Behavioral observation and assessment protocol for language and social-emotional development study in children aged 0-6: the Chinese baby connectome project.

BACKGROUND: The global rise in developmental delays underscores the critical need for a thorough understanding and timely interventions during early childhood. Addressing this issue, the Chinese Baby Connectome Project (CBCP)'s behavior branch is dedicated to examining language acquisition, social-emotional development, and environmental factors affecting Chinese children. The research framework is built around three primary objectives: developing a 0-6 Child Development Assessment Toolkit, implementing an Intelligent Coding System, and investigating environmental influence. METHODS: Utilizing an accelerated longitudinal design, the CBCP aims to enlist a minimum of 1000 typically developing Chinese children aged 0-6. The data collected in this branch constitutes parental questionnaires, behavioral assessments, and observational experiments to capture their developmental milestones and environmental influences holistically. The parental questionnaires will gauge children's developmental levels in language and social-emotional domains, alongside parental mental well-being, life events, parenting stress, parenting styles, and family relationships. Behavioral assessments will involve neurofunctional developmental evaluations using tools such as the Griffiths Development Scales and Wechsler Preschool and Primary Scale of Intelligence. Additionally, the assessments will encompass measuring children's executive functions (e.g., Head-Toe-Knee-Shoulder), social cognitive abilities (e.g., theory of mind), and language development (e.g., Early Chinese Vocabulary Test). A series of behavior observation. experiments will be conducted targeting children of different age groups, focusing primarily on aspects such as behavioral inhibition, compliance, self-control, and social-emotional regulation. To achieve the objectives, established international questionnaires will be adapted to suit local contexts and devise customized metrics for evaluating children's language and social-emotional development; deep learning algorithms will be developed in the observational experiments to enable automated behavioral analysis; and statistical models will be built to factor in various environmental variables to comprehensively outline developmental trajectories and relationships. DISCUSSION: This study's integration of diverse assessments and AI technology will offer a detailed analysis of early childhood development in China, particularly in the realms of language acquisition and social-emotional skills. The development of a comprehensive assessment toolkit and coding system will enhance our ability to understand and support the development of Chinese children, contributing significantly to the field of early childhood development research. TRIAL REGISTRATION: This study was registered with clinicaltrials.gov NCT05040542 on September 10, 2021.

Common Feeding Practices Used by Chinese Caregivers of 6-10-Month-Old Infants: A Behavioral Observation Study in Shaanxi Province.

OBJECTIVE: To explore the feeding practices and feeding environment of Chinese families with 6-10-month-old infants. DESIGN: One day of caregiver-recorded feeding occasions. SETTING: Homes in Shaanxi, China. PARTICIPANTS: Families recruited using convenience sampling. VARIABLES MEASURED: Videos were coded for feeding practice frequency and acceptance rate, feeding environment, and responsiveness to infant fullness cues and eating pace. ANALYSIS: Wilcoxon rank sum tests examined the differences in feeding practice use based on caregiver type, infant sex, and infant weight status. RESULTS: Twenty-eight families provided videos for coding. The most commonly observed feeding practices were opening the mouth, giving instructions, and interfering with the child's actions. Prompts to eat were accepted 86.9% of the time. Overweight infants' caregivers used significantly more coercive prompts to eat than did caregivers of healthy-weight infants (P < 0.05). Mothers used more autonomy-supportive prompts to eat than did fathers (P < 0.05). Early, active, and late infant fullness cues were captured in 25.6%, 34.8%, and 8.5% of videos, respectively. 53.6% of caregivers fed at the right pace, whereas 14.5% and 31.9% fed too slow or too fast, respectively. Approximately 5.5% of videos had a screen on, and 33.5% of videos included at least 1 other distraction during the meal. CONCLUSIONS AND IMPLICATIONS: Differences in feeding practices among caregivers suggest that targeted advice may further improve feeding practices. Improving the caregiver's ability to identify satiety cues and respond to infant eating speed may also reduce the risk of overfeeding.

