Parent Support University Week 4

April 22, 2020

AnswersNow Chief Science Officer, Adam Dreyfus, speaks about the topic of Discrete Trial Training as a part of the Parent Support University series and answers questions live.

Transcript:

Speaker 1 (00:00):

Good evening AnswersNow family and folks. Hopefully this works. I just put it in my headset after I tested it out. So hopefully we're getting pretty good audio. We are here on a Wednesday evening to do our ongoing series on teaching parents and caregivers how to think like a behavior analyst how to know all this stuff that, cause we hear it all the time. I actually, let me finish my intro. I'm Adam Dreyfus. I'm the chief science officer of AnswersNow. What is AnswersNow? It is a downloadable app and a website so you can go to either your Apple store or your Android store and download AnswersNow onto your phone. Or you can go to getanswersnow.com and interact that way. So we'll be going back and forth with that a little bit.

Speaker 1 (00:46):

We've got a new offering. We used to we're not used to, we just started doing one time video calls. So you don't want to sign up, you don't want to do the whole thing. You don't want to get assigned to somebody you just have a question or you want to have a quick little conversation. So you can go sign in for a 30 minute call and talk to a behavior analyst. And then Bob's your uncle. You're all done. So go to getanswersnow.com. Check that out. I'm here to answer whatever questions you might have. I'm going to be talking about Discrete Trial Training. This is probably one of the most common ways that people interact with applied behavior analysis is that they see somebody doing discrete trial training or if you've got a child or a relative on the spectrum and you hire someone to come into your house or go to a clinic, they mostly do discrete trial training.

Speaker 1 (01:42):

A lot of people confuse discrete trial training with ABA because it's so common. And some people, a lot of people, that's their only experience of it. So we're going to talk about that a little bit. But I'm also, here  you go. You gotta a BCBA sitting here. And you can ask any questions that you want. We'd like it when you interact. So if you use the little heart things, Oh, Hey, I like that. Or little frowny faces. I don't like that. Or Adam needs to get a haircut. This is true. I've been kind of getting away with it in the pandemic and then I do these things. I'm like, this is getting a little, get a little wooly. I ain't gonna let my kid shave my head. That should be one of those challenges.

Speaker 1 (02:21):

So we are here to talk about all things and AnswersNow and answer your questions. Say hello and go from there. So one of the things we were wearing, our fourth installment of the parent support university. So I hear two things from parents most of the time. One is, Oh, I wish I knew all the stuff that, you know and that's way easier done than said there all that information is out there. It's not a, yes, I went to school for it. But tons of places put it out there for free so you can learn all this stuff that the BCBAs know. And they also say I just don't want to be the therapist. I just don't want to be the therapist.

Speaker 1 (03:07):

It's too hard for me to be a therapist for my own kid. And what AnswersNow is all about is like, Hey, listen, we're not going to ask you to be a therapist. We, if your kid needs an in home support or a special school, like absolutely do that. This is not a substitute for any of those things. But we can help you with the parenting part of it. Cause a lot of the struggles that parents have are not like, Oh, he doesn't know his numbers. It's he doesn’t play with his siblings or, we had somebody who we're working with now who tickles, right? You think, well, it’s not a very big deal. You'd be surprised at how many clients that I've had who are like, listen, my kid won't stop tickling me. It's driving me crazy and I've tried to do everything.

Speaker 1 (03:50):

I'm very straightforward kind of proposition there. Each kid is individual, so it doesn't mean they're all doing it for the same reason, but it's a pretty straightforward behavior to kind of handle, the tickling. It sounds like it might be kind of funny. It is not funny if you've got a four or five year old who won't stop tickling you no matter what you are trying to do. So, my favorite sort of, I like to say that what AnswersNow does is you know, we have parents and then we have this great big body of knowledge that can largely solve most of their problems. And they just don't access it, right? They don't, they hire experts or maybe they read a book. It's just too much. It's the barrier of entry is too high. It's a lot of weird words like tacked and manned and reinforcement and punishment.

Speaker 1 (04:38):

All kinds of high barrier of entry. So this is what we're all about is lowering that barrier of entry making it much more accessible. So the National Professional Development Center about seven or eight years ago put together a website that has all of the practices that we know work evidence based practices. I think there's 22, maybe a couple more there. They're still adding onto it. Because there's another thing that we are very used to with autism. And the parents and the caregivers. They're like, man, every time I turn on my computer there's like some new intervention or some new cure or there's some new book, there's some new, some new something. And so what the National Professional Development center did is they basically just said, Hey, listen, what, what do we know now? Just works now.

