dependence.

Longitudinal studies are of aetiological and public health relevance but can be undermined by attrition. The aim of this paper was to identify effective retention strategies to increase participation in population-based cohort studies. Systematic review of the literature to identify prospective population-based cohort studies with health outcomes in which retention strategies had been evaluated. Twenty-eight studies published up to January 2011 were included. Eleven of which were randomized controlled trials of retention strategies (RCT). Fifty-seven percent of the studies were postal, 21% in-person, 14% telephone and 7% had mixed data collection methods. A total of 45 different retention strategies were used, categorised as 1) incentives, 2) reminder methods, repeat visits or repeat questionnaires, alternative modes of data collection or 3) other methods. Incentives were associated with an increase in retention rates, which improved with greater incentive value. Whether cash was the most effective incentive was not clear from studies that compared cash and gifts of similar value. The average increase in retention rate was 12% for reminder letters, 5% for reminder calls and 12% for repeat questionnaires. Ten studies used alternative data collection methods, mainly as a last resort. All postal studies offered telephone interviews to non-responders, which increased retention rates by 3%. Studies that used face-to-face interviews increased their retention rates by 24% by offering alternative locations and modes of data collection. Incentives boosted retention rates in prospective cohort studies. Other methods appeared to have a beneficial effect but there was a general lack of a systematic approach to their evaluation.

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A systematic review of the effect of retention methods in population-based cohort studies

The cohort of individuals with autism spectrum disorder (ASD) diagnosed as part of the first wave of what is often referred to as the autism epidemic is rapidly approaching adulthood. This cohort represents only the proverbial tip of the iceberg with some reports noting that 70% of the currently identified individuals with ASD are less than 14-years old. These numbers represent a looming crisis of unprecedented magnitude for adults with autism, their families, and the ill-prepared and underfunded adult service system charged with meeting their needs. A review of the current literature on outcomes for adults with ASD indicates that, independent of current ability levels, the vast majority of adults on the spectrum are either unemployed or underemployed and, further, that large numbers of adults with autism remain without any appropriate services. Many have had inadequate transition programming including little attention to service coordination, minimal direct family involvement and/or absence of treatment based on evidence-based practices. Lastly, issues related to staff and provider recruitment and retention present significant, systemic challenges to the provision of effective services. As such there is a significant and growing need for greater attention to individual needs of adults with ASD if we are provide the opportunity for a positive quality-of-life.

Addressing the Needs of Adolescents and Adults with Autism: A Crisis on the Horizon

Among the numerous treatments available for helping to educate people with autism, applied behavior analysis (ABA) is the best empirically evaluated, as many articles in this dual-volume special issue document. Unfortunately, the best supported treatments are not always the best disseminated or accepted. Recently, however, ABA has emerged with widespread recognition beyond the limited community of academic and behavioral psychologists and special educators. In fact, ABA has been recognized by the surgeon general of the United States as the treatment of choice for autism in his mental health report for children: “Thirty years of research demonstrated the efficacy of applied behavioral methods in reducing inappropriate behavior and in increasing communication, learning, and appropriate social behavior” (U.S. Department of Health and Human Services, 1999). Corroborating the surgeon general’s recommendation are state governments in New York (Department of Health, 1999) and California (Collaborative Work Group on Autistic Spectrum Disorders, 1997), as well as a collaborative group in Maine (MADSEC Autism Taskforce, 1999). New York and Maine reference the unparalleled quantity of outcome research supporting behavior analytic instruction and its best-practice features (see Jacobson, 2000). Beyond governmental organizations, the popular media has begun to recognize and educate the public about ABA treatment for autism. For example, ABC broadcast a Nightline episode endorsing ABA early intervention for children with autism

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The Contributions of Applied Behavior Analysis to the Education of People With Autism

Although advances in pharmacotherapy have enabled people living with HIV/AIDS to live longer, fuller lives, some leave medical care, resulting in sub-optimal treatment and increased health risk to themselves and others. Forty-one patients who dropped out of an urban, publically funded primary care HIV clinic were contacted and encouraged by outreach staff to return. Participants were interviewed within two weeks of returning, and themes associated with dropping out and returning were elicited and content analyzed. Dropping out was associated with drug/alcohol use, unstable housing/homelessness, psychiatric disorders, incarceration, problems with HIV medications, inability to accept the diagnosis, relocation, stigma, problems with the clinic, and forgetfulness. Returning was associated with health concerns, substance abuse treatment/recovery, stable housing, incarceration/release, positive feelings about the clinic, spirituality, and assistance from family/relocation. Because a large number of patients reported substance abuse, depression, and past suicide attempts. Clinic staff should assess substance use, depression, and suicidal ideation at each primary care visit and encourage patients to obtain substance abuse treatment and mental health care. Future interventions could include providing SBIRT and/or onsite mental health and substance abuse treatment, all of which may boost retention.

Factors contributing to dropping out from and returning to HIV treatment in an inner city primary care HIV clinic in the United States

Contingency management (CM) for drug abstinence has been applied to individuals independently even when delivered in groups. We developed a group CM intervention in which the behavior of a single, randomly selected, anonymous individual determined reinforcement delivery for the entire group. We also compared contingencies placed only on cocaine abstinence (CA) versus one of four behaviors (CA, treatment attendance, group CM attendance, and methadone compliance) selected randomly at each drawing. Two groups were formed with 22 cocaine-dependent community-based methadone patients and exposed to both CA and multiple behavior (MB) conditions in a reversal design counterbalanced across groups for exposure order. The group CM intervention proved feasible and safe. The MB condition improved group CM meeting attendance relative to the CA condition.

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Interdependent group contingency management for cocaine‐dependent methadone maintenance patients

https://rdw.rowan.edu/cgi/viewcontent.cgi?article=1096&context=csm_facpub

Randomized clinical trial examining duration of voucher-based reinforcement therapy for cocaine abstinence.

OBJECTIVE To determine whether longer durations of voucher-based reinforcement therapy (VBRT) increase long-term abstinence compared to standard durations. METHODS Cocaine-abusing or dependent methadone-maintenance patients (N = 130) were randomized to receive either Standard (12-week; n = 62) or Extended (36-week; n = 68) VBRT. Participants provided 3 urine samples weekly during VBRT, and each cocaine-negative sample produced a voucher exchangeable for goods and services. RESULTS Extended VBRT produced longer durations of self-reported continuous abstinence during study Year 1 (M = 74 vs. 46 days; F(1,128) = 5.23, P = 0.024), but not during Year 2. However, each week of abstinence during Year 1 was associated with an increase of 9.19 days of abstinence during Year 2, regardless of study condition (t(1) = 4.92, P < 0.001). CONCLUSIONS Longer-duration VBRT can increase abstinence during VBRT, but may not maintain it afterwards. However, longer during-treatment abstinence begets later abstinence suggesting that further research regarding this relationship is needed.

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Beth J. Rosenwasser

Papers

The Contributions of Applied Behavior Analysis to the Education of People With Autism

Factors contributing to dropping out from and returning to HIV treatment in an inner city primary care HIV clinic in the United States

Interdependent group contingency management for cocaine‐dependent methadone maintenance patients

Randomized clinical trial examining duration of voucher-based reinforcement therapy for cocaine abstinence.

Extended voucher-based reinforcement therapy for long-term drug abstinence.