Task Sequencing for Students With Emotional and Behavioral Disorders

Abstract

We reviewed studies utilizing task sequencing to improve academic outcomes for children with emotional and/or behavioral disorders (EBD) in educational settings. Task sequencing interventions included high-probability, high-preference, and task interspersal interventions. Although task sequencing is commonly used in research, a synthesis of recent applications in educational settings for students with EBD is absent. Systematic searches of electronic databases and ancestral references identified 11 studies meeting inclusion criteria. These 11 studies were reviewed and analyzed for (a) participant characteristics, (b) experimental design, (c) type of academic outcome as the dependent variable, (d) intervention description, (e) certainty of evidence and research quality, and (f) reported student academic outcomes. Implications for continued applied practice and future research are discussed.

Keywords

emotional/behavioral disorders task sequencing academic intervention high-probability sequence interspersed requests high-preference strategy

Students with emotional/behavioral disorders (EBD) exhibit serious social, emotional and/or behavioral difficulties that can affect academic progress, relationships with others, self-care, or vocational abilities (Bradley, Doolittle, & Bartolotta, 2008; Wood & Cronin, 1999). When compared with their peers, students with EBD experience poorer school and postschool outcomes (Lane, Wehby, Little, & Cooley, 2005; Reid, Gonzales, Nordness, Trout, & Epstein, 2004; Trout, Nordness, Pierce, & Epstein, 2003). Students with EBD have the second lowest high school graduation rate and the highest dropout rate (Bradley et al., 2008). In addition, students who present with serious academic and behavioral deficits are at risk for placement in more restrictive settings (Gagnon & Leone, 2005; George, George, Kern, & Fogt, 2013). These poor educational outcomes strongly predict lifelong difficulties (Lane, Barton-Arwood, Nelson, & Wehby, 2008; Scott & Shearer-Lingo, 2002). Therefore, fostering improved educational outcomes for this population is critical (Mathur & Nelson, 2013).

The link between the presence of challenging behavior and poorer academic performance is strong (Lane, Carter, Pierson, & Glaeser, 2006; Morgan & Sideridis, 2013). Challenging behavior is common for students with EBD in academic settings and likely stems from specific academic skill deficits (Reid et al., 2004) and low motivation to complete academic work (Lan & Lanthier, 2003; Olympia, Sheridan, Jenson, & Andrews, 1994). Likewise, the presence of challenging behavior may function as a way for a child to endure the academic and social demands of school (Kern, Delaney, Clarke, Dunlap, & Childs, 2001). The growing body of research demonstrates a complex reciprocal relationship between academic deficits and challenging behavior (Mason, Kubina, & Hoover, 2011). Fortunately, an expanding database of interventions exists to address the complex needs of students with EBD (Hawkins & Axelrod, 2008; Hill & Coufal, 2005; Simpson, Peterson, & Smith, 2011; Stahr, Cushing, Lane, & Fox, 2006).

Behavior analytic interventions have addressed challenging behavior associated with low academic performance in several ways: (a) direct motivational strategies (Hawkins & Axelrod, 2008), (b) behaviorally based emotional coping programs targeting de-escalation (Anhalt & Morris, 2007), (c) reduction of response effort (e.g., assignment modification, breaking down responses into smaller parts, and fluency building of tool skills; Johnson & Street, 2012; Ryan, Pierce, & Mooney, 2008), and (d) indirect motivational strategies (Belfiore, Lee, Vargas, & Skinner, 1997; Skinner, Hurst, Teeple, & Meadows, 2002).

Indirect motivational strategies are those strategies wherein the primary mechanism affecting the conditional probability of a response is neither reinforcement nor punishment of the target stimulus–response pair itself. Task sequencing is one such indirect motivational strategy. Various labels have been applied to interventions that capitalize on task sequencing including terms such as high-probability (high-p) sequencing (Lee & Laspe, 2003; Lee, Lylo, Vostal, & Hua, 2012) and task interspersal (Benavides & Poulson, 2009; Volkert, Lerman, Trosclair, Addison, & Kodak, 2008).

Researchers discovered that if a target response class is reinforced at a high rate, it is more resistant to changes in the rate of reinforcement for target or alternative responding, as occurs in the context of extinction, noncontingent reinforcement (Nevin, 1979; Nevin, Tota, Torquato, & Shull, 1990), or differential reinforcement of alternative behavior (Mace et al., 1990). A number of procedural variations of task sequencing interventions have been used to achieve target outcomes for varied populations (Cates, 2005; Heinicke & Carr, 2014). The number of stimuli associated with high-p behaviors (e.g., compliance to easy or preferred requests, simple problem completion, attending) is varied across studies and procedures, but generally ranges from three to five presentations prior to presentation of the stimulus associated with the low-probability (low-p) behavior (e.g., completion of multidigit math problems, multisentence paragraph writing).

High-p Sequencing

The methodology of high-p sequencing involving multiple high-p requests prior to each low-p request was initially demonstrated in an applied realm by Mace and colleagues (1988) to increase compliance with task demands. Several studies then replicated the basic finding of high-p sequencing with compliant behavior by presenting a series of high-p requests for compliance prior to a low-p request; the probability that a person will engage in compliance for the subsequent low-p request greatly improved (Davis, Brady, Hamilton, McEvoy, & Williams, 1994; Ducharme & Worling, 1994; Horner, Day, Sprague, O’Brien, & Heathfield, 1991; Mace & Belfiore, 1990).

Task Interspersal Procedures

Research has suggested interspersing mastered tasks with unknown or novel tasks may improve compliance and acquisition of new tasks. Horner et al. (1991) used an interspersal training procedure to reduce rates of both self-injurious behavior (SIB) and aggression. Rates of SIB and aggression were reduced for difficult tasks interspersed with easy tasks relative to the presentation of difficult tasks in isolation.

Singer, Singer, and Horner (1987) also effectively applied these principles to their work with adults with intellectual disabilities (ID) in a residential treatment setting. In this study, the authors presented what they termed “pretask requests” prior to transitions from preferred activities to work sessions. A series of requests for which compliance was very likely were issued prior to a request to transition to another less preferred task. The results of this study indicated that delivery of familiar pretask requests prior to a request to transition from preferred activities to a work activity resulted in an increase in the probability of compliance for all participants.

