Discrete Trial Research Articles

Comparing the Effectiveness of Discrete Trial Training Delivered via Telehealth and In-Person on Skill Acquisition.

The onset of the COVID-19 pandemic affected the delivery of early intensive behavioral intervention (EIBI) services. As a result, many EIBI service providers shifted to either temporarily or permanently providing some or all of their services via telehealth. Most published research on behavior analytic approaches to telehealth has focused on training others to implement behavior analytic interventions in an in-person setting. In contrast, relatively few researchers have evaluated direct EIBI service delivery via telehealth (i.e., professionals directly providing behavior analytic interventions to clients/learners using technology). Little is known about the effectiveness of behavior analytic interventions delivered remotely to learners via telehealth compared to standard in-person intervention delivery. The purpose of the present study was to directly compare the effectiveness of discrete trial training delivered remotely via telehealth and in-person on the acquisition of labeling occupations for children diagnosed with autism spectrum disorder in an EIBI program. The results and implications of the effectiveness of the different teaching modalities and observed generalization and maintenance will be discussed.Evaluating the effectiveness of behavior analytic interventions delivered remotely via telehealth compared to standard in-person delivery could help increase access to services for those in need.We found little difference in the acquisition of labeling occupations across the two modalities for all three participants.Future researchers should consider how to incorporate strategies to promote generalization into direct telehealth services.Future researchers should evaluate how learners without previous exposure to discrete trial training may perform during direct telehealth services.

Remote training of educators in Taiwan to disseminate discrete trial training for students with developmental disabilities

AbstractEducators in many areas of the world lack the necessary resources and training to serve students with developmental disabilities effectively. Telehealth technologies and a train‐the‐trainer approach may help disseminate evidence‐based instructional strategies to teachers in underserved areas. In this study, experimenters combined synchronous and asynchronous remote training to prepare six teachers in Taiwan to implement discrete trial training (DTT) with students. First, the experimenter taught three teachers from a private school to implement DTT with their students. Then, they trained these participants to teach another educator at their school. Finally, the three teachers trained those additional educators. Results indicated that the training was effective for all participants and that the DTT skills of the three trainers maintained over time and transferred to their in‐classroom instruction. These findings replicate and extend the current literature suggesting that the use of telehealth and a train‐the‐trainer model is a promising and socially valid method for disseminating ABA to countries with limited resources.

Identifying and Validating Indices of Happiness and Unhappiness in Autistic Children and Examining Them as Quality of Life Indicators During Presession Pairing

ObjectivesHappiness is paramount to an improved quality of life (QoL), but there are barriers to assessing the happiness and overall QoL of autistic children using traditional measures. To address this, Study 1 aimed to identify and validate the idiosyncratic mood indices of three autistic children. In Study 2, these indices were measured as QoL indicators during discrete trial teaching (DTT) sessions that followed presession pairing. Task engagement was recorded as a secondary measure.MethodsThree preschool boys on the autism spectrum participated in both studies. Their individualized indices of happiness and unhappiness were first identified and validated using an abbreviated procedure that extended previous research. The effects of presession pairing were then examined using a concurrent multiple baseline design across participants. The idiosyncratic mood indices were measured using 10-s partial interval recording, while task engagement was measured using 15-s whole interval recording.ResultsStudy 1 demonstrated that the abbreviated procedure was efficient for identifying and validating the idiosyncratic mood indices of the participants. Study 2 found that presession pairing improved the mood of all three children during DTT, but there were minimal increases in task engagement. Percentage of nonoverlapping data (PND) scores initially revealed no effects for indices of happiness (M = 43.2%), large effects for indices of unhappiness (M = 76.4%), and no effects for task engagement (M = 37.6%). Contrary to this, omnibus Tau-U scores suggested large effects for indices of happiness (Tau-U = 0.7), very large effects for indices of unhappiness (Tau-U = 0.9), and moderate effects for task engagement (Tau-U = 0.5).ConclusionsIndividualized indices of happiness and unhappiness can and should be used as QoL indicators during behavioral interventions for autistic children.

Randomized, controlled trial of a mixed early start Denver model for toddlers and preschoolers with autism.