Natural clues to danger: attachment behavior in threatening situations.

A fundamental principle of attachment theory is that threatening situations give rise to individual differences in the extent to which people seek proximity to close others. The current research examines the way in which attachment styles predict individual differences in attachment-relevant behavior during threatening events. We tested alternative theoretical perspectives concerning the association between adult attachment (specifically, attachment avoidance) and attachment behavior in the presence of natural clues to danger by observing couples (N = 204) when they were watching horror vs. control film excerpts. Results suggest that highly avoidant people engaged in less attachment behavior across both threatening and non-threatening situations. These findings have implications for the understanding of attachment-related processes and how working models of the self and others facilitate (or inhibit) the expression of attachment behavior.

User behaviors in a community-based multifunctional urban park with dog friendly area.

Urban parks are essential for community revitalization; for example, they are places to walk dogs and interact with other dog keepers. This study focused on an urban park with a dog-friendly area to be used by both dog keepers and other users as an alternative to off-leash dog parks that completely separate them and clarified aspects of park use through behavioral observation. The behaviors of 7122 visitors in 14 areas in the park and 294 pairs of dogs and their keepers in the dog-friendly area were observed. The results showed that the visitors' age groups and use behaviors differed by area. The dog-friendly area was in constant demand among dog keepers as a place where they could stay and interact with others and as a destination or relay point when walking their dogs. Visitors used the park in accordance with rules and morals, and the park was well managed. As it can be comfortably used by everyone (with or without dogs), this park can serve as a model for the development and maintenance of community-based multifunctional parks in urban areas.

Unpacking interactions among student teams in a practice-based IPE setting: a qualitative evaluation study.

In many healthcare settings, teams change composition regularly, so healthcare students must be trained to function effectively in dynamic teams before entering the workforce. Interprofessional clinical rotations provide an ideal venue for learners to practice these skills, but little is known about how student teams interact in such settings. In this qualitative observational evaluation, learners from multiple health professions at a single institution participated in scheduled clinics in low-income housing communities for older adults. Interprofessional student teams met with program participants for care coordination, health and wellness assessments, and assistance in setting and achieving health goals; team composition changed from week-to-week. A purposive sample was selected from video-recorded encounters between student teams and their program participants. The aim of this study was to explore team interactions and document learner behaviors. Two researchers independently reviewed discrete segments of each video, recorded their observations and reflections, and then the team discussed, categorized, and identified relevant examples of both effective and ineffective behaviors. Four major themes were observed: inclusiveness, leadership, joy of practice, and sharing of clinical knowledge. Students demonstrated both positive and negative examples of behaviors that aligned with each theme. Understanding how students behave on teams in dynamic settings where patient care is taking place can help educators establish practice-based interprofessional education models that better prepare learners to function effectively and strategies that may improve team interactions.

Gabriele Meyer-Enders und Gerd Lehmkuhl Kinder gestalten Narrative ­ erste Erfahrungen mit dem revidierten Sceno 2-Test / Children Create Narratives ­ First Experience with the Revised Sceno-2 Test.

Children Create Narratives - First Experience with the Revised Sceno-2 Test The Sceno Test, created by Gerthild von Staabs, has been in use and has been useful in its original version for more than 80 years. It has now undergone a major revision.The test will retain its relevance as a projective diagnostic procedure offering children and juveniles opportunities to design scenes and to voice narratives coming along with them. It can serve as an instrument encompassing all therapeutic approaches to explore infantile wishes, perceptions, and interpretations and can provide, as intended by Gerthild von Staabs, indications of family dynamics.The revision of the test will be discussed at great length.

Diversity, equity, and inclusivity in observational ambulatory assessment: Recommendations from two decades of Electronically Activated Recorder (EAR) research.

