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Population

The EI children enrolled in the home-based program for the given year ranged in age from twenty-three months to 42 months of age. The verbal behavior, social and cognitive repertoires of each child varied however all children had severe delays across these domains. Specifically, verbal behavior functioning ranged from pre-speaker and pre-listener to speaker and listener behaviors. However, about 80% of the children had severely limited speaker as well as listener skills.  Social skills were also severely delayed as is characteristic of children having PDD.  

Interdisciplinary model

CCEI provides services in an interdisciplinary model using ABA, speech and language therapy, occupational therapy, and physical therapy as well as sensory integration, natural environment training, and family support.  Our model of ABA is applied to young children with disabilities in preschool and EI programs by professional staff that collaborate about effective treatments on a daily basis.  The teams work together with a focus on the individual child. Parents are a central part of our interdisciplinary team. We provide family training and family support groups monthly. Parents are encouraged to be active members of the treatment team. Their input is necessary with regard to individual child deficits, family situations, and cultural issues. In addition, parents receive training regarding specific behavioral techniques to foster the generalization of skills in their home and communities.

CCEI is not a CABAS® school, however the program was based on the that model and incorporated the following CABAS® components in its’ program: LUs[2], PSI modules[3], TPRA’s [4]and data decision analysis[5].

 ABA special instruction

CCEI provides home-based and center-based services. The data reported within this study are limited to the center-based program. Each of the 24 children targeted were enrolled in a 10-hour weekly ABA program. A majority of the children’s programs were supplemented by ten hours of homebased ABA special instruction. The specific components of the center-based program only were as follows.

Discrete trial training and Learn Units

Discrete trial training (DTT) using learn units (LU) is an intensive, structured teaching program. Each skill taught was broken down into its simplest elements and smallest step possible for initial acquisition.  The skills taught follow a developmental progression with a strong emphasis on the generalization of skills to more natural learning environments. The child was presented with an antecedent stimulus. The child’s response (if correct) is reinforced by giving positive reinforcement (e.g. verbal praise, a book, toy, edible). The child’s response (if incorrect) is given a correction, and appropriate responses are modeled or prompted.  Prompt levels may vary from verbal or physical guidance to repeating the instructional antecedent. Prompts are faded as correct responding increases. As new behaviors are learned to mastery, acquisition tasks are added to each individual child’s programs. DTT is generally therapist directed. Target goals will include attending skills, non-verbal and verbal imitation, self-help skills, academic and social skills. The LU is a three-term-contingency that may occur in a scripted, automated, discrete, captured, dispersed or massed form (Greer, 2002).

Natural environment teaching

The natural environment teaching (NET) component relies on naturally occurring opportunities in the environment (e.g., group instruction, captured learn units) to promote learning.  Addition of this component emphasized child-directed activities (choices) while still incorporating the stimulus-response-consequence paradigm. Target goals included language, play and social skills. During NET, antecedents that may be child initiated were paired with multiple cues interspersed by the therapist. All goal directed attempts by the child were reinforced to strengthen appropriate responding. The reinforcers were the natural consequences of the desired  behavior.  This approach began as a small component of a given child’s two hour session per day. NET was expanded as they mastered skills, and increased the generalization opportunities.

Verbal behavior

Skinner (1957) presented the framework for the functionally independent verbal operants which has proven to be invaluable to practitioners setting out to teach communication skills to early learners.  The verbal behavior (VB) approach and VBA is a

focus on teaching the specific components of expressive language (e.g., echoic behavior, mands, tacts, intraverbals) by emphasizing the function of a word as opposed to the form of a word.  This approach has been effective in rapid skill development, functional communication training and reduction of inappropriate behaviors (Greer & Ross, 2008).  Group instruction
DTT, LU delivery and NET procedures continued during group instruction. The main difference is that students were not isolated into specific one to one settings. A group program or group setting consisted of a child engaging with generally three or more of his or her peers during an instructional period (two hours). During the group instruction, teachers may have positioned the children to be seated in a semi-circle arrangement facing the teacher who led the group.  Teacher assistants (TA) sat behind each child to prompt, praise, reinforce, and record data throughout the group activity.  Group instruction formats may have also occurred in a rectangular seating arrangement around a table for art activities, or on the floor, for music activities using various instruments.  Therefore, the children continued to receive LUs parallel to their peers in an approximation of a typical group setting.

Teacher training (PSI)

Staff instruction consisted of treatment packages with decision analysis protocols, direct instruction of research based tactics and frequent observations by the supervisors.  Staff received training by completing PSI modules.  Supervisors presented

content and modules that were completed weekly which included reading specific chapters in assigned texts, passing written exams on the content of the reading, and the clinical application of the subject matter. Training sessions were scheduled weekly and consisted of the delivery of instruction. Staff also received formal observations of their teaching procedures using the TPRA observation procedures mentioned above.

Data decision protocol
The data decision protocol allowed us to monitor student progress and to make timely data based decisions regarding the next step in instruction,  by analyzing the trends in the child’s data.  Based on the landmark dissertation by Keohane (1997), the decision analysis protocol enables teachers using ABA to teach 2-3 times more objectives.  This is a critical component to best practice ABA programs.

Both instructional formats at CCEI are individualized and involve data collection, graphing, data decision analysis, and the application of scientifically based tactics to ensure optimum instructional effectiveness and efficiency (Greer, 2002; Keohane 1997; Greenberg, 2007).

Supervision

The instructional systems at CCEI are established and maintained using techniques from the science such as the Teacher Performance Rate Accuracy (TPRA) observation procedure (Ingham & Greer, 1992).  Teacher performance/rate and accuracy (TPRA) measurements were administered through direct teacher and teacher assistant observation by supervisors who are board certified behavior analysts. The child’s instruction is measured in LU by dividing the number of three term contingency trials by the rate of instruction. In addition correct responses and incorrect responses are monitored daily to measure response accuracy and learning. Teachers and assistants made graphic displays and analyzed the data daily using the Data Decision Analysis Protocol. Data decisions regarding interventions for decreasing trends or stable rates of responding were accordingly scripted. All data were graphed daily. 

Results