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ERIC EJ964431: Data-Based Decision Making: The Impact of Data Variability, Training, and Context PDF

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JOURNALOFAPPLIEDBEHAVIORANALYSIS 2011, 44, 767–780 NUMBER4 (WINTER2011) DATA-BASED DECISION MAKING: THE IMPACT OF DATA VARIABILITY, TRAINING, AND CONTEXT NICHOLAS R. VANSELOW NEWENGLANDCENTERFORCHILDREN RACHEL THOMPSON WESTERNNEWENGLANDCOLLEGE AND ALLEN KARSINA NEWENGLANDCENTERFORCHILDREN The current study examines agreement among individuals with varying expertise in behavior analysisaboutthelengthofbaselinewhendatawerepresentedpointbypoint.Participantswere askedtorespond tobaseline dataandtoindicate whentoterminate the baseline phase.When onlyminimalinformationwasprovidedaboutthedataset,expertsandBoardCertifiedBehavior Analystparticipantsgeneratedbaselinesofsimilarlengths,whereasnovicesdidnot.Agreement wassimilaracrossparticipantswhenvariabilitywaslowbutdeterioratedasvariabilityinthedata setincreased.Participantsgeneratedshorterbaselineswhenprovidedwithinformationregarding theindependentordependentvariable.Implicationsfortrainingandtheuseofvisualinspection arediscussed. Keywords: data analysis, reversal design, scientific behavior, visual inspection _______________________________________________________________________________ Appliedbehavioranalysisincorporatessingle- an ‘‘inconsistent treatment,’’ and an ‘‘irrevers- subject design and visual inspection as the ible effect.’’ Editors of the Journal of Applied primary means of identifying functional rela- Behavior Analysis (JABA) and the Journal of the tions between independent and dependent Experimental Analysis of Behavior rated the variables. Applied behavior analysts are charged demonstration of experimental control shown with producing meaningful and important by each graph on a scale from 0 (low) to 100 changes in socially significant behavior in each (high), and poor agreement was obtained. The individual they serve, and this task is facilitated meancorrelationbetweenraterswas.61,accord- byvisualinspectionofsingle-subjectdata(Baer, ing to the Pearson product moment correlation. 1977; Skinner, 1956). In addition, the programmed differences in the Despite the predominant use of visual data patterns accounted for only a very small inspection in behavior analysis, its reliability proportion of the variance in the ratings. Other has been questioned by studies that have shown studies using similar procedures also demon- poor agreement between scientists. For exam- strated low agreement between visual inspectors ple,DeProspero andCohen (1979)constructed (Danov&Symons,2008;Furlong&Wampold, graphs that depicted ABAB reversal designs 1982; Matyas & Greenwood, 1990; Park, with data that reflected an ‘‘ideal’’ pattern, Marascuilo, & Gaylord-Ross, 1990). These studies question the utility of visual Address correspondence to Rachel Thompson, Western inspectionasareliabledeterminantoftheeffect New England College, Department of Psychology, 1215 of an independent variable. However, Kahng WilbrahamRoad,Springfield,Massachusetts01119(e-mail: etal.(2010)systematicallyreplicatedDeProspero [email protected]). doi:10.1901/jaba.2011.44-767 and Cohen (1979) and found much higher 767 768 NICHOLAS R. VANSELOW et al. agreement for ratings made using the 100-point to make general comments about the data scale (.93 compared to .61 in DeProspero & (Austin & Mawhinney), to characterize the Cohen). Two methodological differences be- data in terms of structured categories (e.g., tween Kahng et al. and DeProspero and Cohen stability and trend; Mawhinney & Austin), might be responsible for these discrepant results. and to identify the point at which in- First, Kahng et al. used the same 100-point tervention was initiated. Compared with scale as DeProspero and Cohen but also asked other research on visual inspection, these participantswhetherthegraphsdid(‘‘yes’’)ordid two studies presented data in a manner that not (‘‘no’’) demonstrate experimental control. was more similar to the daily decisions made Second, participants included only editors of during the research process. These studies JABA. Kahng et al. suggested that the increased also differed from previous research in that agreementmaybeduepartlytothestandardized participants responded to published data sets, trainingforappliedbehavioranalystssuchasthat whereas most other studies (e.g., DeProspero & Cohen, 1979; Furlong & Wampold, 1982; recommended by the Behavior Analyst Certifi- Kahng et al., 2010; Matyas & Greenwood, cationBoard(BACB).Replicationoftheseresults 1990) presented computer-generated graphs and analyses of the variables that influence that may not resemble data typically encoun- agreement or disagreement among visual inspec- tered by participants. torswithdifferenttraininghistoriesarenecessary Like Austin and Mawhinney (1999) and toreconcileKahngetal.’srecentfindingswiththe Mawhinney and Austin (1999), we presented many studies that have shown poor agreement. data point by point and used graphs that Participants in the current study included three includeddatafrompublishedstudies.However, groups (experts, Board Certified Behavior Ana- participants in our study were asked to