Systematic review of interruption and redirection procedures for autistic individuals

Abstract

Interruption and redirection (IR) procedures involve systematically disrupting an undesirable behavior and prompting an individual to engage in an alternative behavior (e.g., Ahearn et al., 2007). These procedures have been frequently assessed for reducing stereotypy for autistic individuals. The purposes of this review were to determine (a) for whom and under what conditions physical and verbal IR procedures are assessed; (b) what outcomes are measured; (c) whether results vary by intervention characteristics, dependent variable types, design quality, and publication status; and (d) the extent to which generalization and maintenance outcomes are measured and show positive effects. IR interventions were moderately successful for reducing stereotypy but were less effective for improving appropriate vocalizations and functional engagement. Generalization and maintenance outcomes, when measured, were poor. Results indicate the need for alternative or augmentative procedures that focus on engagement in meaningful interactions and activities.

Single-case design effect-size distributions: Association with procedural parameters.

“…This article describes a subset of data from a larger project (J. C. Chow, 2023; Ledford, Eyler, et al, 2023); specific search terms and strategies are described in that article and are available via Open Access Materials (Ledford, Eyler, et al, 2023). We conducted title and abstract search via Abstrackr, followed by full-text screening of study PDFs.…”

“…We conducted title and abstract search via Abstrackr, followed by full-text screening of study PDFs. Two separate Preferred Reporting Items for Systematic Reviews and Meta-Analyses diagrams are available via Open Access Materials (Ledford, Eyler, et al, 2023), one for studies that included an engagement measure and one for studies that included a challenging behavior measure. Some studies are included in both (see the Results section for more information on the total number of sources, participants, and designs within and across dependent variable type).…”

“…The four authors coded study characteristics via REDCap hosted at Vanderbilt University (Harris et al, 2022). Authors developed the code book (available via Open Access Materials; Ledford, Eyler, et al, 2023), revised the codes via initial coding and discrepancy discussions, and then coded remaining articles. We double-coded 38% of sources and conducted ongoing discrepancy discussions for 100% of disagreements identified in those sources.…”

“…Additional variables were coded for analyses not reported in this article, including participant demographic information and disability status, implementer status (e.g., endogenous, researcher), publication status, group size, functional relation status (using visual analysis), and whether the dependent variable represented a primary or secondary variable. These analyses are available in a companion article (Ledford, Eyler, et al, 2023).…”

Single-Case-Design Research in Special Education: Next-Generation Guidelines and Considerations

“…Given the complexities associated with assessing practices (Ledford et al, 2021b), we propose that systematic reviews of interventions result not in a determination of "evidence based" or "not evidence based" but rather in a determination of the contexts in which the practice has more or less support and in what areas additional research is needed. Researchers are eager to be influenced by rules, but their behavior may be insensitive to contingencies that operate in opposition to expectation (cf.…”