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Journal of Pediatric Psychology Advance Access originally published online on July 13, 2005
Journal of Pediatric Psychology 2006 31(6):574-581; doi:10.1093/jpepsy/jsj049
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© The Author 2005. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oupjournals.org

Examining Clinical Trial Results with Single-Subject Analysis: An Example Involving Behavioral and Nutrition Treatment for Young Children with Cystic Fibrosis

Scott W. Powers, PhD, ABPP1,2, Carrie Piazza-Waggoner, PhD1, Julie S. Jones, PsyD3, Kathleen S. Ferguson, PhD1,2, Cori Daines, MD2,4 and James D. Acton, MD2,4

1 Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, 2 Department of Pediatrics, University of Cincinnati College of Medicine, 3 Division of Developmental and Behavioral Pediatrics, Greenville Hospital System Children’s Hospital, and 4 Cystic Fibrosis Center, Cincinnati Children’s Hospital Medical Center

All correspondence concerning this article should be addressed to Scott W. Powers, PhD, ABPP, Division of Behavioral Medicine and Clinical Psychology, Center for Child Behavior and Nutrition Research, MLC: D-3015, 3333 Burnet Avenue, Cincinnati, Ohio 45229-3039. E-mail: scott.powers{at}cchmc.org.

Received December 30, 2004; revisions received May 6, 2005; accepted June 22, 2005

Objective To examine the process of change in a clinical trial of behavioral and nutrition treatment for children age 18–48 months with cystic fibrosis (CF) using single-subject analysis. Methods The 5-week treatment included nutrition counseling and child behavioral management training for parents and was designed to increase energy intake measured by diet diaries 600–800 calories per day. Results Energy intake changed at each meal, only when treatment was introduced (week 1: snacks, 420 to 691; week 2: breakfast, 325 to 443; week 4: lunch, 350 to 443; and week 5: dinner, 373 to 460 calories per day). Total daily intake increased in a systematic fashion that exceeded the criterion set each week during treatment. Conclusions Toddlers and preschoolers with CF meet energy intake recommendations as a result of behavioral intervention. Single-subject research designs are important methodologies for advancing clinical investigation in pediatric psychology.

Key words: changing criterion design; multiple baseline design; parenting; pediatrics; single case experimental designs.


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