make lysts[BCBAs],andnovices)withvaryinglevelsof decisions about whether or not to continue the expertise, allowing an examination of agreement baseline phase of the study and to provide within and across these groups. commentsabouttheir decisions. InStudy 1,we The studies of agreement among scientists examined agreement regarding baseline length have focused on visual inspection of data sets among participants with varying levels of with at least two complete phases and agree- expertise in behavior analysis. In Study 2, we ment of experimental control. However, the evaluated the effects of providing additional final data set is a result of many decisions information regarding the independent or de- regardingwhethertocontinueorchangephases, pendent variable on the lengths of participant- and these decisions often occur before experi- generated baselines. mental control is demonstrated. Point-by-point decisions are integral to deciding when to STUDY 1 change phases, and small decisions may affect the demonstration of experimental control in The purpose of Study 1 was to describe and the final graph. We identified only two studies compare the length of baseline phases created that attempted to capture point-by-point data by experts in applied behavior analysis, BCBAs, analysis. and novices in applied behavior analysis when Austin and Mawhinney (1999) and Ma- data were presented point by point. whinney and Austin (1999) asked participants to respond to data presented point by point. Method Graphs were from currently or subsequently Participants. Participants in the expert group published data sets with phase lines removed. had doctoral-level degrees in behavior analysis Acrossthetwostudies,participantswereasked or a related field, had earned their BCBA (or DATA-BASED DECISION MAKING 769 Board Certified Behavior Analyst–Doctoral) intellectual disabilities. Just prior to participating certification, and were currently or previously in the study, the participants were assigned Associate Editors or Editors for JABA. To Chapter 6 on visual inspection from the intro- recruit participants for this group, the authors ductory behavior analysis textbook by Cooper, contacted 13 experts via an e-mail with the Heron,andHeward(1987,pp.130–141).Seven- experimental program attached. Ten experts teen participants from this group completed the completed the experimental program and sent experimental program. the file containing their responses back to the authors. Procedure The second group of participants did not Experimental program. A computer program meet the expert criteria but were BCBAs. was designed to present a graph, one data (Board Certified Assistant Behavior Analysts point at a time. The experimental program or BCaBAs were excluded from this group.) utilized the Visual Basic for Applications pro- BCBAs were recruited in two ways. First, we gramming language available with Microsoft created a computerized spreadsheet from the Windows versionsofExcel 2003 and 2007.By certificant registry on the BACB Web site using common spreadsheet software, we were (http://www.bacb.com). The spreadsheet ran- able to send the experimental program in a domly selected 20 BCBAs at a time. We small file attached to an e-mail. Participants’ contacted these people via e-mail to request data were recorded directly into the experi- their participation in the study. After confir- mental program file that was sent back to the mation, participants were sent the experimental experimenter. program. Four of the 77 people randomly After the experimental program began, par- selected from all of the BCBAs listed in the ticipants were provided with informed consent certificantregistryrespondedtoaninitiale-mail followed by instructions for using the program. The instructions stated that and completed the experimental program. Due to the low response rate with the first method, The goal for each graph is to continue adding data we recruited additional participants by e- points to the baseline phase by clicking the ‘‘Continue Running Current Phase Button’’ until mailing a variety of schools and service agencies you have enough data points that you would begin that employed BCBAs to ask if any of their the next phase (e.g., ‘‘treatment’’) if this were an employees would be interested in participating. applied research project you were supervising or conducting. Throughthisrecruitingmethod,nineadditional e-mails with the experimental program attached Before each graph was presented, a message were sent, and six participants returned their box displayed the x- and y-axis labels, a responses. A total of 10 BCBAs completed the reminder that this was the baseline phase, and experimental program. the expected change in behavior for the next The third group of participants included phase. For example, the message box indicated novices in applied behavior analysis. All partici- thatthetargetbehaviorwasexpectedtodecrease pants had been hired recently at a school for in the next phase if a reduction in behavior was children and adults with intellectual disabilities expected in the phase after baseline (as in the and were enrolled in an introductory course in case of a treatment for aggression). Participants behavioranalysis.Theseparticipantsdidnothave could not view the graph until the ‘‘OK’’ previous training in the interpretation of graphs button in the message box was selected. that depict single-subject experiments; however, After clicking ‘‘OK,’’ the first graph was they were learning about behavior-analytic topics displayed with a single data point. An example relevant to providing services to children with of Graph 5 with one data point is displayed in 770 NICHOLAS R. VANSELOW et al. Figure 1.Graph 5 before (top) andafter(middleandbottom) datapoints wereadded. DATA-BASED DECISION MAKING 771 Table 1 decision.Atthebottomofthedialogueboxwas GraphCharacteristics a button labeled ‘‘continue.’’ If the participant chose to continue with the current phase, y-axis Data Variability Expected clicking ‘‘continue’’ submitted the participant’s Graph label points coefficient Trend change responses,hidthedialoguebox,andshowedthe 1 rpm 6 .08 none decrease 2 rpm 4 .30 increasing decrease graph with another data point added. Figure 1 3 rpm 5 .51 none decrease (middle and bottom panels) displays Graph 5 4 rpm 11 .90 Upattern decrease 5 frequency 8 .88 none increase with data points added as if the participant had clicked the ‘‘continue running current phase’’ Note. rpm 5 responses per minute. For Graph 5, participantsinStudy1saw‘‘numberofcorrectresponses’’ button. If the participant chose to stop adding andparticipantsinStudy2saw‘‘responses’’ontheyaxis. baseline sessions (i.e., the participant selected the ‘‘stop baseline and start intervention’’ thetoppanelofFigure 1.Thegraphscontained button), the current graph ended and the axis labels that matched those in the previous experimental program proceeded to the basic information message box. In Study 1, the y axis information about the next graph. Each subse- waslabeled‘‘responsesperminute’’or‘‘number quent graphfollowed thissamebasicprocedure. ofcorrectresponses,’’andthetopographyofthe Whenallofthegraphs(fivegraphsforStudy responsewasnotspecified.Table 1providesthe 1) had been presented, the experimental pro- specificlabelsusedforeachgraph.Therangeof gram ended by thanking the participant and y-axis values was determined by the default providing instructions to send the completed settings in Microsoft Excel. The x-axis labels file back to the experimenter as an e-mail were always ‘‘sessions.’’ The x axis always had attachment. Clicking the ‘‘complete’’ button at session numbers that corresponded to the data thebottomofthismessagesavedthechangesto points plus five session numbers (without data) the file and closed the program. beyondthecurrentdatapoint.Therewerethree Selected published graphs. The graphs dis- buttons on the screen in addition to the graph. A button above the top right corner of the played by the experimental program contained graph was labeled ‘‘see graph information’’ and datafromstudiespreviouslypublishedinJABA. displayed the message box with the basic First, graphs that met the following criteria information about the previously described from issues of JABA from 1998 to 2008 were graph when selected. enteredintoadatabase.Onlygraphsthatdepict Below the graph were buttons labeled an ABA or ABAB reversal design with a single ‘‘continue running current phase’’ and ‘‘stop data path were selected. Graphs could contain baseline and start intervention.’’ Clicking on additional phases (e.g., ABAC reversal design); eitherof thesetwobuttonspresentedadialogue however,thereversaldesigncouldnotbepartof box that asked if the participant was sure about another experimental design (e.g., a reversal for this decision. Selecting ‘‘no’’ would return the ParticipantAinthetoppanelthatwasalsopart participant to the graph with no changes. If the of a multiple baseline across Participants B and participant selected ‘‘yes,’’ the graph disap- C). These criteria were developed to eliminate peared from the screen and a dialogue box graphs that may have resulted from researcher appeared. This box displayed two items with responses to features of the data that were not space to reply to each. The first item asked why presented to participants in our study. the participant chose to continue or stop the Fromthisdatabaseofgraphs,weselectedfive current phase. The second item was a text box graphs that differed in trend and degree of labeled ‘‘comments’’ in which the participant variability. The characteristics of each of graph couldtypeadditionalinformationaboutthelast are described in Table 1. The five graphs were 772 NICHOLAS R. VANSELOW et al. presented to each participant in semirandom (instead of generated uniquely for each partic- order. Five possible sequences of graph presen- ipant) so that each participant saw the exact tationwerecreated beforetheprogram wassent same data and decisions between participants to the participants. To create the sequences, could be compared. each of the graphs was presented first across the Prior to the start of the study, computer- five sequences, and the order of the remaining generated graphs and the original graphs were four graphs was randomized. Participants then presented to four doctoral-level behavior analysts were assigned randomly to receive one of the who served as faculty for a PhD program fivesequences;however,eachsequencewasused