The case study method: a research tool

In-Home Training for Fathers of Children with Autism: A Follow up Study and Evaluation of Four Individual Training Components

Literature regarding fathers of children with autism remains sparse, and because mothers are the more common intervening parent, few training methods have focused on fathers. Thus, we sought to evaluate effects of in-home training directed at fathers and their ability to train mothers in the same manner in which they were trained. Fathers were taught four skills commonly associated with in-home training interventions for parents of children with autism: following the child's lead, imitation with animation, commenting on the child, and expectant waiting. Father skills were evaluated twice a week for 12 weeks during videotaped in-home father-child play sessions. Analyses included visual inspection of graphed data and statistical analyses of father skill acquisition, mother skill acquisition, and child behaviors with both parents. A multivariate repeated measures analysis of 18 dyads revealed significant increases in frequencies of fathers' imitation with animation, expectant waiting, and commenting on the child. Child initiating rates increased significantly as did frequencies of child non-speech vocalizations. Analysis of mothers revealed significant increases in frequencies of imitation with animation, expectant waiting, and following the child's lead. Child behaviors had similar results for father and mother sessions. Findings are consistent with those from our first study indicating that fathers can effectively implement skills that promote father-child social interactions and that children respond positively to this approach.

Evaluating in-home training for fathers of children with autism using single-subject experimentation and group analysis methods

BACKGROUND

Autism, or the broader category of autistic spectrum disorder, is a complex developmental disability with uncertain etiologies that appears to be increasing in prevalence. Researchers have stated that training programs for children with autism are most effective when they are individualized, address communicative intent of child behaviors, and promote social reciprocity between children and individuals with whom they have regular contact. Yet, to date, most of what is known comes solely from studying mothers, who have traditionally been the most accessible parent.

OBJECTIVES

In this study the mother-child in-home training program was modified and evaluated for its effects on the acquisition of training skills by fathers and on precommunication skills by the autistic children.

METHODS

Frequency counts of skills taught to fathers and targeted child behaviors were obtained from videotaped father-child play sessions. These data were analyzed for each father-child dyad by using graphs and visual analyses, which are integral parts of single-participant experimentation. This procedure was replicated across all of the father-child dyads. Data were then grouped and analyzed using the more traditional repeated measures analysis of variance.

RESULTS

The most significant findings were increases in father use of imitating with animation (p < .0001) and child initiating following training (p < .0004). Also noteworthy were significant increases in father responding (p < .0005) and child vocalizations (p < .05).

DISCUSSION

Results of the study indicate that the in-home training for fathers of children with autism was effective and valued by the participating families.

Single subject experimentation for psychiatric nursing

Mental health nurses encounter countless opportunities to assess medication and intervention efficacy but often find themselves relying solely on descriptive case study accounts and familiar group comparison methodology. Although case studies are useful, they lack scientific rigor and group comparison designs may not be suited to certain client populations or research questions that address individual client characteristics. The purpose of this article is to describe single subject experimentation, contrast this approach with case study and group comparison designs, and discuss how this type of scientific inquiry can be incorporated in psychiatric nursing practice.

The impact of critical injury as described by a spouse: a retrospective case study

This descriptive study explored the initial experience of critical injury from a spouse's perspective. A case study was used to examine the Lazarus stress and coping paradigm. The subject was 43-year-old Caucasian woman, with three young children. Semistructured interviews were conducted 1 month following critical injury. Analysis of data confirmed the cognitive, behavioral, and emotional coping processes as suggested by Lazarus. From the spouse's description, three distinct phases of the critical care experience also emerged: notification, arrival at the hospital, and waiting periods. Cognitive, behavioral, and emotional coping processes were clustered according to the spouse's distinct phases of this experience. A 3 x 3 matrix provides a description of the coping processes during the initial critical care period and offers direction for nursing interventions.

The case study: a viable approach to clinical research

The case study, although associated with several misconceptions which compromise its effective utilization, is especially appropriate for investigation of clinical nursing problems. A literature review of the application of this research approach in other practice-based disciplines was completed. Results indicate that the case study permits focusing upon the individual in an intensive, longitudinal perspective, and facilitates bridging of the research-practice gap. Internal and external validity, considered especially problematic in case studies, can be maximized by a variety of techniques.