1. Discrete Trial Teaching and Naturalistic Teaching Approaches

2. “There are many behavior analytic procedures for arranging learning opportunities, some adult-initiated, some learner-initiated, some embedded in typically occurring activities or sequences of responses, and some that are hybrids or permutations of these. Each type of procedure has its uses and advantages. ABA programming uses any and all procedures to accomplish the job of skill development and skill generalization with each individual learner” (Green, 2001, p. 74).

3. What is Discrete Trial Teaching? (Smith, 2001)
The term discrete trial describes the following procedure:
SD – Response – Consequence – Intertrial Interval
As opposed to free-operant procedure:
Organism is “free” to respond at various frequencies
There’s not intertrial interval
Discrete Trial Teaching/Training (DTT) or Discrete Trial Instruction (DTI) is one of dozens of behavior analytic teaching strategies
It’s a method for individualizing and simplifying instruction to enhance learning
Skills are taught in small, structured steps
Instruction is typically conducted one-to-one in a distraction-free setting
DTT is “one of the most important instructional methods for children with autism” (p. 86)

4. Five Parts to a Trial in DTT (Smith, 2001)
Teacher presents brief, distinctive instruction or question
e.g., “do this”, “what is it?”
If needed, a prompt is provided after or along with the instruction
Child responds correctly or incorrectly
Teacher provides a consequence (reinforcer, ignore, or correction)
Intertrial Interval
Teacher pauses 1-5 s before presenting the next trial
Data may be recorded at this time

5. Some History… (Ghezzi, 2007)
1950s & 60s - Sidney Bijou at U of Washington
Inspired to use discrete trial teaching with children with autism by the Wisconsin General Test Apparatus
WGTA was being used at the time to study visual discrimination learning with young children in labs
They tried to bring this tight control in the lab to a teaching situation for children with DD

6. WGTA

7. Some History… (Ghezzi, 2007)
Wolf, Risley, and Mees (1964)
One of the first ABA studies and earliest demonstrations of DTT
“Dicky”, a boy with autism
Although shaping worked to help him keep his glasses on, it didn’t work to teach him to talk because he rarely vocalized - shaping would be too time-consuming!
Used DTT instead, using models of sounds, blends, whole words

8. Some History… (Ghezzi, 2007)
First well-known model of early behavioral intervention for children with autism was developed by (Ole) Ivar Lovaas in the ’60s and ’70s
Trained in behavior analysis while doing a postdoc with Sidney Bijou in 1958
Lovaas (1993) credits Bijou with helping him bridge “the gap between behavioral psychology and clinical application” (p. 618)
Psychology professor at the University of California at Los Angeles (UCLA)
Applied the science of behavior analysis to the treatment of people with autism in a new way, which he now calls the Lovaas Model of ABA (
Video

9. Limitations of Early DTT (Lovaas & Smith, 2003)
“Teaching one skill did not by itself lead to improvements in other skills” (p. 327)
“Gains tended to be situation-specific; despite improving with therapists in clinical settings, children’s behavior often remained unchanged with caregivers in everyday settings such as home or school” (p. 327)
Cites Lovaas, Koegel, Simmons, and Long (1973)
How did YAP deal with these limitations?
These limitations drove research and development of other behavioral approaches

10. UCLA Young Autism Project (YAP; Lovaas & Smith, 2003)
Stage 1 (2-4 weeks) - DTT
Establish “instructional control”
Extinguish escape-maintained behavior
Establish history of reinforcement for following directions
Stage 2 (1-4 months) - DTT
Direction following
Imitation
Matching, Receptive Object ID
Dressing
Toy play
Stage 3 (6+ Months) - DTT, IT
Verbal Im
Expressive labels
Receptive Picture/Action ID
Expand SH and play
Augmentative system if vocal language is not acquired