The early start Denver model (ESDM) has been extensively studied as a promising early intervention approach for young children with autism spectrum disorder (ASD). Various methodological drawbacks from earlier ESDM investigations must be rectified to expand the application scopes. For this purpose, the present study recruited a very large sample of 249 autistic children (aged 24-47 months), and used a randomized controlled design to compare outcomes from a mixed ESDM (M-ESDM) intervention with a mixed discrete trial teaching (M-DTT) intervention which remains one of the most commonly-used programming for early intervention. Over the course of a 12-week period, both groups (i.e., M-ESDM and M-DTT groups) received 25 h of intensive intervention per week using individual, group, and parent coaching techniques. Findings showed that: (i) the M-ESDM significantly outperformed the M-DTT in enhancing children's developmental abilities in gross motor and personal-social skills for toddlers and preschoolers, as well as in language for preschoolers with mild/moderate ASD and toddlers; and (ii) the M-ESDM dramatically reduced the severity of autistic symptoms in toddlers with severe ASD only, when compared to the M-DTT. However, the M-ESDM did not outperform the M-DTT in terms of improving children's developmental abilities in adaptability and fine motor for toddlers and preschoolers, as well as in language for preschoolers with severe ASD. In addition, when compared to the M-DTT, the M-ESDM did not show an advantage in reducing the severity of autistic symptoms in toddlers with mild/moderate ASD and preschoolers. Clinical Trial Registration: Chinese Clinical Trial Registry. Registration number ChiCTR200039492.

DailyConnect: Piloting Interventions of Situation-Based Emotional Understanding in Naturalistic Home Settings for Children with Autism Spectrum Disorder

DailyConnect is a visual-based mobile application that supports children with autism spectrum disorder (ASD) in recalling memories by reviewing photos through discrete trial training (DTT) to understand situation-based emotions. To assess DailyConnect and its adaptability to a child’s characteristics and emotional situations, a pilot study was conducted that included 15 children with ASD and their parents and teachers. The DTT steps—memory recall and situation recognition, emotion recognition, emotion cues, facial expression recognition, and response behavior—were reliable in assessing the understanding of emotional situations when compared before and after the intervention in four categories of emotional situations, namely, happiness, sadness, anger, and fear. The results revealed that DailyConnect improves the understanding of situation-based emotions, particularly negative emotions (e.g., sadness: mean diff = −.687, sig. < .01, T = −3.866, d = 1.006; anger: mean diff = −.952, sig. < .01, T = −6.187, d = .705; fear: mean diff = −.961, sig. < .01, T = −5.522, d = .627); however, its effectiveness varied for children in different emotional situations. Furthermore, subjective feedback from participants and users (parents and teachers) provided insights into design considerations for similar mobile aids.

A Comparison of Telehealth-Based Instruction with or without Instructive Feedback.

Language delays are commonly displayed by children on the autism spectrum. To help facilitate the development of verbal behavior, practitioners often implement intensive one-on-one, face-to-face instruction. However, the COVID-19 pandemic hindered typical face-to-face service delivery and caused practitioners to assess alternative approaches to facilitate clients' continued progress. Instructive feedback (IF) is one teaching strategy to enhance instruction or make it more efficient. During this teaching procedure, instructors provide formal teaching of target responses and embed demonstrations of secondary target responses within sequences of instruction. In the current study, we investigated the efficacy of IF provided within telehealth instruction. Four participants on the autism spectrum participated in the study. Participants received two forms of telehealth instruction that targeted speaker-responding. The first form consisted of discrete trial instruction (DTI), and the second form combined DTI with IF. These results indicate that both forms of instruction improved speaker-responding of primary targets for all participants. Additionally, a secondary analysis of secondary targets indicated that two of the four participants acquired some secondary targets. These results suggest that including IF within DTI might be beneficial for some participants receiving DTI via telehealth.

Discrete Trial Teaching Method to Improve Receptive Language Skills in Children with Global Developmental Delay

The purpose of this study was to determine the effectiveness of the Discrete Trial Teaching method in improving the receptive language skills of children with Global Developmental Delay. The receptive language skills provided in this intervention are recognizing body parts in the facial area. This research is an-experimental research with a single subject research, which uses the A-B-A model. Baseline measurements were carried out twice, namely before and after the implementation of the intervention. This study used 20 sessions consisting of 5 sessions for the first baseline, 10 intervention sessions and 5 sessions for the second baseline. The participant of this study was a boy aged 3 years and 6 months who was diagnosed with Global Developmental Delay. Data analysis used in this study is visual analysis which includes 6 components. The results showed that there was an increase in scores and with an upward trend and good stability, so it can be concluded that the Discrete Trial Teaching method can effectively improve the receptive language skills of children with Global Developmental Delay.

