ASA's 37th National Conference on Autism Spectrum Disorders (July 13-15, 2006)

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Saturday, July 15, 2006: 10:00 AM-11:15 AM
554 A-B
#1841- Applied Behavior Analysis: Beyond Discrete Trial Teaching
There is consensus among experts that no one teaching strategy will prove effective for all children with autism. Discrete Trial (DT) teaching has historically been the strategy of choice. DT teaching has research to support its effectiveness yet significant limitations. Other strategies are needed to ensure initiation of skills acquired during DT teaching, generalization of those skills to new settings, and reduction of reliance on prompts. An integrated model utilizing teaching strategies that support DT teaching will be detailed.

Presenter:Caroline Gomez, Ph.D., Auburn University Autism Center, Co-director - In 2003, Dr. Caroline Gomez facilitated the opening of the Auburn University Autism Center which includes an early childhood model program and provides comprehensive services to individuals with autism, their families, schools, and other agencies. Dr. Gomez has worked with children with autism and their families for over 20 years. Her past experiences have included (a) teaching children with autism in the U.S.A. and Japan; (b) directing Emory University's model program research replicaion site; and (c) providing autism diagnostic, consultation, and training services.
 
There is consensus among experts that no one teaching strategy will prove effective for all children with autism. In fact, there is little evidence supporting the effectiveness of any specific intervention and no adequate comparisons of comprehensive interventions for children with autism. According to the National Research Council's Committee on Educational Interventions for Children with Autism, using a variety of strategies and then determining effective practices for individual children appears to be the most pragmatic path for collaborators at present.

As parents and professionals collaborate in developing comprehensive educational programs for children with autism, discussion often leads to the merits of Applied Behavior Analysis (ABA). Applied Behavior Analysis is a branch of behavioral psychology applying what is learned from the analysis of behavior to understanding the functional relationship between behavior and conditions. Confusion often arises with discussion of ABA because a variety of strategies are based on the principles of ABA. Adding to the confusion, some advocates define ABA in terms of a single instructional strategy (e.g., Discrete Trial teaching), while others use the term to classify a wide range of strategies.

Discrete Trial (DT) teaching is based on the principles of ABA and has historically been the strategy of choice for children with autism. Discrete trial teaching typically involves fast-paced teaching of discrete skills in a highly structured one-to-one setting. Although DT teaching has empirical research to support its effectiveness, it also has significant limitations.

During DT teaching, children are responding to prompts from the teacher; consequently, they may not learn to initiate behaviors in the absence of clear prompts. Additionally, in DT teaching, the teacher sets up a highly controlled learning environment. Children may not generalize skills acquired in DT teaching to other environments. For example, they may only use the newly acquired skill if there are no distractions, if they are interacting with a familiar adult, or if they are given a particular prompt. Finally, DT teaching can be highly labor intensive requiring teachers to work individually with a child while continually providing prompts.

In spite of its misrepresentation, ABA includes a group of highly utilitarian strategies including Incidental Teaching (IT), Visual Strategies (VS), and the Picture Exchange Communication System (PECS), among others. Incidental teaching takes place in natural settings with the teacher generally following children's interests to take advantage of and create teaching opportunities. However, there are times when it is necessary for the teacher to prompt for a desired response. At that point, the instruction becomes adult directed. In addition, teachers arrange antecedents and control access to reinforcers in typical IT settings. Therefore, the difference between IT and DT teaching, particularly when teaching communication skills, may not be as substantial as some have suggested.

While IT focuses attention on expressive communication, Visual Strategies (VS) focus on receptive understanding. Providing information visually offers an antecedent prompt that facilitates children's understanding and interpretation of information. Visual strategies include body language, natural environmental cues (e.g., furniture arrangement), tools for organization (e.g., calendars), and specifically designed tools (e.g., PECS). This focus on receptive understanding leads to greater comprehension, which leads to greater participation, which may ultimately lead to more effective expressive communication.

The Picture Exchange Communication System (PECS) is a strategy used to rapidly teach self-initiated functional communication. The system was created for children who do not routinely approach others to communicate, actively avoid interaction, or only communicate in response to a direct prompt. Children first learn to initiate a communicative act for a concrete outcome in a social context using single pictures and then learn to combine symbols to create sentences. The primary goal of the PECS is to teach children to functionally communicate, while teaching the child to speak is secondary.

Because of the utility of DT teaching in acquisition of new skills and the utility of IT, VS, and PECS for fostering initiation, generalization, and independence from teacher prompts, these methods, all based on principles of ABA, complement each other nicely in an educational program. However, there are also strategies outside of ABA that should be considered in the development of a comprehensive educational program. The Practice Station (PS) is one such strategy which was adapted from the structured teaching model and based on the principles of cognitive-social learning theory and developmental psychology. The PS is used to practice mastered tasks with the primary goal of teaching universal approaches to tasks (i.e., top to bottom, left to right, work then play) and a secondary goal of increasing the time children can attend to mastered tasks and complete tasks independently. The VS built in to the PS help children understand the task, stay focused, and complete tasks independently.

To date, no studies have examined how teachers should determine which strategies are preferable for a given child when teaching a given skill. At present, this determination is more of an art than a science with the appropriate choice likely to depend on a child's learning style and the difficulty of the skill.

In summary, DT teaching is an important but not sufficient element of a comprehensive educational program for children with autism. Children also require other strategies to initiate the use of skills they have acquired during DT teaching sessions, generalize those skills to new settings, and reduce their reliance on prompts from the teacher. Further research is unlikely to change this overall conclusion. However, we have much work to do in determining how best to combine DT teaching with other strategies when creating comprehensive educational programs for children with autism.

This session will be presented through lecture and discussion using a Power Point presentation. Embedded photographs and video clips will illustrate the concepts and strategies presented. Participants will be encouraged to ask questions as they arise to clarify points.

Session participants will understand: Reported outcomes and challenges of programs using DT teaching in isolation. Plans for generalization of skills mastered using DT teaching. Teaching strategies in addition to DT teaching based on principles of ABA. Teaching strategies outside ABA that support teaching efforts.

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