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Journal of Pediatric Psychology Advance Access published online on July 13, 2005
Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsj049
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Journal of Pediatric Psychology © 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
Received December 30, 2004
Revised May 6, 2005
Accepted June 22, 2005

Article

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*, Carrie Piazza-Waggoner PHD2, Julie S. Jones PSYD3, Kathleen S. Ferguson PHD4, Cori Daines MD5, and James D. Acton MD5

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

* To whom correspondence should be addressed.
Scott W. Powers, E-mail: scott.powers{at}cchmc.org


  Abstract

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.

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