A randomized clinical trial of three prompting systems to teach tact relations

Abstract

Prompts are commonly used during discrete trial teaching for individuals diagnosed with autism spectrum disorder (ASD). Three commonly used prompting systems include constant time delay, most-to-least prompting, and flexible prompt fading. Most of the research demonstrating the effectiveness of these three prompting strategies have been completed through the use of single subject experimental designs. Some within the field of behaviorally based approaches to ASD interventions have called for more randomized clinical trials of these approaches. The purpose of the present study was to compare these 3 prompting systems to teach tact relations for 27 individuals diagnosed with ASD through a randomized clinical trial without a control group with respect to pre-post responding, generalization, sessions to mastery, and responding during teaching. Overall, minimal differences were observed across the 3 systems. The results are discussed with respect to future research and clinical application of the methods evaluated.

Functional Communication Training and Most-To-Least Prompting as Treatments for Problem Behavior

“…In addition to extending the conceptualizations of MOs and escape-maintained problem behavior, the data suggest adding MTL of the task to the list of antecedent-based interventions for escape-maintained problem behavior that includes demand fading (Gerow et al, 2020), reducing session duration (Moore et al, 2005), presession pairing (Kelly et al, 2015), noncontingent reinforcement (Slocum et al, 2018), and interspersing new and mastered tasks (Shillingsburg & Frampton, 2019). This case study extends previous research on using MTL to increase language, leisure, and academic skills (Cengher et al, 2016; Cihon et al, 2020; Schnell et al, 2020). Finally, the data extend previous research on using FCT to reduce escape-maintained problem behavior (Gerow et al, 2020).…”

Concerns About ABA-Based Intervention: An Evaluation and Recommendations

“…In the decades following Wolf et al ( 1964 ) there have been numerous studies demonstrating the effectiveness of procedures based on behavior analytic principles for autistics/individuals diagnosed with ASD. These studies have included evaluating the effectiveness of shaping (Koegel et al, 2012 ), discrete trial teaching (DTT; Cihon et al, 2020 ), incidental teaching (McGee et al, 1985 ), pivotal response training (PRT; Koegel et al, 1987 ), naturalistic developmental behavioral interventions (NDBIs; Schreibman et al, 2015 ), group instruction (Ledford et al, 2008 ), behavioral skills training (Gunby & Rapp, 2014 ), functional communication training (Durand & Carr, 1991 ), functional analysis (Jessel et al, 2016 ), extinction (Hoffman & Falcomata, 2014 ), and response cost (Falcomata et al, 2004 ). Studies have also evaluated the effectiveness of comprehensive behavioral interventions for autistics/individuals diagnosed with ASD (e.g., Howard et al, 2005 ; Koegel et al, 1987 ; Leaf et al, 2011 ; Lovaas, 1987 ; Lovaas et al, 1973 ; Sallows & Graupner, 2005 ; Schreibman et al, 2015 ) as well as follow-ups and replications of these studies (e.g., Howard et al, 2014 ; Koegel et al, 1999 ; McEachin et al, 1993 ).…”

Promoting the emergence of tacting three‐digit numerals through a chain prompt combined with matrix training

“…That is, both participants improved from zero correct tacts in the Results for Art initial baseline sessions to mastering the targets on the diagonals and in the full matrices within the first three to five treatment sessions per matrix (M = 3.4). In the Cihon et al (2020) study, children with ASD learned to tact six characters using direct-training methods after a mean of 160 trials or 26.7 trials per target. By contrast, the current participants learned to tact 192 targets after a mean of 54.4 trials or 0.6 trials per target.…”

“…Teaching children with ASD to tact each of these 999 numerals would require many sessions and trials using common training methods that involve direct teaching of every target (e.g., Lovaas, 2003). For example, Cihon et al (2020) compared the efficacy and efficiency of three common prompting procedures (most-to-least, constant time delay, and flexible prompt fading) to train children with ASD without intellectual disabilities to tact six comic book characters. The children required a mean of 160 trials to master the six tacts.…”

“…Given the relative complexity of this skill and the large number of targets, standard prompting procedures (e.g., echoic prompts with differential reinforcement) may not facilitate rapid acquisition of trained multidigit numerals and the emergence of untrained targets for ASD populations (cf. Cihon et al, 2020). Complex conditional stimulus control may require an alternative approach, such as providing individuals with ASD a prompt that makes the component discriminations as salient as possible (Davison & Nevin, 1999).…”