11. UCLA Young Autism Project (YAP; Lovaas & Smith, 2003)
Stage 4 (12 months) - DTT, IT, dyads with typical peers
Expressive labels - colors, shapes
Beginning “language concepts”
Recognizing emotions
Beginning sentences (“I want____”; “I see ____”)
Pretend play and peer interaction
Toilet training
Stage 5 (12 months) - DTT, IT, small group, typ PK
Using “language concepts”
Conversation
Comprehending stories
Perspective-taking
Learning from models
Working independently
Helping with chores

12. The “Lovaas Model of ABA”
Was widely disseminated as a treatment for children with autism in the 80s
Manuals
Program evaluations
1981
2003

13. A Reaction to DTT (LeBlanc, Esch, Sidener, & Firth, 2006)
In the ’70s and ’80s, a community of researchers heavily influenced by Stokes and Baer (1977) began developing interventions for children with autism
Stokes and Baer…
Reviewed the ABA research on generalization
Categorized 9 techniques for assessing and training generalization

14. Naturalistic Teaching Approaches (NTAs) (LeBlanc et al., 2006)
Approach to intervention was characterized by a strong emphasis on
Promoting skill generalization
Incorporating parents, teachers, siblings, peers
Conducting teaching during play, at home, in daycare (not in “work” or separate teaching environments)
From the beginning of instruction (not an afterthought or added at the end after tight stimulus control was attained)

15. NTAs – 3 Important Characteristics (LeBlanc et al., 2006)
Linguistic Framework
Goal of increased “motivation”
Goal of “spontaneity”

16. NTA Conceptual Framework for Language (LeBlanc et al., 2006)
Tendency to describe and categorize language according to form
Receptive/expressive
Advantage: Language is more easily shared with special educators and speech therapists
Pubs are in JABA but also special ed and speech journals

17. NTA and “Motivation” (LeBlanc et al., 2006)
One goal of NTA interventions is to have the child demonstrate willingness to participate in instruction and become more responsive to others
Signs of motivation:
Response latencies are shorter
Frequencies of verbalizations increase
Positive affect is clearly evident in the teaching environment (problem behavior rarely occurs during teaching)
Techniques designed to enhance motivation:
Interspersal of maintenance with acquisition trials
Reinforcement of attempts (looser shaping criterion)
Incorporation of child choice and child-initiated activities
Use of natural or “functional” reinforcers

18. NTA and “Spontaneity” (LeBlanc et al., 2006)
Definition: Stimuli embedded within the child’s ongoing activities, interactions, and general environment set the occasion for Language.
A spontaneous response would be in the absence of explicit adult-mediated prompts such as
Say, “I want juice”
“What do you want?”

19. Halle (1987) Teaching Language in the Natural Environment: An Analysis of Spontaneity
Continuum of controlling or discriminative stimuli in the presence of which responses appear more or less spontaneous

20. NTA and Stimulus Control (LeBlanc et al., 2006)
Training context to natural environment
DTT-Only Programs: Little correspondence
NTA Programs: High correspondence
Controlling stimuli during training and in natural environment
Some correspondence, but in NTA there is typically not an emphasis on determining what the controlling stimuli are in either situation
Not an issue that is often discussed/valued

21. Incidental Teaching (IT)
IT is an NTA used “to get elaborated language by waiting for another person to initiate conversation about a topic and then responding in ways that ask for more language from that person” (Hart & Risley, 1982, p. 5)
Developed by Hart and Risley (1968, 1974, 1975)
Disadvantaged preschool children in Kansas

22. Steps of IT Fenske, Krantz, and McClannahan (2001)
Arrange a setting that contains materials of interest to the child
Wait for the child to initiate an interaction about an object of interest
Ask for more elaborate language, or approximations to speech
Provide the object for which the child initiated
Practice!

23. Differences Between IT and DTT Fenske et al. (2001)
Discrete Trial Training
Incidental Teaching
Teacher-initiated
Child-initiated
Structured learning environment
Natural environment
Teacher-selected materials and reinforcers
Child-selected materials and reinforcers
Does this comparison mean you should do only one and not the other?