Automatic stabilization of finite-element simulations using neural networks and hierarchical matrices

Petrov–Galerkin formulations with optimal test functions allow for the stabilization of finite element simulations. In particular, given a discrete trial space, the optimal test space induces a numerical scheme delivering the best approximation in terms of a problem-dependent energy norm. This ideal approach has two shortcomings: first, we need to explicitly know the set of optimal test functions; and second, the optimal test functions may have large supports inducing expensive dense linear systems. A concise proposal on how to overcome these shortcomings has been raised during the last decade by the Discontinuous Petrov–Galerkin (DPG) methodology. However, DPG has also some limitations and difficulties: the method requires ultraweak variational formulations, obtained through a hybridization process, which is not trivial to implement at the discrete level.Our motivation is to offer a simpler alternative for the case of parametric PDEs, which can be used with any variational formulation. Indeed, parametric families of PDEs are an example where it is worth investing some (offline) computational effort to obtain stabilized linear systems that can be solved efficiently in an online stage, for a given range of parameters. Therefore, as a remedy for the first shortcoming, we explicitly compute (offline) a function mapping any PDE parameter, to the matrix of coefficients of optimal test functions (in some basis expansion) associated with that PDE parameter. Next, as a remedy for the second shortcoming, we use the low-rank approximation to hierarchically compress the (non-square) matrix of coefficients of optimal test functions. In order to accelerate this process, we train a neural network to learn a critical bottleneck of the compression algorithm (for a given set of PDE parameters). When solving online the resulting (compressed) Petrov–Galerkin formulation, we employ a GMRES iterative solver with inexpensive matrix–vector multiplications thanks to the low-rank features of the compressed matrix. We perform experiments showing that the full online procedure is as fast as an (unstable) Galerkin approach. We illustrate our findings by means of 2D–3D Eriksson–Johnson problems, together with 2D Helmholtz equation.

Teaching Supervisory Skills to Behavior Analysts and Improving Therapist-Delivered Discrete Trial Teaching

ABSTRACT This study evaluated a systematic method of training and evaluating supervisors in Applied Behavior Analysis (ABA) settings. Using a concurrent multiple baseline across subjects design, this study assessed the use of a training protocol designed to teach masters’ and doctoral-level Board Certified Behavior Analysts® (BCBA®s/BCBA-D®s) to supervise therapists administering discrete trial teaching (DTT) sessions for children with autism spectrum disorder. Therapists’ performances before and during training for their supervisors was also assessed. Results revealed that the implementation of systematic supervision training improved supervisor and therapist performances when compared to baseline values.

Dynamic Assessment of AAC Action Verb Symbols for Children with ASD.

The purpose of this study was to determine whether children with autism spectrum disorder (ASD) make progress in learning to use action verb symbols on augmentative and alternative communication (AAC) applications across different communicative functions (requesting, labeling) and instructional formats (embedded instruction, discrete trial teaching). Four preschool-aged children completed graduated prompting dynamic assessment sessions in which they were provided with varying levels of support (e.g., models, gestures) across three instructional conditions: (a) requesting actions embedded in play, (b) labeling actions embedded in play, and (c) labeling actions presented via video during discrete trial teaching. An adapted multielement single-case design was used to compare participants' abilities to use symbols with different levels of support across the instructional conditions and a control. Differences between instructional and control conditions were established for three participants. Three participants also reduced the levels of support they needed to use symbols in at least two instructional conditions. Although participants initially required lower levels of support (i.e., less restrictive prompts) in the requesting condition compared to labeling conditions, these differences only maintained for one participant. Across participants, differences between labeling conditions were minimal. Although children with ASD can use verb symbols with low levels of support during DA, additional intervention may be needed to increase independent responding. Individual characteristics may influence success across communicative functions.