Speaker 1 (05:23):

We're not going to go round and round about it. So what we're doing here with our Parent Support University is unpacking all of those evidence based practices. So we've done antecedent based intervention, cognitive behavioral intervention, differential reinforcement. And now we're on number four,  discrete trial training, D, T T as it is usually called. If you are a parent of a child on the spectrum or, had been around it, you have seen this. This is mostly what this looks like is the kid sitting at a table with an instructor or a teacher and they're just doing kind of one thing at a time. Discrete means not discreet. Like, Oh, I'm being discreet cause I'm wearing a shirt. Discrete means like a very clear boundaries,  discrete with E T E. So a discrete trial means that what you're doing is you're trying to reduce the instructional moment to its smallest possible components.

Speaker 1 (06:24):

So you're trying to break it down. Cause if there's one thing that we've learned about kids on the spectrum and adults on the spectrum is they don't just learn putting them in a classroom. And they don't learn like most of the other kids do. In the sense of they, you know, most of our learning is through observation. So what, discrete trials that say, I'm going to break this down. So there's a perfect example. I've got a pen. I'm not gonna sit up here and say, Oh, Hey, here's where we're going to do a, I'm going to be talking to you guys about a pen today. Pens are used for writing pens could be ink pens or whatever, are too much talking, right? For most of the kids on the spectrum, they're not going to be able to pull out of all that that I'm talking about this. And so a discrete trial, okay. I'll show you an example of one where if I wanted to teach them how to say this just by seeing it. So that's a generically kind of called the label. We call it a tact which is one of those crazy words that we talk about. So I would just hold it up.

Speaker 1 (07:33):

I wouldn't say anything. Right. I would just make sure I got the kids' attention hold up. And what I wanted them to say it's pen, right? I just want him to say the word pen. So, and they say duck. Pen. Now the, well, let's do it the way they get it right. Oh, that's right. It's a pen and here's a little squeeze on the head or whatever that kid finds reinforcing. So you're trying to, the key to it, and it's what I want you to generalize out of this is if you're trying to have an instructional moment with somebody on the spectrum stop talking so much. All you need to do is be a, is have their attention. And you can usually get that just by walking into their field of view. I do when I'm working with somebody for a while I like a, a, what I call it, sort of a naturally occurring way to get somebody's attention instead of doing whatever else you're going to do.

Speaker 1 (08:40):

I do, I teach these kids that when I do an intake of breath, like it means I'm about to talk. It's, I'm about to do something. And I, they learn that means like, Oh, I need to pay attention to him. He's about to do something and when he's doing something that's really good for me. Right. It's really important to kind of make learning fun. I say all the time, like, if your kid doesn't want to do discrete trial, it's being done wrong. Why? Because they're in an environment where they're getting tons of attention from somebody. If it's done right, it's really reinforcing. So they're getting lots of stuff that they like, and it could be that they just want to be with the teacher, but usually there's something else they've got, like maybe they want to be on the iPad, maybe they want a snack, maybe they want something to drink, maybe they want to play with a toy.

Speaker 1 (09:26):

So they get access to all these fun things. And if you're doing it right, like I said, it's a very high level of getting things kinda right. I remember I had one of the teachers, I run a school, large school and they said, Oh, you know, when we take out the program book, which is where we kind of take all the data and it's the signal to the kids like, Hey instruction, it's going to happen. It's going to happen over here. Now how they get really upset, I'm like, well that is the absolute wrong thing that it should happen. What should happen is you sit down and you pull out your materials and the kid comes running over cause this is going to be awesome. They're going to learn some stuff. They're gonna get a lot of reinforcement.

Speaker 1 (10:08):

They're going to get to hang out with somebody they want to hang out with. If those pieces are not in place it is not going to go very well. So your discrete trial is just this, you want to break whatever you're trying to teach them into the smallest possible component and not use a bunch of of language, even their own name, right? Like, if I say David Pen, he's going to learn that is, this is a David pen. Right? Does that make sense? I hope so. That you want to strip out as much language as possible and only use the words that's you want to use. The other key to really good discrete trial is you want the difference between a correct answer and an incorrect answer to be big. So if I say I'm going to ask the question, what is this? Pen.