in behavior analysis to determine whether the once before a sequence was repeated. computer-generatedgraphssimulatedtypicaldata Computer-generated data points. A potential patterns.Onepersonwhorated thesegraphsalso limitation of using published data is that participated as an expert in Study 1 (Participant participants might choose to continue baseline A-2). The other three did not participate in any beyond the number of data points available in otherpartofthestudy.Thebehavioranalystswere the original graph. To address this problem, providedwiththefiveoriginalgraphsandthefive computer-generated data points were calculated computer-generated graphs presented in a ran- using the mean, range, and standard deviation dom order. For each graph, the participant was of the original baseline data. However, these askedwhetherthegraphdisplayedpublisheddata calculations were not basedon the entire graph. or computer-generated data. A third option Instead, the graph was divided into two to four allowed the participant to respond that he or she sections (consisting of at least three data points did not know whether the data were obtained or each) based on the number of data points, computer generated. Three of the four partici- and the mean, range, and standard deviation pants responded that they did not know which were calculated for each section separately. data were published or computer generated. The To generate a data point, the program first fourth participant correctly identified only five semirandomly selected one of the sections, with ofthe10graphs,whichwaschancelevelrespond- the last section being selected more often than ing. These results suggested that the computer- the other sections. Next, a number that fell generated data could not be distinguished from between a range that was 20% larger than the thepublisheddata,increasingourconfidencethat original range was generated randomly. For the computer program generated data with example, if the original range was between 10 patterns similar to data collected in the course of and20,adatapointbetween8and22couldbe applied research. generated. The slightly larger range was includ- ed because, visually, computer-generated data Calibration and testing. Extensive testing and points in graphs created without this increase calibrationoccurredbeforethecomputerprogram appeared at more predictable values and more was sent to the participants. The first author often within a much smaller range than the generatedlistswiththenumberofdatapointsfor original graphs. The computer program was each graph and responses to open-ended ques- designed to generate data points that would tions.Then,hecreatedgraphswithintheprogram preservethemeanandstandarddeviationofthe usingthoselistsofdatapointsandresponses.The current graph. Using this type of calculation, datarecordedbythecomputerprogramandthose thepatterns apparent in the originalgraph were from the lists were compared. Any calculations preserved as the graph continued past the data in the computer program were checked against presented in the original published graph. Each calculations completed manually by the author. graphwasextendedto300datapointsusingthe After this stage was completed, the authors sent program described above and was pregenerated the programs to colleagues with instructions to DATA-BASED DECISION MAKING 773 Figure2.DatafromtheexpertparticipantsinStudy1.Thedifferencefromthemeanwascalculatedbysubtractingthe mean numberofadded points averaged for agraph fromthe numberofdata points generated byasingle expert. complete the program and provide comments regarding agreement easier among graphs by about their user experience. These testers also providing a standard reference point from were instructed to try to cause the program to which to analyze the differences in agreement fail. Information collected from the initial testers for each of the graphs. The number and range was used to improve the program and solve of data points are provided in some figures to any problems the participants might experience. show differences in the graphs created by Finally, a second group of testers completed the different participant groups. Using difference updated program. The first author checked the from the mean in all graphs might show the data collected throughout the process to ensure levelofagreementamonggroupsbutwouldnot that it was complete and calculations were provide information about different baseline accurate. lengths created by the different participants. Data analysis. The two primary dependent measures were the number and range of data Results and Discussion points added to each graph and the difference InStudy1,thedecisionsmadeinresponseto from the mean number of data points. Differ- data presented point by point were described ence from the mean was calculated by subtract- for three different participant groups. Figure 2 ing the mean number of data points averaged displays the results for the participants in the across all participants for a graph from the expert group. This graph presents the number number of data points generated by a single of data points each participant generated for participant. Data points concentrated around each graph as a difference from the mean. For zeroindicatethatmostoftheparticipantsadded Graphs 1 and 2, which contained data paths a similar number of data points to the graph. with little variability, the experts generated More disagreement among participants is ap- graphs with very similar numbers of data parent when the data points vary further points. Nine of the 10 participants generated from zero. This analysis makes comparisons graphs within one data point of each other. 