Ambient audio sampling methods such as the Electronically Activated Recorder (EAR) have become increasingly prominent in clinical and social sciences research. These methods record snippets of naturalistically assessed audio from participants' daily lives, enabling novel observational research about the daily social interactions, identities, environments, behaviors, and speech of populations of interest. In practice, these scientific opportunities are equaled by methodological challenges: researchers' own cultural backgrounds and identities can easily and unknowingly permeate the collection, coding, analysis, and interpretation of social data from daily life. Ambient audio sampling poses unique and significant challenges to cultural humility, diversity, equity, and inclusivity (DEI) in scientific research that require systematized attention. Motivated by this observation, an international consortium of 21 researchers who have used ambient audio sampling methodologies created a workgroup with the aim of improving upon existing published guidelines. We pooled formally and informally documented challenges pertaining to DEI in ambient audio sampling from our collective experience on 40+ studies (most of which used the EAR app) in clinical and healthy populations ranging from children to older adults. This article presents our resultant recommendations and argues for the incorporation of community-engaged research methods in observational ambulatory assessment designs looking forward. We provide concrete recommendations across each stage typical of an ambient audio sampling study (recruiting and enrolling participants, developing coding systems, training coders, handling multi-linguistic participants, data analysis and interpretation, and dissemination of results) as well as guiding questions that can be used to adapt these recommendations to project-specific constraints and needs.

Coding Dyadic Behavior in Caregiver-Child Interaction from a Clinical Psychology Perspective: How Should Multiple Instruments and Outcomes Be Dealt with?

The experiences children have in the interactions with their caregivers influence their developmental outcomes. To target caregiving and optimize intervention effects, the assessment of caregiver-child interactions is highly relevant for families affected by parental mental disorders. Behavioral observation is a widely used method for assessing family dynamics, and the literature offers a wide variety of instruments with which to code such data. However, a structured overview of behavioral observation instruments (BOIs) is lacking, and the multitude of types of dyadic behaviors (DBs) assessed within each BOI are complicating their application. We aim to provide an overview of the BOIs applied to families affected by mental disorders and suggest a DB taxonomy that may be used across BOIs. We first conducted a systemic literature search to identify the most frequently used BOIs and the DBs they capture in clinical psychology. Second, we asked 13 experts to sort DB terms based on perceived conceptual similarity and analyzed these results using multidimensional scaling. We found approximately 450 different terms for DBs, and we argue that DBs can be classified within two overarching dimensions, i.e., in terms of structure and in terms of reaction to a child's signals. These efforts can facilitate the coding and application of BOIs in clinical practice.

Psychometric Properties of the Dutch Contextual Assessment of Social Skills (CASS): An Independent Observational Outcome Measure of Social Skills in Autistic Adolescents.

The goal of this study was to translate and adapt the original 9-item of the Contextual Assessment of Social Skills (CASS) to a Dutch version and assess its psychometric qualities. Autistic adolescents aged 12 to 18 years (n = 99) took part in a randomized controlled trial. In this study, pre-intervention data were utilized. The original CASS was adapted to ensure cultural relevance and the content validity was assessed. Data was used to assess reliability and structural validity, using confirmatory factor analysis. 4-item were added to the CASS during the adaptation to better align with the objectives of the experimental intervention. The original 9-item had inter-item correlations between .01 and .70. The Cronbach's alpha for the original 4-item total score was moderate (α = .69), while for a 7-item total score, it was high (α = .86). This 7-item total score had a sufficient model fit (Comparative Fit Index = .90). This total score had a significant correlation with the Assertion subscale of the Social Skills Improvement System-Adolescent (SSIS-A) (r = 0.26, p < .01), and the Social Responsiveness Scale-2 (SRS-2) total score (r = - .21, p = .04) indicating sufficient convergent validity. The CASS total score was not correlated with the Repetitive and Restricted Behavior scale of the SRS-2 (r = - .08, p = .43), indicating sufficient divergent validity. The Dutch CASS can be considered a conceptually sound and reliable observational instrument for assessing social conversational skills in Dutch autistic youth. Further evaluation of its feasibility when implemented in practice, outside of clinical research, is needed.Trial registration: Dutch trail register NTR6255 (NL6117) 08/02/2017 https://www.trialregister.nl/trial/6117.

