Discrete Trial Training (DTT)
Involves a 1 to 1 instructional approach used to teach skills in a planned and systematic manner. DTT is used when the learner needs to learn a skill that is best taught in small, repeated steps.
- Effects 1 in every 88 children in the US
- No known cause or cure, but there are numerous evidence-based practices for treating individuals with autism
- ASDs are a group of developmental disabilities that display core symptoms in the areas of:
- Social Interactions and Relationships
- Lack of empathy or difficulty understanding another person's emotions
- Lack of interest in sharing enjoyment, interests, and achievements with other people
- Verbal and Non-Verbal Communication
- Delay in, or lack of, learning to talk; repetitive use of language
- Problems starting and holding conversations
- Difficulty understanding their listener's perspective
- Limited Interests in Activities or Play
- Preoccupation with certain topics
- Need for sameness and routines
Frequency and Duration
Target Population
- Children and youth with autism
- DTT can be used to teach students from early childhood through elementary school at all ability levels
- Due to the intensive and repetitive nature of DTT, there is more evidence for using DTT with younger children (2 to 9 years of age)
- Especially useful for children with strong interfering behaviors and problems with attention span
- Customized to each learner's skills, needs, interests, preferences, and family situation
- Not a "one size fits all" program
- Usually implemented around 25 to 40 hours per week.
- Sessions are typically 1:30-3 hours long, consisting of short periods of structured time devoted to a task usually lasting 3 to 5 minutes. 10 to 15 minute breaks are usually taken at the end of every hour.
- Can be taught in home, school, and community settings
- Encourage families to use DTT in daily lives
Why is it Effective?
- DTT is believed to be effective because it gives the child a clear message as to what is expected
- It also lets the child know if the response is correct and appropriate
- Repetitive nature facilitates acquisition and mastery of skill
Costs and Training Requirements
Effectiveness
- Strong empirical evidence for effectiveness of DTT for skill acquisition- documented across several investigations and large-scale studies
- DTT is the only instructional method shown by empirical research to be effective for teaching new skills to individuals with autism
- Directly related to the skill of the child is the amount of treatment the child receives
- Found to be even more effective when applied with other behavior analysis techniques
- April 2002- amounted to about $4,200 per month, so $50,000 annually per child
- It is likely that ABA programs using DTT will involve a high cost because they are time intensive
- Teacher/Practitioner should have:
- An advanced degree
- Specific training in behavior analysis
- A strong history of having worked with and designed programs for children with autism
- The most advanced practitioner must maintain ongoing supervision over the rest of the educational team
History of DTT
Description/Method
How is it Effective?
Step 1: Deciding What to Teach- Assessment and Summarizing
- Assess what the child can/cannot do in order to make an education plan/goal
- Also take the child's IEP into account during assessment and planning
- 1 to 1 instructional approach
- Helps teach skills through skill analysis, repetition, reinforcement, and consequences in a 9-step process
- Positive praise and/or tangible rewards are used to reinforce desired behaviors
- Data collection is VERY important in DTT- helps assess skill level, progress, challenges, skill acquisition, and maintenance
- Aim for generalization of learned skills and behaviors
Step 2: Breaking the Skill Down Into Teachable Steps
- First developed in the 1970s by Psychologists Ivar Lovaas and Robert Koegel at UCLA
- The "Lovaas Model"
- Developed as a specific form of ABA (Applied Behavior Analysis) treatment which analyzes behavior and environment
- Task analysis- have child complete task in order to observe each step of the skill and their mastery of the skill
- Determine:
- A range of responses that are or are not acceptable
- Prompting that may be required
- Consequences that will reinforce the desired behavior or discourage undesired behavior
- Other basic evaluations:
- Speech/language
- Reading/literacy
- Gross/fine motor
Step 3: Setting Up the Data Collection System
- Promotes the development of communication/language
- Promotes adaptive behavior
- Improves cognitive/academic skills
- Improves social and behavioral skills
- Reduces interfering behaviors
- Can be used to teach imitation and symbolic play skills
- Data sheets designed specifically for skill being taught
- Data sheets record things like:
- Level of prompting needed
- Any interfering behaviors
- Other necessary info- toileting, food intake, etc.
- Summary/comments for each skill
- Space designated for parent, therapist, and school communication
- *One of the high defining characteristics of a high quality DTT program is their collection of trial by trial data
Step 9: Review and Modify
- Continue to review learner's progress and modify the program
- Should review mastered programs and continue to teach maintenance trials, which are targeted for generalization
- Generalization may mean:
- Practicing trials in other settings
- With different adults
- With different reinforcers
- With different instructions/stimuli
- Discuss the reviews and modifications with educational team regularly
Step 4: Designating Locations
- Usually a quiet place without too many distractions
- Sufficient space for instruction and for breaks
- Easy access to peers for generalization
- Adequate lighting and seating
- One or more locations are better than one because multiple locations can be helpful when working towards generalization
Step 8: Conducting Discrimination Training
- Consists of teaching the learner a new response to the stimulus. In order to do so, the learner must first be taught how to discriminate the stimulus from others
- Teachers use other stimuli, or distracters, in order to evaluate whether they have successfully learned how to discriminate the stimulus from the others
- Want to teach generalized use of the skill
- Teach how the skill can be applied to multiple situations
Step 5: Gathering Materials
Step 7: Massed Trial Teaching
- Teacher/Practitioner assembles and determines the materials used during DTT- having the correct materials will make the program easier and more efficient*
- Materials include:
- Notebooks/binders for data collection
- Preference list for each kid
- Variety of tangible reinforcers (edible & non-edible)
- Sensory items
- Instructional materials
- Pens, pencil, markers
- Bins for storage
- Repeat same learning trial several times in a row to ensure the learner is successful multiple times at whatever step of the skill is being taught
- If learner is successful, repeat 3 or 4 times until mastery is accomplished
Step 6: Delivering the Trials
- Transitions = VERY important
- Give warnings such as "5 more minutes" or set an actual timer
- Obtain child's attention
- May need to show reinforcers to motivate them
- If learner's response is appropriate, the teacher delivers a reinforcing consequence or a reinforcer and marks response as correct
- If inappropriate, provide feedback and prompting, and begin trial again.
- Gradually take away/reduce prompting over time
- Observe and record different types of prompts (i.e. physical, verbal, modeling or demonstration, etc.)
- Teacher immediately repeats the same instruction for the targeted number of trials
- Over time, teachers can reduce the rate of tangible reinforcement. By the end, the child should find social rewards sufficiently powerful for learning
Discrete Trial Training (DTT):
An Evidence-Based Practice for Teaching Children with Autism