It is important to keep repeating that while ABA (Applied Behavior Analysis) is the deep and comprehensive field of Applied Behavior Analysis, it has long been routinely and incorrectly considered synonymous with the provision of DTT, or Discrete Trial Training methods particularly to young children with autism. DTT is not a ‘treatment’ for young children with autism but just one type of relevant and useful direct instruction strategy which falls within the field of Applied Behavior Analysis.
ABA ≠ DTT.
For more on this and related, take a look at my post: https://www.linkedin.com/pulse/considering-applied-behavior-analysis-discrete-trial-lou
We do know – generally – that more active and interconnected (the interconnection being key) services especially for younger children with autism is – can be – to their, and their family’s advantage. A substantial misrepresentation too often embedded within autism services is that the need for ‘active services’ mean 40 hours of primarily 1:1 services using a more pre formatted developmental and/or skill sequence ‘script’ and interactive style which often is disconnected from family and primary context.
This would be not unlike claiming that all children with diabetes should be given the exact same medication regimen.
Another reality is that even as we know overall that sustained and more active services are generally better, there is no specific research which primarily validates a particular or specific strategy, instruction or intervention style or construct across children with autism. Communication/expressive strategies which more often are a relevant need for children with autism, for instance, are very similar to the need present and methods applied to children with conduct disordered profiles.
One thing this all means is that 40 hours of a DTT framed 1:1 service – or 40 hours of any pre-established service, for that matter – is no more automatically relevant for a child with autism than would be a Tylenol for anybody with a headache. The determination must be made one child at a time.
Active play; child discovered preferences and choices; knowing and respecting the child’s preferred learning style (rather than making presumptions since, after all, he or she IS ‘autistic’); peer comparable experiences and social relationship building; instructional differentiation and modification using age appropriate core curriculum, family/caregiver active involvement; skill transference and generalization; targeting ‘normative’ and adaptive skill development – among a number of other things – must also be incorporated.
Too often, misuse and even abusive instructional methods have evolved from the DTT framework in the often incorrect presentation that interfering – or what really are a blend of learned behaviors and the child’s own unique personality and temperament – actually represent ‘neurological symptoms’ of autism in the same way that wheezing is to asthma or seizures to epilepsy. Behavior, those productive and those interfering alike, are most often learned in the same way whether we are aware of what’s happening or not.
Forcing young children to do passive often decontextualized 1:1 table time, to keep them in the chair and/or at the exact location; to use hand over hand (HOH) strategies when they’ve actually just had enough, do not like what they are being told to do and/or how they are being taught (every child doesn’t like puzzles or a constantly animated instructor/therapist, for instance!) in order to ‘work through the autism’ is absolutely incorrect.
Such an approach sometimes just reflects upon poor instructional practice. Other times, however, it can become abusive even when the provider – most very often – brings no intent to that end.
Another point is that good teaching works. We know how to teach young children with and without autism to include those with learning; motivational, behavioral and engagement challenges and those who lack ‘learning readiness skills.’
Too often, more pure DTT models routinely contradict how to teach, how children learn best and true instructional ‘best practice’ They can also ignore a realistic developmental continuum and the awareness that child development can be highly uneven for ALL children. Because a child happens to be identified with autism hardly means that there is single ‘way’ to address or perceive child development.
A primary rule is to first and always; teach the child not the autism. If and as more specific interfering events and behavior occurs…if/when individualized skill deficits exist ranging from expressive and social, cognitive processing, adaptive or key ‘learning readiness skills’ among a number of potential others, we just need to teach to them as well. And these most often should be taught in context; taught where they apply and are supposed to be used. Such deficits and areas of interference to successful learning for children is hardly limited to those with autism.
If the program is in place even before the child enters the room or specific program, red flags should be waving high. If somebody claims to know what to do for