24. McGee, Krantz, and McClannahan (1985) “Traditional Training”
Teacher asks, “Where is the candy?”
Errors are followed by verbal prompts
Descriptive praise follows both prompted and unprompted responses
Reinforcement = turtle (a preferred item, but not the candy)
On the next trial, the turtle is under the box and the candy is the reinforcer

25. McGee, Krantz, and McClannahan (1985) Incidental Teaching
Child initiates for preferred item, “candy”
Teacher asks, “Where is the candy?”
Errors are followed by verbal prompts to say, “the candy is under the box”, but later changed to a prompt to say, “I want the candy under the box”
Descriptive praise follows both prompted and unprompted responses
Reinforcement = candy
Question: What is an appropriate antecedent to someone’s specifying location?

26. Research on IT Has been used to teach
Children with autism to receptively identify items required to make lunch (McGee, Krantz, Mason, and McClannahan, 1983)
Children with autism to request using prepositions (McGee et al., 1985)
Children with autism to read sight words on tokens before exchanging them (Fabry, Mayhew, & Hansen, 1984)
Children with autism to select the name of the toy desired (McGee, Krantz, & McClannahan, 1986)
Children with autism and profound MR to sign (Schepis, Reid, Fitzgerald, Faw, Van Den Pol, & Welty, 1982)
Adults with autism and MR to request food during peer tutoring (Farmer-Dougan, 1994)
Studies have shown facilitation of acquisition AND generalization
Variations of IT: MITS, “Mand Model” (not the same as mand training!)

27. IT Researchers Todd Risley PhD at U of Washington Co-founder of JABA
Taught at U of Kansas and U of Alaska
Pat Krantz
PhD at U of Kansas
Director of PCDI
Lynn McClannahan
PhD at University of Kansas
Gail McGee
PhD at Auburn University
Research at PCDI
Professor at Emory University in Atlanta
Director of Emory Autism Center

28. Analysis of Spontaneous Language Indentifying Natural Cues
IT occurs in the context of a situation where language is naturally appropriate
Identify the antecedent stimuli that set the occassion to engage in the following language skills:
Greeting
Asking for help
Question asking (wh)
Commenting about what just happened
Small talk
Expressing emotions

29. Pivotal Response Training
Multi-component intervention package developed by Robert Koegel and Laura Schreibman
Targets “pivotal” behaviors to produce changes across a variety of areas of functioning
Because this could save time and money (Koegel, Koegel, & Brookman, 2003)
Targets in PRT (“Pivotal” behaviors)
Motivation to respond to social and environmental stimuli
Self-regulation/Self-monitoring
Responsivity to multiple cues
Self-initiation of social interactions
e.g., What’s that? – initially taught with preferred items in bag and faded to neutral items around the room
e.g., Where is it? – favorite items hidden around room; answer is given with preposition
e.g., Whose is it? – Use items that the child “clearly associates” with a particular member of the family
Child is prompted to say, “Whose is it?”
Parent says, “It’s yours”
Child is prompted to say, “Mine”
Also, Look! Help!

30. Behavioral Cusps
“What makes a behavior or change a cusp is that it exposes the individual’s repertoire to new environments, especially new reinforcers and punishers, new contingencies, new responses, new stimulus controls, and new communities of maintaining or destructive contingencies. When some or all of those events happen, the individual repertoire expands; it encounters a differentially selective maintenance of the new as well as some old repertoires, and perhaps that leads to some further cusps” (Rosales-Ruiz & Baer, 1997, p. 534)
Not the same as prerequisites
Examples
Crawling
Reading
Generalized imitation