The effective learning of discrete trial teaching: Evidence from pre-service teachers of children with autism

The effective learning of discrete trial teaching: Evidence from pre-service teachers of children with autism

Inter-response time shaping by percentile schedule with discrete trial procedure

The percentile schedule has been used as a convenient procedure for the automatic shaping of operant responses. Experiments 1, 2, and 4 of this study examined whether two variables related to the percentile schedule—“update the reinforcement criterion for each response” and “retreat of the reinforcement criterion”—are critical factors of the percentile schedule on shaping. Experiment 3 examined the effect of combining one of the shaping rule “reinforce movement, not position” with the percentile schedule. Eight pigeons were exposed to a discrete trial procedure. In each trial, pigeons were required to peck one key and then to the other, and the interval between pecks was defined as the inter-response time (IRT). A percentile schedule was applied to this IRT aiming to lengthen it. The results showed that (1) IRTs were lengthened by the percentile schedule; (2) "update the reinforcement criterion for each response," "retreat of the reinforcement criterion," and "reinforce movement, not position" had no significant effect on lengthening IRT; and (3) the frequency of IRT occurrence decreased when the "retreat of the reinforcement criterion" was removed. These results indicate that the aforementioned percentile schedule variables are not critical for the percentile schedule on IRT shaping. Because the discrete trial procedure can dissociate the effects of variables on the length and frequency of IRT, this procedure seems effective for future shaping studies.

Teaching Children with Autism Spectrum Disorder to Answer Questions Using an iPad-Based Speech-Generating Device.

This study investigated whether a systematic instruction package was effective in child acquisition of question answering using an iPad-based speech generating device (SGD). The study was conducted with two children with autism using a multiple probe across behaviors design. Results demonstrated that the systematic instruction package consisting of graduated guidance, discrete trial teaching, time delay, and reinforcement resulted in acquisition of answering all questions. Follow-up data were collected one, three, and five weeks after instruction ended. For all participants, skills maintained during follow-up and generalized to novel settings and skills. Social validity data were also collected and indicated that teachers without experience using SGDs found them to be effective and feasible for teaching communication skills.

Negative reinforcement of behavioral variability without previous training with positive reinforcement

In a previous study, Fonseca Júnior and Hunziker (2017) provided evidence of the control of behavioral variability by avoidance contingencies. However, their study presented three methodological weaknesses: (1) only one contingency reversal was conducted in the experimental design adopted, (2) the lever press was shaped using a positive reinforcement procedure, and (3) the intermittency of reinforcement between Lag n and Yoke conditions was not successfully equaled. The present study aimed to overcome these three methodological limitations. Three experimentally naive male rats with no prior history with positive reinforcement had sequences of three lever presses between two levers negatively reinforced under the following discrete trial avoidance contingencies that provided similar intermittency of reinforcement: Lag 1, Yoke, Lag 1, and Yoke. All subjects showed high levels of behavioral variability under the Lag 1 contingency and decreased levels of behavioral variability under the Yoke contingency. These results replicate the findings of Fonseca Júnior and Hunziker, suggesting that behavioral variability can be controlled by avoidance contingency without previous exposure to positive reinforcement. Moreover, these findings suggest that the high levels of variation obtained under the Lag n condition are an effect of operant contingency and not a mere byproduct of the intermittency of reinforcement.

Individual differences in cocaine seeking during voluntary abstinence predicts cocaine relapse and the circuitry mediating relapse.

There are no FDA-approved treatments to facilitate recovery from cocaine use disorder. Contingency management offers non-drug reinforcers to encourage abstinence and is effective at reducing drug seeking during treatment, but once discontinued, relapse rates increase. We sought to establish a choice-based rodent model of voluntary abstinence (VA) from cocaine to test the ability of ceftriaxone, an antibiotic consistently shown to prevent relapse to cocaine seeking in rodents, to attenuate relapse after discontinuation of VA, and to investigate relapse-induced neuronal activation via c-Fos expression. Male Sprague-Dawley rats self-administered sucrose pellets for 5days and intravenous cocaine for 12days. Rats then underwent 14days of voluntary or forced abstinence. VA sessions entailed the opportunity to choose between sucrose and cocaine delivery in discrete trials (20 trials/day). Ceftriaxone (or vehicle) was administered during the last 7days of abstinence. During a relapse test, only the cocaine-paired lever was available and presses on the lever delivered cocaine-paired cues. There were more presses on the sucrose lever during VA, but cocaine intake did not decline to zero. Ceftriaxone had no effect on cocaine intake during VA. Neither ceftriaxone nor VA reduced cocaine seeking during the relapse test, and cocaine intake during VA positively correlated with cocaine seeking during the test in vehicle-treated animals. Relapse-induced c-Fos expression was found to be greater in the ventral orbitofrontal cortex following VA. Sucrose availability leads to a decrease in, but not cessation of, cocaine seeking and a differential engagement of the circuitry underlying relapse.