Human-AI teaming: leveraging transactive memory and speaking up for enhanced team effectiveness.

In this prospective observational study, we investigate the role of transactive memory and speaking up in human-AI teams comprising 180 intensive care (ICU) physicians and nurses working with AI in a simulated clinical environment. Our findings indicate that interactions with AI agents differ significantly from human interactions, as accessing information from AI agents is positively linked to a team's ability to generate novel hypotheses and demonstrate speaking-up behavior, but only in higher-performing teams. Conversely, accessing information from human team members is negatively associated with these aspects, regardless of team performance. This study is a valuable contribution to the expanding field of research on human-AI teams and team science in general, as it emphasizes the necessity of incorporating AI agents as knowledge sources in a team's transactive memory system, as well as highlighting their role as catalysts for speaking up. Practical implications include suggestions for the design of future AI systems and human-AI team training in healthcare and beyond.

Teachers' perception of aggressive student behavior through the lens of chronic worry and resignation, and its association with psychophysiological stress: An observational study.

Aggressive student behavior is considered a leading risk factor for teacher stress. However, teachers' coping styles may affect how they perceive and respond to aggressive student behavior. This study tests whether teachers' perceptions of aggressive student behavior mainly mirror objectively observed aggression in presence of the teacher (as coded by external observers) or whether teachers' perception of aggressive student behavior primarily reflects teachers' avoidant coping styles, such as chronic worry and resignation. Finally, we examine whether observed and teacher-perceived aggression relates to increased vital exhaustion and psychophysiological stress among teachers (i.e., higher hair cortisol concentration). In an ambulatory assessment study, we administered self-reports to 42 Swiss teachers to assess perceived student aggression, chronic worry, resignation, and vital exhaustion. Additionally, four consecutive lessons per teacher were filmed, and aggressive student behavior in presence of the teacher was coded by four trained external observers. The concentration of cortisol was assessed in hair samples. Results showed that teacher-perceived and observed aggression were moderately associated. Observed aggression was related to teacher perceptions to a much lesser extent than teachers' avoidant coping styles, that is, chronic worry and resignation. While teacher-perceived student aggression was associated with teachers' self-reported vital exhaustion, we did not find any significant association with hair-cortisol concentration. Our findings suggest that teachers perceive student aggression through the lens of their coping styles. Teachers' dysfunctional coping styles are associated with an overestimation of student aggression. Teachers' overestimation of student aggression relates to higher levels of vital exhaustion. Therefore, it is crucial to identify and change teachers' dysfunctional coping styles to prevent a vicious cycle of dysfunctional teacher-student interactions.

Home-visiting programs based on the Brazelton approach: a scoping review.

This review maps and summarizes the quantitative studies on the main outcomes associated with home visiting (HV) programs using Brazelton methods aimed at supporting expectant and new parents. One hundred thirty-seven records were identified, and 19 records were selected. The design of our study was based on the methodological framework for conducting scoping reviews. Quality was assessed through the Jadad scale. Studies were coded for participant characteristics (number, mean age, and risk status), methodology (recruitment, home visit frequency, age of the child, Brazelton method, and research design), and intervention outcomes (on infants, parents, and home visitors). The studies mostly focused on the impact of Brazelton HV programs on infant development, the mother's psychological well-being, mother-infant interaction, and home visitor satisfaction. Experimental and quasi-experimental studies consistently have shown that parents receiving the intervention have greater knowledge of their children. Results are less conclusive regarding the intervention's impact on other domains of child development, mothers' psychological well-being, and mothers' sensitivity to the relationship with the child. Overall, the results suggest that the improvements associated with the intervention are mainly influenced by the risk status of families. Further research is needed to better understand the benefits of HV based on the Brazelton approach and the target population that may benefit most from this intervention. CONCLUSION:  Although the impact of the Brazelton home visiting intervention is not yet fully understood, there is promising evidence of its positive effects on child development, maternal well-being, and parental knowledge. Further research with consistent methodologies and larger sample sizes is needed to strengthen our understanding. However, existing findings in the literature underscore the importance of preventive interventions such as the Brazelton program in improving family well-being, with potential long-term benefits. WHAT IS KNOWN: • Home visiting programs based on the Brazelton approach aim to increase parents' knowledge and sensitivity to their children. • There is no clear picture in the literature of the effectiveness of these programs. WHAT IS NEW: • Existing studies consistently show the effectiveness of these programs to improve parents' knowledge of their children. • Findings on the impact of these programs on child development, mothers' psychological well-being and sensitivity to their child are inconclusive and may be influenced by the risk status.