For the purpose of this review, we will refer to the collective body of strategies as task sequencing. Task sequencing interventions have been employed with varied populations including adults, children, adolescents, persons with disabilities, and typically developing individuals (Belfiore, Lee, Scheeler, & Klein, 2002; Cates, 2005; Davis, Brady, Williams, & Hamilton, 1992; Horner et al., 1991; Lee, 2006; Mace et al., 1988; Oliver & Skinner, 2002; Singer et al., 1987). For example, Mace and colleagues (1988) used task sequencing to intervene on challenging behavior in a study with four adult males with ID who demonstrated chronic noncompliance in a residential setting. The study compared the effects of high-p sequencing with psychotropic medication on compliance across command types (“do” or “don’t”). Each low-p command was preceded by a series of three or four high-p commands. Improvements were demonstrated with psychotropic medications, but high-p sequencing resulted in substantial improvements in compliance across command types. Harchik and Putzier (1990) increased compliance to medication-taking by presenting five commands for “easy” tasks immediately prior to a direction to take medication. These researchers found that medication was more likely to be taken when it was immediately preceded by five commands to engage in easy behaviors like hand clapping. Comparison studies evaluating the relative efficiency of task sequencing to various other compliance promoting strategies (typically some form of prompting), have maintained its efficiency relative to other strategies (Horner et al., 1991; Houlihan, Jacobson, & Brandon, 1994; Kennedy, Itkonen, & Lindquist, 1995).

Task sequencing has been used effectively to address (a) compliance, (b) communication skills, (c) social skills, (d) SIB, (e) aggression, (f) functional skills, (g) rehabilitation-related behaviors, and (h) academic deficits (Belfiore et al., 2002; Davis et al., 1992; Davis et al., 1994; Horner et al., 1991; Lee, 2006; Oliver & Skinner, 2002; Singer et al., 1987). More recently, research studies have examined the effects of task sequencing on academic variables including reading acquisition (Cates et al., 2003; Joseph & Nist, 2006), mathematics computation (Burns, 2005), mathematics accuracy (Hawkins, Skinner, & Oliver, 2005), paragraph reading (Martin, Skinner, & Neddenriep, 2001), and classwide mathematical output (McDonald & Ardoin, 2007; Montarello & Martens, 2005).

Identification of a specific academic or behavioral variable as the primary cause of poorer school outcomes for students with EBD is complex (Lane et al., 2006; Morgan & Sideridis, 2013). Therefore, interventions ideally should concurrently address both behavioral and academic deficits. Research demonstrates that modifications to instructional content results in improved outcomes across a variety of settings for children with EBD (Umbreit, Lane, & Dejud, 2004). With consideration to the often reciprocal relationship of behavioral and academic struggles (Mason et al., 2011), the implementation of task sequencing to improve academic outcomes for children with EBD should be of interest to both researchers and practitioners. Similar research with task sequencing demonstrated generally positive behavioral and academic outcomes; however, a specific synthesis regarding the use task sequencing for children with EBD in academic settings is absent.

The purposes of this systematic literature review were (a) to identify relevant peer-reviewed literature utilizing task sequencing academic interventions for students with EBD, (b) to summarize intervention components and procedures within task sequencing, (c) to synthesize overall task sequencing outcomes, and (d) to develop relevant suggestions for continued applied practice and research for task sequencing in academic settings for individuals with EBD.

Method

Search Procedures

Systematic searches were conducted across four electronic databases: Academic Search Premier, Education Resources Information Center (ERIC) First Search, Medline, and PsychINFO. In all four databases, the terms “task sequenc*,” “high probability sequence,” “high-p sequence,” “high preference strategy,” “task interspersal” or “behavior* momentum” paired with either “academic intervention,” “classroom intervention,” “emotional disturbance,” “behavior disorder,” “conduct disorder,” “disruptive disorder,” and “oppositional defiant disorder” were inserted as free text into the keyword search field. An asterisk (*) was used as a wild card symbol to identify variations on the terms. If the search term combination provided a low number of articles (i.e., fewer than five) the search was repeated with the same terms but completed as an in-text search with quotations, if available.

Ancestral searches of included articles were completed to identify additional studies for inclusion. We searched the reference lists of studies containing (a) an intervention meeting inclusion criteria with a dependent variable different from those used in this study (i.e., communication, life skills), (b) a population excluded from this review (i.e., moderate to severe ID, autism spectrum disorder [ASD], traumatic brain injury [TBI], and adults older than 18 years of age), and (c) previous literature reviews focusing on task sequencing interventions for clinical, home, or community settings. Our search of the databases and reference lists occurred between March and June of 2014. Studies of interest were identified and then abstracts were reviewed to qualify studies for further data extraction. After a list of possible studies for inclusion was identified (n = 15), the first and second author reviewed each article in detail to determine appropriateness for inclusion.

Inclusion and Exclusion Criteria

To be included in this review, studies had to be published in a peer-reviewed journal and written in English. Publication year was not restricted. The study had to describe an intervention comprised of task sequencing to improve academic performance or access to academic content for one or more students with an EBD. The research had to apply an experimental (e.g., group design with random assignment, multiple baseline single-subject design) or quasi-experimental (e.g., nonrandomized groups) design. The study also needed to include a dependent measure of (a) academic outcome (i.e., increase academic productivity, decreased latency to begin academic task, increased reading fluency), (b) appropriate behaviors to facilitate academic readiness (i.e., compliance, intervals on task, transitions), or (c) inappropriate behavior that reduced access to academics (i.e., aggression, work refusal, arguing with teachers, disruptive verbalizations).

