Autism and Discrete Trial Teaching

Discrete trial is a teaching method often used in working with children diagnosed with autism. It is an instruction routine, and although used in conjunction with Applied Behavior Analysis (ABA), the two are not the same thing. Discrete Trial Teaching is a part of ABA.

I have worked as a paraeducator/teaching assistant for a number of years; this article is not meant to be a comprehensive guide, but merely an overview of Discrete Trial Teaching, in terms I hope everyone can understand.

Each child is different, but there are several diagnostic criteria taken into account when diagnosing autism. According to the DSM-IV (American Psychiatric Association's Diagnostic Statistical Manual-Fourth Edition) these include, but are not limited to: impairment in social interaction (avoiding eye contact, misuse of or not recognizing in others various facial expressions and body language, lack of social or emotional connection, etc.), impairment in communication ( delay or lack of speech, inability to maintain conversation with others, or try to communicate with gestures) and repetitive or restricted behavior, interests, and activities (repetitive motions like spinning and rocking, intense focus on one interest such as dinosaurs, to the exclusion of everything else, etc.). This is an abbreviated list; for more information, consult the DSM-IV.

Discrete trial teaching tries to adapt teaching methods to learning methods in autistic children, and address some of the behavioral and learning issues associated with autism. It can be used to teach children certain social skills, such as recognizing facial expressions, as well as motor skills and problem solving. It is designed to break down tasks into small steps for easier learning and retention; uses reinforcers (things the child likes or desires) as an immediate response to success; ignores undesired behaviors; and places a high value on constant data collection and assessment of the child's progress.

A typical task might be for a child to complete a puzzle. It could be a simple puzzle, with only 4 pieces. The teacher might model the expected behavior several times, using simple phrases to explain what she is doing, and guiding the child's hand with hers. "This piece with a cow goes here. This piece with a horse goes here." Often, both physical and verbal prompts are used. The next step might be for the teacher and child to place three pieces of the puzzle in place, with the expectation that the student will place the last piece without help. When that task is completed, then the next step is helping to place two pieces, while the student places the last two without help, until the student can put the puzzle together with out help or any physical or verbal prompting. This could take days or even weeks, and the process is carefully monitored on data sheets and graphs. Again, this is only one example, and each child will have a list of goals and tasks specifically formulated for him/her.

Another task might be to help the child identify facial expressions and emotions in others. There might be three index cards, each with a photograph of a person's face, showing "happy", "sad" and "surprised". The child, through various stages, will learn to match the face with the word, and eventually learn to recognize those emotions in the faces of others when they occur naturally.

Reinforcers are used to immediately reward desired behavior. The first should be praise; this will allow the child to be weaned from physical objects as a reward down the road. Praise is usually exaggerated and accompanied by facial expressions; you want the child to know that you are pleased and excited! This can then be followed by a minute or two of play with a favorite toy, a small food reward (a cracker or a few raisins, perhaps) or whatever has been determined as a pleasurable thing the child will "work" for. Then, it's on to the next task.

Unwanted behaviors are either ignored, or countered by a positive request, depending on the situation. The idea is to try and shape behavior gradually. Hand flapping, a common problem, may be met with "hands down, please" or "quiet hands, please". The same phrases will be used as often as possible, to remain consistent. Wording and requests are always as brief and specific as possible, to eliminate confusion, and to make success as easy for the child as possible.

That is one of the things I like best about this method; its emphasis is on the child being positive and successful much of the time, by breaking everything down into small components and by using repetition and consistency.

Data collection is extremely important. It is done on a continual basis, and each child is closely monitored for progress and attainment of goals. Students are also assessed periodically to make sure that they have retained what they learned previously.

This is by no means a textbook explanation of discrete trial teaching, but I hope I have at least given you some idea of what is involved. For further information, I have included several websites under "Resources".

Working with autistic children can sometimes be exhausting and frustrating, but at the same time, it can also be very rewarding. It teaches you many things, including new ways to view the world, people, communication, and surroundings. It is amazing how many everyday things we simply take for granted.