Conception and Development of the Warmth/Affection Coding System (WACS): A Novel Hybrid Behavioral Observational Tool for Assessing Parent-to-Child Warmth.

A vast body of research and theory underscores the importance of parental warmth/affection (hereby 'warmth' and 'warmth/affection' are used interchangeably) as a distinct relational process that is fundamental to core developmental processes including parent-child attachment, socialization, emotion recognition and responsivity, and empathic development. The increasing focus on parental warmth as a viable transdiagnostic and specific treatment target for Callous-Unemotional (CU) traits highlights the critical need for a reliable and valid tool for measuring this construct within clinical contexts. However, existing assessment methods have limitations in their ecological validity, clinical utility, and the comprehensiveness of their coverage of core warmth subcomponents. In response to this clinical and research need, the observational Warmth/Affection Coding System (WACS) was developed to comprehensively measure parent-to-child warmth/affection. This paper chronicles the conception and development of the WACS, which adopts a hybrid approach of utilizing both microsocial and macro-observational coding methods to capture key verbal and non-verbal subcomponents of warmth that are currently underrepresented or poorly captured by existing assessment tools. Recommendations for implementation and future directions are also discussed.

Women's Disengagement Behaviors During Couple Conflict: Investigating Risk Indicators of Intimate Partner Violence.

Intimate partner violence (IPV) is a major public health concern, leading to prevention efforts focused on identifying risk indicators of escalating conflict between partners. Certain behaviors during conflict discussions have been uniquely linked to IPV, and there is evidence that disengagement behaviors-an emerging construct-are associated with IPV as well. However, research on disengagement and IPV has largely been limited to self-report, and available observational research is largely cross-sectional. Addressing these limitations, this study prospectively examined the association between observed disengagement behaviors during couple's conflict discussions and IPV 1 year later, using a sample of 83 heterosexual married or cohabitating partners. Behavioral coding was used to assess each partner's observed disengagement behaviors and each partner's psychological and physical IPV was assessed via questionnaire 1 year later. Linear regressions were used to investigate links between indicators of engagement (i.e., listening, questions, eye contact) and psychological and physical IPV perpetration and victimization. Less question asking and higher eye contact by women were associated with greater psychological and physical IPV perpetrated by both women and men 1 year later. Lower listening behaviors by women were associated with greater psychological (but not physical) IPV perpetrated by men 1 year later. In contrast, no disengagement behaviors displayed by men were significantly related to IPV. Applying a latent change score framework using baseline IPV data, findings indicated replicability of results, though with less consistency, suggesting that women's disengagement behaviors may reflect a larger pattern of abuse that predates and follows disengaged couple interactions. Findings suggest that a unique blend of verbal and nonverbal indicators of women's disengagement during couple conflict provides a meaningful signal of the emotional climate of the relationship.

Emergence from General Anaesthesia: Can We Discriminate between Emergence Delirium and Postoperative Pain?