In studies in which only some participants met inclusionary criteria, only the data for participants qualifying for this review were included. Study quality and rigor were measured with consideration to all participants meeting inclusion criteria for each study. Participants in the study qualified if they were (a) between 5 and 18 years of age, (b) reported as having an EBD (i.e., EBD, behavior disorder, emotional disability, conduct disorder, disruptive disorder, oppositional defiant disorder, Individualized Education Plan [IEP] behavior goals), or (c) had an educational placement in a restrictive/alternative setting due to challenging behavior. Participants with a moderate to severe ID, ASD, TBI, or described as having multiple severe disabilities were excluded from this review. Participants with a secondary comorbid condition aside from a primary diagnosis of an EBD were included as long as the other comorbid condition was not a moderate to severe ID (i.e., general description of a severe disability, moderate ID, severe ID) or ASD, (d) the intervention occurred in a private or public educational setting. Studies that took place in a nonacademic setting (i.e., clinic, home, or day care) were not included in this review. For example, two participants in the Davis and Reichle (1996) study attended a day care, which was not considered to be an educational setting, so only the participants in a public kindergarten were included. The authors concluded that day care differed from an educational setting because the primary purpose is supervision rather than school readiness. Eleven studies were identified for inclusion in the review.

Interrater Agreement

The first and second author independently completed searches with all search term combinations for all databases. Next, the first and second author independently conducted ancestral searches. The first author compared the identified articles from both lists and developed a single running list. Finally, the second author utilized a coding checklist to extract data into a table. Articles were coded for the following information: (a) participant characteristics, (b) disability description and/or educational setting, (c) description of dependent variable(s), (d) description of the independent variable, (e) experimental design characteristics, and (f) reported outcomes. The first author confirmed the accuracy of the extracted data before final inclusion into the table. There were 90 items for which there could be agreement or disagreement (i.e., 15 studies with 6 checklist items per study). Initial agreement was obtained for 86 of the items (95.6%), then discussed by the authors until 100% agreement was obtained. Any questions or disagreements concerning inclusion were presented to the third author to make a final decision concerning inclusion, acceptability, or coding descriptions.

Once articles were identified for inclusion, the first author extracted various procedural aspects including design standards and strength of evidence. Single-subject research designs were assessed according to criteria from Kratochwill and colleagues (2010). Studies met design standards with or without reservations with evidence of (a) a systematic manipulation of the independent variable, (b) at least three attempts to demonstrate an effect for at least three different points in time, (c) a minimum of three data points in each phase, and (d) interobserver agreement (IOA) collected in each phase for at least 20% of data points. Quality indicators reported by Horner and colleagues (2005) were also assessed for the studies with a single-subject design and included reviewing the reporting quality of (a) participants and setting (i.e., described with sufficient detail, process for selection is described), (b) independent variables (i.e., described with replicable precision, variable is systematically manipulated, overt measure of treatment fidelity is documented), and (c) dependent variables (i.e., described with replicable precision, IOA data are collected at minimal standards of 80%).

Once the single-subject studies were identified as meeting design standards with or without reservations, certainty of evidence recommendations from The What Works Clearinghouse were assessed for each study and reported to have strong, moderate, or no evidence (Kratochwill et al., 2010) based on visual analysis of the data (e.g., trend, variability, level change). The second author checked the accuracy of agreement on design standards, strength of evidence, and quality indicators for the included studies. Initial agreement was obtained on 94% of items and after discussion with the third author agreement was obtained on 100% of items.

Group design study quality and certainty of evidence were assessed using criteria provided by an 18-question checklist from Gersten et al. (2005). The checklist was comprised of essential (e.g., intervention described with replicable precision, analysis linked to research question, procedural fidelity assessed) and desirable (e.g., data on attrition rates, IOA measures reported, provides test–retest reliability) quality indicators. Certainty of evidence was identified using suggestions from Gersten et al. (2005) for research that qualified as either acceptable (i.e., met all but one essential quality standard and one desirable standard) or high quality (i.e., met all but one essential quality standard and at least four desirable standards).

Results

We reviewed 11 articles published in five different journals: Journal of Behavioral Education (n = 3), Psychology in Schools (n = 3), Journal of Applied Behavior Analysis (n = 3), and a single study from both Education and Treatment of Children and Journal of Emotional and Behavioral Disorders. All articles were published between 1996 and 2012. The majority of studies (n = 6) were published between the years 2000 and 2004, with a 7-year gap before the next article meeting inclusion criteria was published in 2011. Only three studies related to task sequencing used with students with EBD in academic settings have been published in the past 10 years.

Table 1 describes (a) participant demographics (i.e., number, gender, age/grade level, disability description), (b) setting description, (c) experimental design, (d) dependent measure, (e) intervention description, (f) procedural measures described (i.e., treatment fidelity, IOA, and treatment fidelity), and (g) summarized intervention outcomes and certainty of evidence. Social validity findings were omitted from the table but reported in results section.

Table 1.

Summary of Included Studies.