774 NICHOLAS R. VANSELOW et al. Participant D-1 added approximately two more studies varied from .1 to .25 (DeProspero & data points than most of the other participants Cohen, 1979; Kahng et al., 2010). In the for Graphs 1 and 2. Graph 1 contained a data current study, the variability coefficient varied path with no trend, whereas the data path from.08to.90.Participantscreatedbaselinesof in Graph 2 had a steadily increasing trend similar lengths for graphs with variability (Table 1). Disagreement among the expert coefficients less than .25 in the current study. participants increased as the variability in the This supports the evidence that agreement graphs increased. Participants created graphs among visual inspectors may be higher than withawiderrangeinthenumberofdatapoints previously reported when variability is within for Graphs 3, 4, and 5. For Graph 5, the ranges previously studied (Kahng et al., Participant C-1 continued baseline until 41 2010). However, as variability in the data data points were presented. increased beyond .30, agreement began to Similar results were obtained for the BCBA decrease. The variability of Graphs 3, 4, and 5 group; however, the results for the novices was .51, .90, and .88, respectively. At this level differed from those of the experts and BCBAs. of variability, there was a wider range of data Themeannumberofbaselinedatapointsforall points added to the graph before participants graphs across the three participant groups is began the next phase. displayed in Figure 3. For Graphs 1, 2, and 3, Participants also provided an explanation for the results obtained from the BCBA group their decision. The two types of comments that closely matched those from the expert group. occurred most often after participants were For Graphs 4 and 5, the mean number of data asked why they continued baseline was that points in the BCBA graphs differed slightly either one data point was insufficient to change from the experts, although the general pattern phases (six experts and nine BCBAs) or that acrossgraphswassimilar(thevariabilityandthe three data points are required for a baseline mean number of data points in each graph (four experts and two BCBAs). Although some increased as the variability in the data path participants changed phases at three data points increased). For novice participants, the mean for graphs with stable data paths, some number of data points remained approximately participants chose to exceed this minimum by thesameforeachofthefivegraphs.Inaddition, one or two data points. We also provided the the variability among participants decreased as participants with the opportunity to provide the data paths in the graphs became more any additional comments. In this section, three variable; an opposite relation was observed with experts stated that their decisions might have experts and BCBAs. Based on these data, it been different if more information about the appears that, in isolation, rules for visual type of treatment that would follow was inspection provided in textbooks may be provided. These experts might have reduced insufficient to produce expert performance. It the number of data points in baseline if the seems likely that additional experience with treatment was one that was likely to produce a data-based decision making accounts for the strong effect. Three experts and three BCBAs differences among these groups. commented that their decisions may have been To compare the current results with previous affectedbyinformationaboutthetopographyof studies, a variability coefficient for each of the theresponse(e.g.,severeself-injuriousbehavior). five graphs was calculated by dividing the Although the response topography never was standard deviation of a set of data by the mean provided, one participant in the BCBA group (Kahng et al., 2010). The variability coefficient stoppedthegraphafteronedatapointandmade ofthedata presentedto participantsin previous commentssuggestingthatshewouldevaluatethe DATA-BASED DECISION MAKING 775 Figure 3. The mean number of data points for each graph from all groups in Study 1. The bars represent the minimumandmaximum numberof datapoints foreach group. safety of conducting sessions with such a high- the problem behavior and the likely effects of rate behavior or attempt different analyses. the subsequent treatment. These two categories were selected due to comments from the participants in Study 1 and suggestions in STUDY 2 previous research (e.g., DeProspero & Cohen, ParticipantsinStudy1andinpreviousstudies 1979; Kahng et al., 2010; Lerman et al.,2010). (Danov & Symons, 2008; DeProspero & In addition, Cooper, Heron, and Heward Cohen, 1979; Kahng et al., 2010; Matyas & (2007) specifically addressed these two situa- Greenwood,1990)wereaskedtomakedecisions tions as