Unsettled behaviors characterize the early phase after general anaesthesia in the pediatric population in up to 80% of cases. Emergence delirium (ED) and acute pain are the two most relevant sources of this phenomenon. Research and clinical guidelines are difficult to implement due to the variability of the definition of unsettled behavior and measurement of the different components. The most probable incidence of ED is between 10% and 20%, and the potential risk factors could be summarized as young age, male gender, preoperative anxiety, baseline sleep-disordered breathing, volatile anaesthesia and ENT or ophthalmologic surgery. Self-reporting behavioral and observational scales are unable to reliably differentiate between ED and pain in a child who is not fully awake, making correct treatment choices difficult. This may lead to an undertreatment of pain in agitated children or to the overuse of opioids for self-limiting ED. This paper considers the current knowledge on the identification and treatment of ED and pain and provides a pragmatic approach for daily practice.

Influence of an Automatic Enrichment Device on Laying Hen Behavior and Plumage Condition.

Feather pecking and cannibalism are prominent problems in modern laying hen husbandry. Among the various approaches to address this issue, environmental enrichment plays a crucial role. In this on-farm study, four winter gardens of an organic farm henhouse were equipped with an automatic enrichment device. Different quantities of downpipes dosing grain on rough-coated pecking plates (PPs) were tested. One group served as a control (CG) without an automatic enrichment device, while the others were offered different numbers of PPs, with one equipped with a doubled amount of PPs (DEG) compared to the other two groups (SEG). Video analyses of the hens' duration of stay and behaviors in the recorded winter garden area and around the PPs were performed, and regular assessments of the plumage condition were conducted. By the end of the production cycle, no hens with intact plumage were found, with hens in the CG and DEG showing worse scores and earlier deterioration in the plumage condition than in the SEG. The offer of PPs showed a significant influence on the duration of stay in the filmed area. Hens in the DEG stayed significantly longer (mean: 129 s, SD: 126 s) than those in the CG (mean: 79 s, SD: 91 s; p < 0.05) and SEG (mean: 75 s, SD: 83 s; p < 0.005). On the performed behavioral bouts per hen and minute (CG mean bouts/minute (SD): 5.47 (2.92); SEG mean (SD): 5.33 (2.76); SEG mean (SD): 5.81 (3.24)), no significant influences were detected. Environmental pecking was the behavior most frequently observed in all winter gardens, where, particularly around the PPs, pecking at the device was observed. Therefore, the enrichment device can be assessed as well accepted by the hens in winter gardens. The effect of the device on the plumage condition remains unclear, with external factors probably showing a greater influence than the enrichment.

Using Observational Dyadic Methods in Youth Mentoring Research: Preliminary Evidence of the Role of Actors' and Partners' Self-disclosure in Predicting Relationship Quality.

Self-disclosure builds high quality relationships, but knowledge of self-disclosure in youth mentoring relationships is limited by a lack of research and reliance on self-reports. To demonstrate the value of observational methods and dyadic modeling of mentoring communication processes, this study examined the associations between behavioral observation of self-disclosure and self-reported relationship quality in 49 mentee-mentor dyads (mentees: 73.5% female; x̄ age = 16.2, range = 12-19; mentors: 69.4% female; x̄ age = 36.2, range = 19-59). Video-recorded observations of disclosure were coded on three dimensions: amount (number of topics and detail of disclosure), intimacy (disclosure of personal or sensitive information), and openness (willingness to disclose). More intimate mentor disclosure was associated with higher mentee relationship quality, whereas higher amount of mentor disclosure combined with low intimacy was associated with lower mentee relationship quality. Greater mentee openness correlated with higher mentor relationship quality, but more intimate mentee disclosures were associated with lower mentee relationship quality. These preliminary findings illustrate the potential of methods that enable in-depth investigation of dyadic processes to advance understanding of how behavioral processes may influence mentoring relationships.

Instruments to measure interaction of mothers and newborns: A systematic review.