Citation	Participant description		Task sequencing intervention description			Results and certainty of evidence
Citation	Age/gender	Disability/setting	Dependent variable	Independent variable	Design	Results and certainty of evidence
Axelrod and Zank (2012)	Two males ages 10, 11	Behavior disorder, one child with comorbid ADHD 20% resource room, 80% general education	Percentage of 10-s intervals of compliance during a 90-min reading period with low-p requests. Secondary data taken on compliance to high-p commands.	High-p sequencing A = baseline, B = 3:1 (high-p to low-p requests), C = 1:1 (fading) then maintenance: 4-6 low-p commands w/o preceding that with a high-p command.	Multiple baseline across participants with embedded reversal (ABABACA) IOA: 99% measured for 33% of sessions Tx Integrity: 100% measured for 28% of sessions	Results: Improvement in compliance with low-p teacher requests during independent seatwork. Immediate change in level with sustained improvement in fading and maintenance phases. Certainty: Meets design standards with reservations and moderate evidence. Participants, setting, DV, and IV described with replicable precision.
Belfiore, Lee, Scheeler, and Klein (2002)	One male, age 10	Emotional disturbance Self-contained classroom for behavior in a public school	Latency in seconds to initiate low-p math problems (multiple digit problems).	High-p sequencing A = baseline, ATD = 3:1 (3 single-digit math problems to 1 multidigit math problems) and escape from task demands coupled with high-p sequencing, A, ATD.	Reversal design with an ATD (Baseline-ATD-Baseline-ATD) IOA: 100% measured for 30% to 10% of sessions Tx Integrity: 100% measured for same IOA sessions	Results: Both interventions of the high-p sequence and escape/high-p condition decreased latency to initiate low-p math problems substantially and to a comparable degree with one another. Certainty: Does not meet design standards. Participants, setting, DV, and IV described with replicable precision.
Belfiore, Lee, Vargas, and Skinner (1997)	Two females, ages 14, 15	Placement in separate school for behavior Alternative school for behavior	Latency in seconds to initiate low-preference math problems (single digit vs. multiple digit).	High-p sequencing A = baseline: 5 low-p multidigit math problems, B = 3 high-p single-digit math problems then presentation of l low-p multidigit math problem.	ABAB Reversal Design IOA: 83% to 100% measured for 21% of sessions Tx Integrity: 100% measured for 40% of sessions	Results: High-p sequencing resulted in an immediate and appreciable decrease in latency to initiate multidigit multiplication problems. Certainty: Meets design standards with reservations, moderate evidence. DV and IV described with replicable precision, participants and setting description was not described with enough detail to replicate.
Davis and Reichle (1996)	Two out of 4 qualifying participants 1 male 1 female both age 5	EBD Self-contained classroom with access to general education	Percentage compliance with low-p requests.	High-p sequencing Variant (introduced in the same order) and invariant (randomly selected) A = baseline, B = (invariant) 3 high-p requests then 1 low-p request (3:1) followed by praise if child demonstrated low-p request, C = (variant) same as phase B.	Combined multiple baseline and reversal (ABCBC) IOA: 91% and 90% for low-p and 98% and 97% for high-p requests measured for 25% and 30% of sessions Tx integrity: 97% and 98% agreement, % of sessions not reported	Results: Both variant and invariant high-p sequencing yielded an immediate increase in the percentage of compliance with low-p requests, but only the variant intervention sustained. Certainty: Meets design standards with strong evidence. Participants, and IV described with replicable precision. DV (time to comply not specified) and setting not described with sufficient detail to replicate.
Davis, Reichle, and Southard (2000)	One out of 2 qualifying participants 1 male, age 6	EBD with mild ID Self-contained classroom serving students with EBD	Percentage of successful transitions in a classroom setting.	High-p sequencing (3:1) with praise following each of the teacher requests. Presentation of a distractor then presented with low-p request.	ATD IOA: 100% of high-p, 95% of low-p, 100% for distractor for 26% of sessions Tx fidelity: 99% average across all participants and conditions	Results: Both the high-p sequencing and distractor yielded increases in percentage of successful transitions. High-p sequencing produced a slightly higher percentage and significantly less variability compared with distractor condition. Certainty: Meets design standards with reservations with strong evidence. Participants, setting, DV and IV described with replicable precision.
Lee and Laspe (2003)	One out of 4 qualifying participants 1 male, age 10	Emotional disability with specific learning disability Self-contained classroom for children with multiple disabilities	Number of words written in 20 min of journal writing activities during language arts.	High-p sequencing (3:1), high-p (3:1) plus verbal praise, verbal prompting before each low-p request w/o high-p requests, verbal prompting plus verbal praise.	ATD with reversal components IOA: 99% measured for 28% of sessions across all conditions Tx fidelity: 100% measured for 15% of sessions	Results: Praise enhanced the effectiveness of both verbal prompting and high-p sequencing appreciably. Both were effective for increasing total words written. Efficacy measures demonstrate the high-p sequence required fewer mean implementations. Certainty: Does not meet design standards. Participants, setting, DV, and IV described with replicable precision.
Lee, Belfiore, Scheeler, Hua, and Smith (2004)	Experiment 2: 2 males, 2 females; 3 aged 10, 1 aged 11	Special education services for behavior and academics Self-contained resource room	Latency to initiate low-p math problems (single digit).	High-p sequencing Experiment 2 conditions: Baseline, low-p plus R+ (tokens), 3 high-p requests then 1 low-p request (3:1), 3:1 condition but with addition of tokens.	ATD across 3 conditions IOA: 100% measured for 15% to 20% of sessions Tx fidelity: 100% measured for 15% of sessions	Results: Reduced latency from baseline for 75% of students. Decreased latency of greater magnitude in the high-p conditions than low-p conditions plus token. Certainty: Meets design standards with reservations, with moderate evidence. Participants, setting, DV, and IV described with replicable precision.
Lee, Lylo, Vostal, and Hua (2012)	Three males ages 14, 16, 18	EBD Alternative school placement for students with EBD	Latency to initiate nonpreferred math problems; percentage of problems correct, digits correct per minute.	High-p sequencing A = baseline, B = 3:1 ratio single-digit math problems were h-probability (multidigit math problem).	Multiple baseline across participants IOA: 92% to 96% measured for 32% of sessions Tx fidelity: No measures were reported	Results: High-p sequencing was found to significantly decrease latency to initiate math problems and also to increase the rate of problem completion. Negligible improvements in accuracy (percentage of problems correct or digits correct per minute) were found. Certainty: Meets design standards with reservations with moderate evidence. Participants, setting and DV were described with replicable precision; overt Tx was not reported for the IV.
Skinner, Hurst, Teeple, and Meadows (2002)	One male, 3 females ages 9 to 11	Diagnosed as emotionally disturbed based on student’s IEP, male had comorbid diagnosis of ADHD Alternative school for students with EBD	Percentage of intervals of on-task behavior during math independent work time for previously taught skills measured with momentary time sampling and rate of problem completion.	Task interspersal Math problems, 1 single-digit math problem interspersed with 3 target multidigit problems (1:3 ratio of high to low-p).	ATD IOA: 95% measured over six sessions (approximately 50% of sessions) Tx fidelity: No measures were reported	Results: Students completed more math problems using the high-p strategy. On-task levels increased for 75% of students. Certainty: Meets design standards with moderate evidence. Participants, and DV were described with replicable precision; overt Tx was not reported for the IV, detailed setting description was absent.
Teeple and Skinner (2004)	Thirty males, 2 females ages 12 to 17	Emotional disabilities as defined by the state Self-contained school for students with severe behavior problems	Mean number of target (multisentence) and control paragraphs written and accurately punctuated sentences.	Interspersed discrete tasks Experimental condition had one brief interspersal paragraph preceding every two multisentence paragraphs (1:2 ratio).	Within subjects group design IOA: 100% measured for 20% of assignments, accuracy of assignments measured at 92% agreement Tx integrity: 100% for monitored sessions	Results: Interspersal procedure increased discrete task completion rates without decreasing opportunities to respond or response accuracy levels. Students did not rank interspersal writing assignments more favorably for time, effort, or difficulty. Students chose experimental assignments containing interspersed tasks over control. Certainty: Acceptable quality. Adequate but low n for a paired-sample t test. Intervention was counterbalanced to prevent an order effect. Significance was determined a priori p < .05. DV, and IV described with replicable precision.
Vostal and Lee (2011)	Two males, ages 14, 15	EBD Alternative school for students with EBD	Latency in seconds to begin next paragraph, rates of ORF.	High-p sequencing Continuous reading tasks between 3rd- and 5th-grade level passages. Control: Traditional 5th-grade level passages with a paragraph on each page, intervention: 1 3rd-grade level passage preceding every 5th-grade level passage (1:1 ratio of high to low-p).	Multielement design IOA: 95% measured for 22% of sessions, ORF: 99% measured of 22% of sessions Tx fidelity: 100% measured for 22% of sessions	Results: A clear decrease in the latency to begin the next paragraph while reading with high-p packets was demonstrated as well as an increase of oral reading fluency in experimental conditions for the first 10 words of low-p paragraphs. Certainty: Meets design standards with moderate evidence. Participants, setting, DV, and IV described with replicable precision.