31. PRT Procedures Natural Language Paradigm (NLP) – 1st step
PRT applied to language intervention specifically
Developed first and then applied to nonlanguage and called PRT
Interspersal of maintenance and acquisition tasks
Using child-preferred activities and stimuli in the natural environment (e.g., not flashcards)
Allowing child to make choices during activities
Turn-taking
Use of natural reinforcers (e.g., not tokens)
Training parents to implement procedures - parents implement much of the therapy
Taught A-B-C pattern of behavior
Taught about motivation
Taught how to identify learning opportunities in the natural environment
Given parent training manual
Lots of practice with feedback
Reinforcing attempts
Much of the training is done in natural environment settings

32. NLP
PRESENT A REASONABLE ARRAY: Therapist holds up or lays on floor 2 to 3 items and says “Pick one”.
PREVENT ACCESS TO TOY: Therapist prevents learner from removing toy from his or her hands.
MODEL: Therapist provides an appropriate play activity and verbal model with the toy the learner reached for.
PAUSE: Therapist waits 5 seconds for learner to respond.
REINFORCE: If the learner says something relevant, intelligible, and meeting the current criterion, the therapist gives the toy to him or her, or produces reinforcement with the toy.
CONTINUE TO MODEL: Therapist continues to provide verbal and physical models during the play interval.
PROVIDE A NEW MODEL: After the learner plays with the toy for a brief period (e.g., about 15s), the therapist returns to step 2 with new verbal model, and continues following remaining steps for several cycles.

33. Gillett and LeBlanc (2006): http://homepages. wmich
LeBlanc, Geiger, Sautter, and Sidener (2006):

34. Koegel, Koegel, and Brookman (2003)

35. PRT Research (Koegel et al., 2003)
Most parents reach 80% mastery criterion within about 25 hours
Research on individual components of PRT
Choice reduces problem behavior maintained by escape, increases accuracy
Interspersal of maintenance tasks increases child affect and accuracy
Reinforcement of attempts improves speech production and affect
Many other procedures evaluated without label of NLP/PRT
Research on PRT as a package
“Empirically supported treatment” (p. 351)
Both group and single-case designs
Multiple labs
Multiple settings
Manualized procedures
Treatment integrity data
Independent diagnoses
More effective than a “traditional, analogue individual target behavior approach”
Improved gains when parents rather than clinicians implement procedures
Reduction of parent stress

36. Video Clip of PRT

37. PRT
Intervention is manualized (Koegel, Schreibman, Good, Cerniglia, Murphy, & Koegel, 1989)
3 levels of certification, books, workshops, conference, SuperNanny, US and Canada government support
PRT is included in Evidence-Based Psychotherapies for Children and Adolescents
Recent review by Humphries (2003) showing effectiveness of PRT

38. PRT Researchers Robert Koegel PhD with Lovaas at UCLA
Professor at UC Santa Barbara
Director of Koegel Autism Center
Editor of Journal of Positive Behavioral Interventions
Lynn Kern Koegel
Trained in psychology and as a speech & language pathologist
Laura Schreibman
Professor at UC San Diego
Autism Research Program (funded by NIMH)
Works in collaboration with the Koegels
Glen Dunlap
BA in Psychology at UCSB
PhD in Speech and Hearing Sciences at UCSB
Professor at University of South Florida
Director of Research and Training Center on Positive Behavior Support
Lee Kern-Dunlap
BA at UCSB
PhD in Special Ed at University of South Florida
Professor at Lehigh University (social, emotional, behavioral needs/ADHD)
Marjorie Charlop-Christy
BA at UCLA
Professor at Claremont McKenna College in Claremont, CA
Director of Claremont Autism Center

39. PRT and Lovaas Model Are these things different than ABA?
Positive Behavioral Support and ABA (Carr & Sidener, 2002)
Person-centered planning
Focus on individualized ax & tx for the client
Functional assessment
Positive intervention strategies
Multifaceted interventions (tx packages)
A focus on the environment
Change environment vs. change the person
Meaningful outcomes
Ecological validity
Generalization and maintenance
Systems-level intervention