Interactions between newborns and their parents/primary caregivers are characterized by asymmetric and dependent relationships. This systematic review mapped, identified, and described the psychometric parameters, categories, and items of instruments used to assess mother-newborn interaction. Seven electronic databases were accessed in this study. Furthermore, this research included neonatal interaction studies describing instruments' items, domains, and psychometric properties while excluding studies that focused on maternal interactions and lacked items for assessing newborns. Additionally, studies validated with older infants that did not have a newborn in the sample were used for test validation, which is a criterion used to decrease the risk of bias. Fourteen observational instruments from 1047 identified citations were included that addressed interactions using varying techniques, constructs, and settings. Particularly, we focused on observational settings that assessed interactions with communication-based constructs in the context of proximity or distance as influenced by physical, behavioral, or procedural barriers. These tools are also used to predict risk behaviors in a psychological context, mitigate feeding difficulties, and conduct neurobehavioral assessments of mother-newborn interactions. The elicited imitation was also an observational setting. This study found that the most described properties in the included citations were inter-rater reliability followed by criterion validity. However, only two instruments reported content, construct, and criterion validity, as well as a description of an internal consistency assessment and inter-rater reliability. Finally, the synthesis of the instruments reported in this study can guide clinicians and researchers in selecting the most appropriate one for their own application.

Immediate effects of individualized music listening on behavioral and psychological symptoms of dementia: A randomized controlled trial.

OBJECTIVES: Evidence suggests that individualized music listening (IML) can effectively reduce the behavioral and psychological symptoms of dementia (BPSD). So far, however, studies have been primarily based on questionnaire measures of BPSD completed by proxy. We therefore investigate effects of IML on BPSD based on systematic observation. We address the methodological limitations of previous observational studies by using a validated instrument, time-based sampling, and longitudinal analytical methods. METHODS: We compared BPSD of nursing home residents with dementia in an IML intervention group (IG; n = 44) and a control group (CG; n = 46) in a randomized controlled trial (DRKS00013793; ISRCTN59052178). Trained raters observed 18 BPSD in 15 four-minute intervals before, during and after an IML session. We used t-tests to compare BPSD in the IG and CG before, during and after the session and piecewise latent curve modelling to compare BPSD trajectories across 1 hour. RESULTS: BPSD were observed less frequently in the IG than in the CG during, but not before or after the session. Likewise, whereas the CG experienced a stable trajectory of BPSD, the IG experienced a u-shaped trajectory characterized by stability before the session, a decrease during the session, and increase after the session. There was significant interindividual variability in baseline BPSD and in the pre- and post-session slopes. DISCUSSION: Our results provide additional evidence that IML effectively reduces BPSD, although the effect is short-lived. As IML rarely has negative side effects, is highly accepted and easily implemented, IML should be integrated into the everyday care routines for people with dementia. CLINICAL TRIAL REGISTRATION: German Clinical Trials Register DRKS00013793; ISRCTN registry, ISRCTN59052178.

An Examination of Measurement Procedures and Characteristics of Baseline Outcome Data in Single-Case Research.

There has been growing interest in using statistical methods to analyze data and estimate effect size indices from studies that use single-case designs (SCDs), as a complement to traditional visual inspection methods. The validity of a statistical method rests on whether its assumptions are plausible representations of the process by which the data were collected, yet there is evidence that some assumptions-particularly regarding normality of error distributions-may be inappropriate for single-case data. To develop more appropriate modeling assumptions and statistical methods, researchers must attend to the features of real SCD data. In this study, we examine several features of SCDs with behavioral outcome measures in order to inform development of statistical methods. Drawing on a corpus of over 300 studies, including approximately 1,800 cases, from seven systematic reviews that cover a range of interventions and outcome constructs, we report the distribution of study designs, distribution of outcome measurement procedures, and features of baseline outcome data distributions for the most common types of measurements used in single-case research. We discuss implications for the development of more realistic assumptions regarding outcome distributions in SCD studies, as well as the design of Monte Carlo simulation studies evaluating the performance of statistical analysis techniques for SCD data.