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Discrete Trial Training (DTT)

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on 21 November 2013

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Transcript of Discrete Trial Training (DTT)

Discrete Trial Training (DTT):
An Evidence-Based Practice for Teaching Children with Autism

History of DTT
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
Description/Method
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
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
Frequency and Duration
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 setting
s
Encourage families to use DTT in daily lives
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
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
Step 2: Breaking the Skill Down Into Teachable Steps
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
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 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 5: Gathering Materials
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
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
Step 7: Massed Trial Teaching
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 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 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
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
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
How is it Effective?
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
Costs and Training Requirements
Costs
Training Requirements

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
Full transcript