Note. ADHD = attention-deficit/hyperactivity disorder; ATD = alternating treatments design; Tx = treatment; DV = dependent variable; IV = independent variable; IOA = interobserver agreement; EBD = emotional behavioral disorder; IEP = Individualized Education Plan; ID = intellectual disabilities; R+ = positive reinforcement; ORF = oral reading fluency.

Participant Demographics

Across the 11 studies, task sequencing interventions were provided to 54 participants with an EBD. The Teeple and Skinner (2004) study employed a group design with 32 students with EBD; therefore, the participant pool for the remaining 10 studies had a total of 22 participants. Studies employing a single-subject research design had an average of 2 participants with an EBD (range = 1-4). A total of 44 (81.5%) of the participants were male and 10 (18.5%) were female, similar to common gender ratios in research for students with EBD (Cullinan, Osborne, & Epstein, 2004). The age range of participants spanned from 5 to 18 years (approximate M = 13). Diagnostic or educational classifications included (a) EBD (n = 4), (b) behavioral disorder (n = 1), (c) emotional disturbance (n = 2), (d) emotional disability (n = 2), separate special education placement for behavior (n = 1), and IEP for behavior (n = 1). Information concerning participant race/ethnicity was provided in two studies (18%) with the only reported race/ethnicity as Caucasian. No study reported socioeconomic status of the students.

Setting

The majority of studies (n = 9) took place in the student’s primary classroom setting while two studies took place in a classroom adjacent to the student’s primary special education placement (Lee et al., 2012; Vostal & Lee, 2011). Placement settings included a separate school for children with severe behaviors (n = 5), a self-contained classroom for children with behavior difficulties (n = 4), a general education classroom (n = 1), and a special education resource room (n = 1). Seven studies (63.6%) took place at the elementary level (kindergarten to fifth grade) and four studies (36.4%) at the middle or high school level.

Dependent Variable

Dependent variables related to direct academic tasks, academic readiness skills, or a combination of both. The most common measure was latency of task completion (n = 5). Additional dependent variables included on-task behavior (Skinner et al., 2002), compliance to teacher or peer requests during the school day (Axelrod & Zank, 2012; Davis & Reichle, 1996), rate of successful transitions to access academics (Davis, Reichle, & Southard, 2000), and output of written words (Lee & Laspe, 2003; Teeple & Skinner, 2004). Target subject areas included math (n = 5), reading (n = 2), writing (n = 2), and general classroom compliance with peers or teachers (n = 2).

Compliance

Two studies focused on student compliance to teacher requests during the school day. Axelrod and Zank (2012) demonstrated large increases in compliance during independent reading with the introduction of the intervention compared with baseline for two elementary students with EBD. Davis and Reichle (1996) investigated academic readiness behaviors for two kindergarteners with EBD and discovered that the percentage of correct responses to requests delivered in a variant sequence were more effective than high-p requests delivered in an invariant sequence.

Latency

Five studies measured student latency to begin a task or comply with a request. Four of these studies measured latency to solve a math problem (Belfiore et al., 2002; Belfiore et al., 1997; Lee, Belfiore, Scheeler, Hua, & Smith, 2004; Lee et al., 2012) and one study measured latency to begin reading paragraphs (Vostal & Lee, 2011). Belfiore et al. (2002) demonstrated decreased latency to initiate low-p math problems with the introduction of high-p sequencing. Belfiore et al. (1997) had similar outcomes resulting in an immediate and appreciable decrease in latency to initiate multidigit multiplication problems for two high school–aged students with EBD. Vostal and Lee (2011) also discovered reduced latency for two high school students to begin reading a paragraph during a continuous reading task. For Lee et al. (2004), Experiment 2 demonstrated that students displayed a reduction in latency to begin working on low-p math problems when introduced with a 3:1 high-p to low-p sequence of problems more so than with low-p problems followed by reinforcement (tokens). The high-p condition paired with reinforcement had the highest magnitude of latency reduction, suggesting that increased density of reinforcement positively affected student responding. A similar follow-up intervention by Lee and colleagues (2012) demonstrated reduced latency to complete math problems and increased rate of problem completion for all high school–aged participants.

Transitions

One study investigated the use of task sequencing to support successful transitions during the school day (Davis et al., 2000). In educational settings, transitions usually consist of moving from one activity to the other, which can entail both physical movement (i.e., moving from one classroom to another) and content change (i.e., working on math then switching to reading). Research by Davis et al. (2000) demonstrated that the introduction of the high-p sequencing yielded an increase of successful transitions to access academic periods as did the use of a distractor. Yet, high-p sequencing produced a slightly higher percentage with less variability compared with the distractor condition or baseline.

