Behavioral intervention for autism: A distinction between two behavior analytic approaches.

Abstract

Few professionals working with children and families affected by autism spectrum disorders (ASD) would deny that behavioral intervention is the treatment of choice. Programs based in Applied Behavior Analysis (ABA) methodology such as discrete trial instruction (DTI) and applied verbal behavior (AVB) remain popular interventions for children diagnosed with ASD. They remain popular to the extent that special education litigation has increasingly involved requests that school districts provide or reimburse parents for a program characterized by ABA. Several distinctions, important for school personnel and educational consultants alike, can be made between a these programs. These distinctions are provided along the following dimensions: curriculum, reinforcement and motivation, delivery of instruction, prompting and error correction, language acquisition, augmentative communication, and data collection. Key Words: autism, behavioral intervention, Discrete Trial Instruction, Applied Verbal Behavior. ********** Schreibman (1997) indicates that few professionals working with children and families affected by autism spectrum disorders (ASD) would deny that behavioral intervention is the treatment of choice. Behavioral treatment has been defined as synonymous with applied behavior analysis (ABA), and as the application of the principles of learning to human behavior for the resultant effect of improved socially significant behaviors (Schreibman, 1997). Despite some methodological criticisms of the research (Connor, 2003, Eikeseth, 2001, Gresham, Beebe-Frankenberger, & MacMillan, 1999, Gresham & MacMillan, 1997, Gresham & MacMillan, 1998), ABA-based early intervention is empirically supported in helping children with ASD to achieve significant gains (Herbert & Brandsman, 2002). Programs based on ABA methodology remain popular interventions for children diagnosed with ASD (Herbert & Brandsma, 2002, Lovaas, 1987, McEachin, Smith, & Lovass, 1993, Schreibman, 1997). Special-education litigation has increasingly involved requests that school districts provide or reimburse parents for a program characterized by ABA (Yell & Drasgow, 2000). For example, the New York State Guideline Technical Report for clinical practice of the assessment and treatment of ASD for children ages 0-3 years recommends the principles of ABA be included as an important programmatic element (NYDH, 1999). Given the increased demand for ABA methodology for preschool and school-aged children with ASD in school settings, it is necessary that teachers of special education and other school personnel understand the distinction between different types of programs that fall under the umbrella of ABA and what is implied when parents request discrete trial or applied verbal behavior programs. In their selective review of treatments for children with autism, Gresham, Beebe-Frankenberger, and MacMillan (1999) evaluated several programs categorized as comprehensive behavioral and educational treatment programs. These include, among others, the UCLA Young Autism Project (YAP), based on the work by O. Ivar Lovaas (1987); Treatment and Education of Autistic and Related Communication Handicapped Children (Project TEACCH), based on the work of Schopler and Reichler (1971); and Learning Experiences Alternative Program (LEAP), based on the work of Strain and others (1977) (Gresham, Beebe-Frankenberger, & MacMillan, 1999). Since the publication of the Gresham, Beebe-Frankenberger, and MacMillan article in 1999, additional approaches considered behavior analytic in nature have come to the forefront. These include Pivotal Response Training (PRT) (Koegel, Koegel, & Carter, 1999) and Applied Verbal Behavior (AVB) (Sundberg & Michael, 2001). For some educators, the distinction among ABA programs remains nebulous. The purpose of this paper is to distinguish between two popular approaches currently provided for early intervention and school-aged children in home- and school-based settings: Lovaas' Young Autism Project (YAP), more commonly referred to as Discrete Trial Instruction (DTI) or Discrete Trial Teaching (DTT), and B. …