A Comparison Between Direct Telehealth and In-Person Methods of Teaching Expressive Labels to Children Diagnosed With Autism Spectrum Disorder.

Recent behavior analytic research has demonstrated that the provision of applied behavior analytic services via direct telehealth can be an effective teaching modality for some learners with autism spectrum disorder (ASD). Historically, teaching procedures based on applied behavior analysis (ABA), including discrete trial teaching (DTT), have been provided and evaluated via in-person delivery. This study sought to compare the implementation of DTT via direct telehealth to DTT implemented in-person within and across participants. Specifically, this study evaluated the two delivery modalities in terms of skill acquisition, maintenance, efficiency, and learner responding during teaching sessions. Results of an adapted alternating treatments design nested into a multiple baseline design demonstrated that all three participants diagnosed with ASD met the mastery criteria for the expressive labels taught. Areas of future research, participant prerequisite skills, and clinical implications will be discussed in the context of these results.

A Preliminary Evaluation of Conventional and Progressive Approaches of Discrete Trial Teaching for Teaching Tact Relations with Children Diagnosed with Autism

A Preliminary Evaluation of Conventional and Progressive Approaches of Discrete Trial Teaching for Teaching Tact Relations with Children Diagnosed with Autism

A Cultural Generalization: An Effective Training for Staff Integrity on DTT in the Application of the PEAK in Brazil.

Promoting the Emergence of Advanced Knowledge (PEAK) direct training is an evidence-based curriculum with extensive research. Treatment integrity is one of the critical components of an effective treatment. In developing countries where training opportunities are scarce, providing precise training poses a challenge. The current study evaluated the effectiveness of behavioral skills training (BST) role-play to train three staff members to implement the PEAK-DT language curriculum, using discrete trial teaching (DTT) with three learners with autism spectrum disorder (ASD). Not only did the staff members implement the programs with high treatment integrity, but the learners also improved their performance on targeted skills. In addition, this study considered maintenance and generalization of the skills learned. Overall, data show that the BST role-play was successful as the staff members enhanced the skills of three learners with autism.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40617-022-00745-1.

자폐성 장애 학생을 위한 국어 및 수학과 중재 관련 국내 단일대상 연구 동향 및 질적 지표분석

This study attemps to analyze the single-subject design studies related to school subject(reading, writing and math) for students with autism spectrum disorder. Method: 19 studies were selected based on inclusion criteria. The characteristics of research were analyzed on the basis of CEC(2014) qualitative indicators. The effect size was also analyzed the independent variables based on Evidence-Based Practice (EBP), and calculated as the Percentage of Non-overlapping Data (PND). Result: The very effect size PND was found based on the independent variable being Visual supports(VS), Discrete trial training(DTT), Video modeling(VM), Direct instruction(DI), VS+DI and Technologyaided instruction and intervention(TAll). Quality indicators show that 80% of studies evaluated were experimental environments, participant, dependent variable, independent variable, treatment integrity and internal validity. Additionally, 16 of 19 studies met more than 80% of the CEC quality indicators. Conclusion: These results address the need for more intervention strategies based on EBP to teach school subjects for students with ASD and should be emphasized using quality indicators for single subject research. According to the result, future direction for research school subject with students with ASD was discussed.

Using a social robot for children with autism: A therapist‐robot interactive model

AbstractSocial robots have great potential for the therapy of children with autism spectrum disorder, but the practical use of them is challenging. In this article, we presented a social robot YANG, which can interact with children with autism in their daily training. We propose a therapist‐robot interactive (TRI) model, which integrates with the practice of discrete trial training (DTT), a basic method utilized in autism training. To evaluate the TRI model, we implemented the model in YANG and conducted a single‐subject experiment in a rehabilitation training center. Data were collected on three children (ages 3–4) and their three therapists as they interacted with YANG in training sessions. Results showed that the children's learning ability significantly improved. YANG formed natural and friendly relationships with the children and delivered substantial support to therapists. Our research brings insight into using social robots for children with autism.