Academic output

Three studies examined the use of task sequencing to improve student academic output (i.e., the amount of academic work completed: math problems, words read, words written). Lee and Laspe (2003) evaluated task sequencing on the number of words written during journal writing activities with and without the addition of praise. The participant was exposed to two conditions: high-p sequencing alternated with the presentation of a verbal prompt. Phases for both conditions included baseline, high-p sequence or verbal prompt only, and high-p sequence or verbal prompt with added praise. The high-p condition paired with praise doubled word-writing output compared with baseline, yet showed less effectiveness than the condition of verbal prompts paired with praise.

Skinner et al. (2002) evaluated the use of the high-p strategy for problem completion during math. All students increased academic output during the intervention phase and three out of four participants increased intervals of on-task behavior during the mathematics independent work periods. An interspersed procedure for paragraph writing demonstrated increased task completion without decreasing response accuracy levels (i.e., accurate punctuation) for high school students with EBD (Teeple & Skinner, 2004).

Accuracy

Two studies investigated the effect of using task sequencing to improve accuracy (i.e., percentage correct/accurate tasks) for student’s academic output (e.g., percentage correct math digits, percentage correct punctuation of paragraph writing). Teeple and Skinner (2004) discovered that interspersing target paragraph writing assignments with brief paragraphs increased a student’s opportunity to respond without decreasing accuracy of punctuation. Aside from the primary dependent measure of latency, Lee and colleagues (2012) also investigated if the task sequencing could improve both accuracy of mathematics problem completion while increasing the number of correct digits recorded per minute. Results demonstrated that, overall, the presentation of the high-p sequence reduced latency to initiate the low-p problems, yet had negligible effects on problem accuracy of overall percentage of correctly completed problems and digits correct per minute. Results from these studies suggest academic output can be increased using task sequencing without negligible effects on accuracy.

Task Sequencing Intervention Description

The majority of studies (n = 9) employed a sequence with the presentation of high-p requests prior to the presentation of a low-p request. For example, Lee and colleagues (2012) used a high-p strategy and presented students three single-digit math problems (high-p requests) prior to presenting a multidigit math problem (low-p request). Vostal and Lee (2011) had students read one easy paragraph (high-p) prior to reading every paragraph at or above ability level (low-p). Similarly, Axelrod and Zank (2012) investigated if the presentation of high-p teacher requests (e.g., pick up pencil, give teacher high-five) prior to a low-p request (e.g., begin assignment, stop talking) would increase overall student compliance to requests.

Two studies utilized a task interspersal procedure by intermingling difficult and easy problems in each sequence. Skinner and colleagues (2002) applied the same ratio and type of requests, yet interspersed three single-digit math problems with one multidigit problem per sequence. Teeple and Skinner (2004) investigated paragraph writing, yet interspersed a brief paragraph to write prior to the request to write two multisentence paragraphs.

Five interventions (45%) were conducted by classroom staff, which included general and special education teachers (Axelrod & Zank, 2012; Davis & Reichle, 1996; Davis et al., 2000; Lee & Laspe, 2003) and one study employed a practicum student already working in the classroom (Belfiore et al., 2002). In the remaining five studies, the researchers or trained graduate students implemented the intervention (Belfiore et al., 1997; Lee et al., 2004; Lee et al., 2012; Skinner et al., 2002; Vostal & Lee, 2011). One study utilized a combination of both classroom teachers and researchers (Teeple & Skinner, 2004). For two studies (Axelrod & Zank, 2012; Davis et al., 2000), a classroom paraeducator was also trained to collect intervention data.

Seven studies (64%) described conducting an indirect or direct systematic preference assessment with the student prior to intervention to identify high- and low-preference tasks or requests. Preference assessment methodologies included forced choice procedure (Belfiore et al., 2002; Belfiore et al., 1997; Lee et al., 2012) and informal preference assessment (Lee & Laspe, 2003) including teacher report or consultation (Axelrod & Zank, 2012; Davis et al., 2000; Lee et al., 2004; Vostal & Lee, 2011). The remaining studies did not systematically identify student preference, rather, a high-p request was connected to a previously mastered skill and/or required minimal response effort. For example, single-digit math problems (Skinner et al., 2002), individual sentence writing (Teeple & Skinner, 2004), and teacher-reported requests typically followed by student compliance (Davis & Reichle, 1996) were all identified as high-p requests in the absence of a systematic preference assessment.

The majority of studies (n = 8) utilized a ratio of three high-p requests followed by one low-p request for at least one condition of the intervention (Axelrod & Zank, 2012; Belfiore et al., 2002; Belfiore et al., 1997; Davis & Reichle, 1996; Davis et al., 2000; Lee & Laspe, 2003; Lee et al., 2004; Lee et al., 2012). For Axelrod and Zank (2012), three requests were verbal (i.e., teacher states three high-p requests followed by one low-p request) while other studies used isolated academic tasks (i.e., presentation of three simple math problems preceding one multidigit problem; Belfiore et al., 2002; Lee et al., 2004).

Three studies were outliers in this review by employing a higher ratio of low-p requests with a single high-p request compared with other studies. Research by Teeple and Skinner (2004) compared a condition of all low-p requests (multisentence paragraph writing) to a condition of one high-p request (write one sentence) preceding two low-p requests (1:2 ratio). Skinner and colleagues (2002) investigated the rate of math problem completion when one high-p math problem (single digit) was interspersed with three low-p (multidigit) problems (1:3 ratio). Vostal and Lee (2011) employed a 1:1 ratio of high to low-p requests; students read a paragraph below ability level prior to reading a paragraph at or above ability level.

In addition to task sequencing, five studies incorporated the addition of positive (e.g., praise, tokens) or negative (e.g., escape from task) reinforcement throughout one or all conditions. Positive reinforcement was present in the form of teacher praise following completion of low-p request for three studies (Davis & Reichle, 1996; Davis et al., 2000; Lee & Laspe, 2003). The second experiment by Lee and colleagues (2004) implemented a condition where the student received tokens that could be exchanged at the end of the session following completion of requests in the low-p condition and 3:1 ratio (high to low) conditions. Escape from completing math problems was also introduced for one study, which consisted of sequencing math problems already crossed out to the student to signal that completion of the problem was not necessary (Belfiore et al., 2002).