an exception to the ‘‘rule of the-more- about data with minimal information. Com- data-points-the-better’’ (p. 150). ments collected from our participants suggested that their decisions about the length of baseline Method would be influenced by information about the Participants.TheparticipantsinStudy2were type of treatment planned and the form or students studying behavior analysis in doctoral severity of the targeted behavior. In addition programs across the United States. Students to these variables, studies have suggested that were contacted either directly via e-mail or decisions might be influenced by research through their academic advisers. The experi- previously published in the area, the potential mental program was sent to 19 students, and significanceoftheresults(DeProspero&Cohen, eight participants in this group completed both 1979), or the characteristics of the participants Sessions1and2.Oftheeightparticipants,four (Kahng et al., 2010; Lerman et al., 2010). wereBCBAs,onewasaBCaBA,andthreewere The purpose of Study 2 was to evaluate the not certified. effects of information about the target behavior Procedure. The experimental program from or the independent variable on the decisions of Study 1 was used for Study 2 and functioned individualparticipants.Weexaminedtheeffects similarly, with a few exceptions. Only the two of information about the form and severity of graphs with the highest variability coefficients 776 NICHOLAS R. VANSELOW et al. Table2 each graph before it was presented; however, in Graph Orderin Study2 Study2,themessageboxalsoincludedfictitious client initials, and different information was Session1 Session2 provided according to the no-information, Graph Informationtype Graph Informationtype strong treatment, and severe self-injury condi- 5 none 4 none tions described below. The client initials were 4 severeself-injury 5 severeself-injury generated by selecting two consecutive letters of 5 strongtreatment 4 strongtreatment 4 strongtreatment 5 strongtreatment the alphabet randomly (e.g., PQ or LM) and 5 severeself-injury 4 severeself-injury were added to imply that each graph displayed 4 none 5 none a different set of data. The order of graphs and conditions varied across sessions, but all were included (Graphs 4 and 5). These graphs participants experienced the same sequence of were chosen because responses from Study 1 graphs and conditions. showed poor agreement with these graphs. The No information. The information presented variability in responses in Study 1 suggested to the participants was similar to that in Study that these graphs would provide a baseline that 1, except that for Graph 5 the expected might be sensitive to information manipula- direction of change was ‘‘decrease’’ instead of tions. However, Graph 5 was modified slightly ‘‘increase’’ and the y-axis label was ‘‘responses’’ to prevent information in the graph from instead of ‘‘number of correct responses.’’ The conflicting with the additional information participant was informed of the participant’s provided. First, the y-axis label in Graph 5 initials, the axis labels, and the expected was changed from ‘‘number of correct respons- direction of change. es’’to‘‘responses.’’Second,theexpectedchange Strong treatment. In addition to the basic in direction was altered from ‘‘increase’’ to information, an additional line in the message ‘‘decrease’’ because one type of information boxstatedthatthetreatmentimplementedafter involved labeling the target response as severe baseline was expected to have a strong effect on self-injury. This modification seemed reason- behavior.Nodefinitionofstrongtreatmentwas able, given the relatively high level of behavior provided. depicted in Graph 5 (see Figure 1). Severe self-injury. In addition to the basic Participants completed two separate visual information, an additional line in the message inspection sessions, with the experimental program for the second session sent to box stated that the target behavior was severe participants after submission of their responses self-injury. No additional information about fromthefirstsession.Tocreategraphsforthese the form of behavior was provided. two sessions, the data from Graphs 4 and 5 were used to generate 300 points per graph. Results and Discussion Computer-generated Points 150 to 300 were Figure 4 displays the main effects of Study 2. presented as needed in Session 1; the published For both graphs, additional information resulted data and, if necessary, computer-generated inashorterbaseline,onaverage,comparedtono Points 1 to 149 were presented in Session 2. information.Theaveragelengthofbaselineacross Each of the two graphs was presented three participants changed even with the addition of times in a session (once for each of the three veryminimalinformation.Althoughthebaselines conditions), fora totalof six graphs persession. decreased in length and agreement increased Table 2 displays the order of graphs for each slightlyforthestrongtreatmentcondition,much session. Similar to Study 1, the experimental greaterandconsistentdecreasesacrossparticipants program presented the basic information about occurred in the severe self-injury condition.

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