On the utility of within-participant research design when working with patients with neurocognitive disorders

Figures & data

Table 1 Examples of studies using within-participant research design with NCD patients. The examples are in chronological order

Author	Year	Participants	MMSE	Dependent variable	Independent variable	Design
Hussian^Citation36	1988	5 NCD patients	Moderate to severe	Inappropriate toileting, bed misidentification, exit seeking, inappropriate entry, ward disorientation	Verbal, physical, attentional, and perceptual cues	Withdrawal
Bourgeois^Citation22	1993	6 NCD patients	8–19	Conversation skills	Memory aid	Withdrawal
Heard and Watson^Citation24	1999	4 NCD patients	N/A	Wandering	DRO	Withdrawal
Nolan et al^Citation37	2001	3 NCD patients	Average 5.7	Room finding	Memory aids	Multiple baseline across participants
Altus et al^Citation26	2002	5 NCD patients	3–16	Communication and mealtime participation	Family style meals or prepared plates	Withdrawal
Baker et al^Citation25	2006	1 NCD patient	N/A	Aggression	Noncontingent escape	Withdrawal
Sellers^Citation39	2006	4 NCD patients	3–16	Social and agitated behaviors	Animal assisted therapy	Withdrawal
Dwyer-Moore and Dixon^Citation38	2007	3 NCD patients	N/A	Disruptive vocalization, wandering/exiting	DRO, NCA, and FCT + extinction	Multi-element design
Arntzen et al^Citation23	2013	1 NCD patient	20	Identity matching	Length of delay	Withdrawal

Abbreviations: MMSE, mini–mental state examination; N/A, not applicable; NCD, neurocognitive disorder; DRO, differential reinforcement of other behavior; NCA, non-contingent access to attention; FCT, functional communication training.

Figure 1 Hypothetical example of the withdrawal design (ABAB).

Notes: Y-axis shows number of responses per 10 minutes. The first condition is a baseline condition with low rate of responding. The second condition is the first introduction of IV where a change in the dependent variable is observed. The third condition is a reintroduction of the baseline condition where rate of responding decreases again. And the last condition is a reintroduction of the IV.
Abbreviations: IV, independent variable; A, baseline; B, introduction of IV.

Figure 2 Hypothetical example of multiple-baseline registration across three behaviors.

Notes: Top: baseline is registered in six sessions before introduction of IV. Middle: the baseline registration continues for an additional six sessions for the second behavior before the IV is presented. Bottom: baseline registration continued for an additional six sessions before the IV was applied to the third behavior.
Abbreviation: IV, independent variable.

Figure 3 A hypothetical example of a multiple-treatment design is shown.

Notes: Y-axis shows number of responses per 10 minutes. Left: baseline registration of the target behavior. Right: two different IVs are introduced (IV 1 and IV 2) and the rate of responses for the target behavior is measured in the presence of one or the other.
Abbreviation: IV, independent variable.

Figure 4 Hypothetical example of the step-wise change in frequency in behavior when using the changing-criterion design.

Notes: The baseline is recorded for 6 days. On day 7, the IV is introduced.
Abbreviation: IV, independent variable.

HussianRAModification of Behaviors in Dementia via Stimulus ManipulationClin Gerontol1988813743

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BourgeoisMSEffects of memory aids on the dyadic conversations of individuals with dementiaJ Appl Behav Anal19932677878473260

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HeardKWatsonTSReducing wandering by persons with dementia using differential reinforcementJ Appl Behav Anal19993238138410513031

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NolanBAMathewsRMHarrisonMUsing external memory aids to increase room finding by older adults with dementiaAm J Alzheimers Dis Other Demen20011625125411501349

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AltusDEEngelmanKKMathewsRMUsing family-style meals to increase participation and communication in persons with dementiaJ Gerontol Nurs2002289475312240521

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BakerJCHanleyGPMathewsRMStaff-administered functional analysis and treatment of aggression by an elder with dementiaJ Appl Behav Anal20063946947417236347

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SellersDMThe Evaluation of an Animal Assisted Therapy Intervention for Elders with Dementia in Long-Term CareActiv Adapt Aging20063016177

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Dwyer-MooreKJDixonMRFunctional analysis and treatment of problem behavior of elderly adults in long-term careJ Appl Behav Anal200740467968318189099

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ArntzenESteingrimsdottirHSBrogård-AntonsenABehavioral Studies of Dementia: Effects of Different Types of Matching-to-Sample ProceduresEur J Behav Anal2013401729

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