Research Design

The majority of studies (n = 10) utilized a single-subject research design (Gast & Ledford, 2010) employing a multiple baseline design across participants (n = 2), alternating treatment design (n = 5) or reversal design (n = 1). Many studies included an embedded reversal component (n = 4) to an alternating treatments design or multiple baseline design (Axelrod & Zank, 2012; Belfiore et al., 2002; Davis & Reichle, 1996; Lee & Laspe, 2003). One study implemented a within-subjects group design (Teeple & Skinner, 2004).

IOA and Treatment Fidelity

Reviewed studies reported IOA of the dependent variable for an average of 27% of sessions across experimental phases. The average IOA of all reviewed studies was approximately 96% accuracy with all studies reporting accuracy of more than 80%, which is above the common experimental standard for single-subject research (Horner et al., 2005).

Most studies (n = 9) reported treatment fidelity/procedural integrity. When treatment fidelity was reported, it was strong and ranged from 97% to 100% (M = 99.5%) across an average of 23.6% of sessions (range = 15%-40%).

Reported Outcomes

Investigators of each of the 11 studies reported that task sequencing interventions increased academic and academic readiness behaviors (i.e., compliance, writing output, math problem output, words read aloud, on-task) for students with an EBD. Study outcomes were identified as positive (i.e., all included participants improved in targeted skill), mixed (i.e., some included participants improved in targeted skill), or negative (i.e., none of included participants improved in targeted skill). The majority of studies (n = 9) reported positive outcomes and two studies reported mixed outcomes (Lee et al., 2004; Skinner et al., 2002). None of the reviewed studies reported negative outcomes.

Maintenance and generalization were uncommonly assessed in the reviewed studies. One study reported a fading condition from an initial intervention ratio of three high p-requests subsequent to one low-p request (3:1) reduced to a ratio of one high-p to every one low-p request (1:1). The fading condition was then followed by a maintenance condition were request presentations returned to baseline levels (Axelrod & Zank, 2012). This study demonstrated that when the intervention was removed, compliance to low-p requests remained at a higher percentage than baseline.

Certainty and Quality of Evidence

Using criteria of single-case design standards provided by Kratochwill and colleagues (2010), four studies (40%) met full design standards, four studies (40%) met design standards with reservations, and two studies did not meet design standards (20%). Of the eight single-case studies that met design standards with or without reservations, six studies (75%) demonstrated moderate evidence through visual analysis while two studies demonstrated strong evidence (25%). Teeple and Skinner (2004) utilized a within-subjects group design, so quality indicators were assessed according to criteria provided by Gersten et al. (2005) for experimental and quasi-experimental research. For this study, research quality was acceptable with low but adequate n for a paired-sample t test (n = 32), a chi-square applied to counterbalance the control and intervention phase, as well as an a priori significance of p < .05.

Participants were described with sufficient detail for 10 of the studies (91%) while the setting description was sufficiently described for 8 studies (73%). A replicable operational definition was used as the primary measure of quality for the dependent variable(s) considering many of the quality indicators were already met based on our inclusion criteria. Ten studies (91%) satisfied quality indicators for reporting the dependent variable(s) with replicable precision. Quality standards for the independent variable (i.e., sufficiently described, variable systematically manipulated, overt measurement of treatment fidelity is desirable) were assessed for 9 studies (82%) where 2 studies met criteria of quality indicators, yet did not report treatment fidelity (Lee et al., 2012; Skinner et al., 2002).

Social Validity

Social validity measures were collected for three studies (Axelrod & Zank, 2012; Davis et al., 2000; Lee & Laspe, 2003). Two of these studies assessed social validity using a 5-point Likert-type scale to rate stakeholder opinions on specific questions related to intervention efficacy (Axelrod & Zank, 2012; Davis et al., 2000) while Lee and Laspe (2003) used the amount of teacher prompts or delivery of high-p requests as indication of intervention efficacy. The remaining eight studies did not report any specific measures of social validity regarding the perceptions of practitioners, students, or other stakeholders regarding the intervention goals, procedures, or outcome. For studies that did report social validity, teacher opinions were positive toward implementation and outcomes of the task sequencing classroom intervention.

Discussion

The purpose of the current review was to identify research that utilized task sequencing as an academic intervention for students with EBD in educational settings. The systematic review of the literature identified 11 peer-reviewed studies with a total of 54 participants. Each study was analyzed by intervention components and procedures, overall intervention outcomes, and certainty of evidence to develop relevant suggestions for continued applied practice and research.

Nine studies met research design standards with or without reservations, and reviewed studies generally had a high percentage of quality indicators present. In addition, the authors reported positive results for all or most of the intervention participants.

Each of the reviewed studies reported improved academic outcomes attributed to the use of a task sequencing intervention. A variety of permutations of these interventions (e.g., 3:1 ratios, high-p strand with embedded positive reinforcement) have been used to improve both academic skills (e.g., correct completion of math problems) and skills to access academics (i.e., on-task, transitions, compliance). However, the small number of studies meeting inclusion criteria for this review, the limited participant pool, and the lack of generalization and maintenance assessment limit our understanding of the generalizability and long-lasting effects. Despite these limitations, our findings suggest several areas for future research.

In the current review, task sequencing was found to be effective across a variety of participants who varied by age and educational placement. Nonetheless, if we are to determine the efficacy of these interventions for children with complex academic and behavioral support needs, additional contextual information would be helpful to determine for whom, when, and under what situations the interventions work best. This review identified that the majority of studies (n = 10) took place in a separate school or self-contained classroom for children with EBD. School environment (e.g., classroom with other students present) was only reported in three studies, which impedes on more detailed understanding of student context. Therefore, the feasibility of such interventions in large classrooms (i.e., general education settings) calls into question effectiveness of task sequencing interventions for students with EBD outside of one-on-one, small group, or self-contained contexts. Although we hypothesize that task sequencing interventions may be well suited to implement in educational settings where one-on-one attention is neither practical nor appropriate (Killu, 1999), the feasibility and effectiveness of these interventions for students with EBD fully or partially included in general education settings merits further investigation. Future research should examine the utility and efficiency of teacher-implemented task sequencing interventions on academic engagement and skill acquisition across a broader range of classroom sizes and inclusionary contexts.

