Tough Kids_ Practical Behavior Management

							+
 Special Education
 and Related
 Services: What Have
 We Learned From
 Meta-Analysis?                                                                           Presented by
                                                                                          Julia Hood
 By Steven R. Forness
                                                                                          3/11/09
 University of California, Los Angeles
 Neuropsychiatric Hospital




Training School Psychologists to be Experts in Evidence Based Practices for Tertiary Students with Serious Emotional
                                         Disturbance/Behavior Disorders

                                           US Office of Education 84.325K

                                                   H325K080308
+
    Special Education

       Criticism of the effectiveness of special education

       Research efforts in Special Education have also been
        criticized

       Past research efforts of narrative report are insufficient and
        inadequate

       Lack of evidence for effective interventions based on:
           Certain types of problems
           Certain types of children
           In comparison to other interventions
+
    Special Education

       Meta-analysis is being used more frequently as a means to
        synthesize research in the area of interventions and special
        education
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    Special Education

       Current meta-analysis is an update to a previous synthesis in
        order to make the research more current

       24 separate meta-analyses across 20 intervention topics

       Compared mean effect sizes (ES)
           Difficulty because no directly comparable studies
           Studies had different purposes, research samples, and outcome
            measures

       Therefore, only tentative conclusions can be drawn as to
        relative effectiveness and need for further investigation
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    Meta-Analyses for Special
    Education Large ES
    Intervention                     ES     Number of Studies

    Mnemonic strategies
    (Mastropieri & Scruggs,          1.62   24
    1989)
    Reading-comp. strategies
    (Talbott, Lloyd, & Tankersley,   1.13   48
    1994)                            0.98   68
    (Mastropieri et al., 1996)       0.72   58
    (Swanson, 1999)
    Behavior modification
    (Skiba & Casey, 1985)            0.93   41
    Direct instruction
    (White, 1988)                    0.84   25
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    Meta-Analyses for Special
    Education Medium ES
    Intervention                  ES     Number of Studies

    Cognitive behavior
    modification
    (Robinson, Smith, Miller, &   0.74   23
    Brownell, 1999)
    Psychotherapy
    (Weisz & Weiss, 1993)         0.71   110
    Formative evaluation
    (Fuchs & Fuchs, 1986)         0.70   21
    Early intervention
    (Casto & Mastropieri, 1986)   0.68   74
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    Meta-Analyses for Special
    Education Medium ES
    Intervention                   ES     Number of Studies

    Stimulant medication
    (Crenshaw, Kavale, Forness,
    & Reeve, 1999)                 0.67   115
    (Kavale, 1982)                 0.58   135
    Computer-assisted
    instruction
    (Schmidt, Weinstein, Niemie,   0.66   18
    & Walberg, 1985–86)
    Peer tutoring
    (Cook, Scruggs, Mastropieri,   0.58   19
    & Casto, 1985–86)

    Word-recognition
    strategies
    (Swanson, 1999)                0.57   54
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    Meta-Analyses for Special
    Education Small ES
    Intervention                   ES     Number of Studies

    Psycholinguistic
    training
    (Kavale, 1981)                 0.39   34
    Reducing class size
    (Glass & Smith, 1979)          0.31   77
    Psychotropic
    medication
    (Kavale & Nye, 1984)           0.30   70
    Social-skills training
    (Forness & Kavale, 1996)       0.21   53
    (Quinn, Kavale, Mathur,        0.20   35
    Rutherford, & Forness, 1999)
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    Meta-Analyses for Special
    Education Small ES
    Intervention                ES      Number of Studies

    Modality instruction
    (Kavale & Forness, 1987)    0.14    39

    Diet restrictions
    (Kavale & Forness, 1983)    0.12    23
    Perceptual training
    (Kavale & Mattson, 1983)    0.08    180
    Special class
    placement
    (Carlberg & Kavale, 1980)   -0.12   50
+ Single-Participant Studies


     Inclusion of single-subject studies is a controversial topic

     When included, Percentage of Non-overlapping Data (PND)
      is commonly used as the metric
         Data points obtained during intervention phases that do not
          overlap with any data points from baseline or reversal phases are
          divided by the total number of intervention phase data points
         Criteria for effectiveness are:
             90-100 Powerful intervention
             70-90 Favorable
             50-70 Questionable
             Under 50 Unfavorable
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    Special Education “Mega-
    Analysis”
       When all of the mean ES’s from all of the meta-analyses were
        combined, there was an overall ES of .55 for special
        education
           This was partially weighted for the interventions that had more
            than one meta-analysis


       This would imply that there is a substantial benefit to special
        education
           There are dangers to combining studies that are this diverse
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    “special”, “education”, or
    “related”
       Must look at the intervention and the emphasis of
        “special”, “education”, or “related”
     “Special” is  an intervention that involves a unique
        and different method that would not typically be
        used in general education
         Usually designed solely for use in special
          education
         Goal of enhancing hypothetical and
          unobservable constructs that are presumed to
          cause learning deficits
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    “special”, “education”, or
    “related”
     “Education” isthe category of interventions
     that emphasize education by adapting and
     modifying instruction
      Origins in general education and modified
       for special education to accommodate the
       needs of students
      Direct approach of adapting instruction to
       enhance the academic learning of special
       education students
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    “special”, “education”, or
    “related”
      “related” servicesare dependent on other
      professionals aside from the teacher
       Consultation from other professionals (school
        psychologists, behavior analysts)
       Actual delivery of the intervention by another
        individual
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    Special “Education”

       Mneumonic Strategies               1.62

       Reading Comprehension Strategies 0.94

       Direct Instruction                 0.84

       Formative Evaluation               0.70

       Computer-assisted Instruction      0.66

       Peer Tutoring               0.58

       Word Recognition Strategies 0.57

       Mean                        0.84
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    “Special” Education

       Psycholinguistic Training          0.39

       Social Skills Training             0.20

       Modality Instruction               0.14

       Perceptual Training                0.08

       Mean                        0.20
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    “Related” Services

       Behavior Modification                    0.93

       Cognitive Behavior Modification          0.74

       Psychotherapy                            0.71

       Stimulant Medication              0.62

       Psychotropic Medication                  0.30

       Diet Restrictions                        -0.12

       Mean                              0.53
+
    Conclusions

       Best practice
           Combine interventions with medium to high ES’s
           Look at how the combination of certain interventions will produce
            varying ES’s
           Monitor students’ progress
           Teacher cognitive-behavioral self-management
           Possibility of stimulant medications (particularly ADHD)


       Professionals following these guidelines should expect
        better outcomes
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    Considerations About Practice

       Some versions of certain interventions can have different
        effect (positive or negative)

       Some children will benefit more from some interventions
        than other children would

       Many of the studies included are now over 10 years old
           New research has been done and should be considered
+ Final Thought


                   education cannot be
   Overall, special
   considered ineffective based on the results
   of this “mega-analysis”