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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.

Autism Spectrum Disorder

  • 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

Costs

Training Requirements

  • 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

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