Only two studies reported race/ethnicity background of participants, so this review is unable to identify if students from diverse cultural backgrounds have participated. Future research should include more detailed information about participant demographics and type of school environment (i.e., urban, inner-city, suburban, rural, frontier) to assist practitioners in determining the potential impact of interventions on their specific student population. Although most studies utilizing task sequencing strategies have concentrated on core academic areas (i.e., reading, mathematics, writing), we suspect that these interventions could also be effectively applied to improve student access and engagement with a wider range of curriculum (i.e., social studies, science, art, technology, health, electives) and classroom routines.

Collectively, all of the 11 studies indicated positive outcomes (i.e., student improvement for at least 75% of participants) for target dependent variables for students with EBD. Yet, discussion of task sequencing interventions is often absent in systematic reviews of instructional interventions for individuals with an EBD (Evans, Harden, & Thomas, 2004; Templeton, Neel, & Blood, 2008). Task sequencing interventions can offer teachers low or no cost ways to improve student on-task behavior and decrease disruptive behavior while addressing academic skills. Ease of intervention implementation is critical to classroom application and can predict sustained use and high treatment fidelity by teachers (Baker, Gersten, Dimino, & Griffiths, 2004; McIntosh, Filter, Bennett, Ryan, & Sugai, 2010). Therefore, academic and behavioral interventions for students with EBD must be feasible and acceptable to classroom teachers. Recent publications have provided practitioner-friendly reviews of the use of task sequencing to improve the completion of mathematics tasks (Banda, Matuszny, & Therrien, 2009), correct responses following verbal requests, and completion of independent written work (Lee, Belfiore, & Budin, 2008).

To expand the current intervention literature as it pertains to students with EBD, researchers should evaluate the effectiveness of (a) preintervention functional analysis (Iwata, Dorsey, Slifer, Bauman, & Richman, 1994, 1982) to identify the operant function of challenging behavior such as noncompliance, (b) the impact of the addition of an added reinforcement procedure, and (c) changing gradations in high-to low-p ratios. Although the majority of included studies (n = 7) reported conducting a preference assessment, only one study utilized information from a functional analysis conducted prior to intervention implementation (Davis et al., 2000). Pretreatment assessment is essential to accurately identify low-p requests and the social consequences maintaining associated challenging behaviors such as noncompliance otherwise the student may not comply with the high-p request (Oliver & Skinner, 2002). Future research should conduct and report functional behavioral assessment information to inform development of the intervention package (Lee et al., 2012). Likewise, task sequencing strategies could be used to effectively increase the frequency of positive behaviors such as demonstrating respectful social interactions with peers and teachers in the classroom, which could be a positive setting event for many students with conduct issues (Strand, 2000).

Aside from expanding applied research with students with EBD, research should investigate the behavioral mechanisms underlying the effectiveness of task sequencing interventions and the utility and effects of various procedural permutations. Future research should investigate the possible mechanisms at play in these different task sequencing interventions, including motivating operation (MO) manipulations (Michael, 1982; O’Reilly et al., 2006), behavioral momentum (Belfiore, Basile, & Lee, 2008; Nevin, Mandell, & Atak, 1983), and stimulus control (i.e., presentation of high-p tasks as discriminative stimulus for positive reinforcement; Hearst, Besley, & Farthing, 1970; Touchette, 1971). Although providing a hypothesis about the possible mechanisms is beyond the scope of this review, understanding the behavioral mechanism could enhance the use and application of task sequencing interventions for students with EBD.

Although most studies in this review employed a 3:1 ratio of high-p to low-p requests, more information concerning the impact of ratios and subsequent fading is also important. More high-p requests may mean higher opportunities to respond (OTR) and research shows that OTR show positive academic impact for students with EBD (Sutherland & Wehby, 2001). Although some research related to instructional ratios exist, more nuanced investigation of acquisition and instructional time related to sequencing warrants investigation (Cates, 2005), especially for students with EBD.

Similarly, past research demonstrates that positive and explicit feedback following the demonstration of a desired classroom behavior increases the frequency of those behaviors for students with EBD (e.g., Flower, McDaniel, & Jolivette, 2011). Researchers have proposed that completion of smaller tasks may act as a conditioned reinforcer (Skinner et al., 2002), yet some studies in this review embedded additional reinforcement into the intervention and demonstrated more powerful results than when implemented without additional reinforcers. Future research should investigate more thoroughly the potential additive impact of additional embedded reinforcement, especially during fading of high-p requests.

Conclusion

In conclusion, continued research should be conducted to identify the most effective application of task sequencing interventions in academic settings for students with EBD. Considering the increasing research related to the connection between academic and behavioral performance for students with EBD (Lane, 2007), task sequencing interventions are versatile and can simultaneously tackle both academic performance and positive school behaviors. This review provides preliminary evidence of the effectiveness of these strategies to improve academic outcomes and suggests that continued investigation could directly benefit teachers and students with EBD, including those students served in alternative and restrictive settings.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Author Biographies

Christen Knowles, M.S., is a doctoral student in Special Education at the University of Oregon. Her scholarship focuses on Positive Behavior Intervention Supports (PBIS), emotional/behavioral disorders, and self-determination. She was previously a special educator in a self-contained classroom for children with severe challenging behaviors.

Paul Meng is a doctoral student in Special Education at the University of Oregon. His research focuses on systems change related to secondary and tertiary interventions for literacy deficits and problem behavior for students with and without identified disabilities.

Wendy Machalicek, Ph.D., BCBA-D, is an assistant professor in Special Education in the Department of Special Education and Clinical Sciences at the University of Oregon. Her scholarship focuses on the assessment and treatment of developmental delays and challenging behavior for children with intellectual and developmental disabilities including autism spectrum disorder.

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