Speaker 1 (11:01):

Hey, that's right. That's right. It is a pen. That's good. That's, I'm glad you got that. Or I go, what is this? And they say duck. And I'm like, well no, it's not a duck. It's a pen. But that was like a track, right? Like you were pretty close and we're just going to keep trying. That use, very similar. So it's hard for the student, child, client, whatever you want to call them, to experience the difference between a right answer and a wrong answer because they both kind of sound the same. So the next time I hold this thing up, they're like, I'm not sure exactly. I don't know, like I did something. Let me try something else. So you want the difference between a correct answer. I call it make it rain or nothing happens. So they get the correct answer. What is this? Pen. Boom. High five. Here's a little something you really like. Oh, that's awesome. Great. What is this? Duck. What is this? Pen.

Speaker 1 (11:55):

And I said, right, you just repeat back the first part of it. You'd give them the correct answer and you move on. No good jobs, no nice. You're not to be mean to them. But what you're trying to do is to create this big difference so that the next time they see a pen, it increases the chance that they're going to get it right. So here we are deconstructing a discrete trial. So we're about halfway through. Just want to reiterate I am Adam Dreyfus the chief science officer of AnswersNow. You can find out more about us on getanswersnow.com or download us off of your own app stores. We have an Android app and an Apple app. And what we do is we connect you directly to your own clinician. So I'm doing one of these things.

Speaker 1 (12:43):

I might answer your question a little bit. A good way of thinking about that is you've got the first ingredient for a big dinner. But it takes a lot more than that. You're not just going to figure out how to cook a big old meal in 10 seconds or even half an hour. This is gonna take a while. And one of the reasons that we created AnswersNow was so that you could form and build a relationship with a clinician over time, not just two months, but six months, a few years. And some folks were like, Oh yeah, that's, that's great. But I've got an in home. Well, there's a lot of turnover in home. Nothing against in home. I did it for a long time. It's great. It's a, if you can have it available to you, I highly recommend you getting the in home support.

Speaker 1 (13:26):

But those of you who do have in homes know like there's a fair amount of turnover. Your line staff turnover is quite a bit. The BCBAs might have a turnover. And what AnswersNow affords you, is a longitudinal relationship. Just like you, like one with your doctor. You go in and you've had your same doctor for four or five years. He knows your history, he knows what you've gone through. He knows that what's worked, what hasn't worked or frankly more these days. Probably she. So that's our kind of core proposition. We also have a bunch of other stuff on the website. We've got communities that are kind of like these open free groups where parents can come in and get questions answered and talk to each other. We've got goals where they're kind of a lot of little, paint by numbers is the best way.

Speaker 1 (14:14):

They're automatic and you can track your own progress and they walk you through. How to do some of the things that are challenging for some of our families. And we're always open for what is it that you need? What kind of support do you need? Is it around a specific goal? Is it to have a sense of community? Is it to not feel so isolated? Different people have different reasons that they come to us. Our basic premise is that the parent or the caregiver is kind of like a CEO. And more than any other disability category, I think autism fits the bill with that. Because if you're a parent or a caregiver and it's not just like, Oh, I gotta make sure there's experts. There's all kinds of different expert.I’ve got speech.

Speaker 1 (14:59):

I've got the behavior people, I've got, maybe I'm doing some music therapy and then I've got to take the kid to school and then I've got playgroup and I got to manage insurance and I got to figure our finances. And it just, it's an incredible amount of stuff that the parents of children on the spectrum have to sort of navigate. And we're here for that. We're here to help you out. Do you need help with advocacy? Do you need help getting in touch with resources around your IEP? We do a lot of support around educational settings. How do I talk to the teacher? How do I call a meeting? How do I express that I'm not happy with the progress or that I don't like that behavior plan. There's all kinds of stuff that we can help with.

Speaker 1 (15:43):

So and tonight as here at seven o'clock East coast time I'm here in Richmond, Virginia. We're talking about discrete trial training DTT, which is one of the most common applications of applied behavior analysis, which is what us BCBAs do. Look at all these acronyms. I can't, for the life of me, it's hard for me to avoid the acronyms. It's nice seeing some people coming in,  and visiting. If you have a question, you can just type it into the bar on the side there. So let's demystify as I said before, a DTT discrete trial training is not ABA. ABA is like Ford motor company and discrete trial is like a Ford Fiesta. It's one of the types of Fords. So there's lots and lots of different types of interventions out there.

Speaker 1 (16:38):

Discrete trial. Some people say, yeah, but that's a lot, right? But the kids sitting to the table for a long time and they're going through a lot of things. Yes, yes. Cause if you've got a kid who has severely impacted communication skills, severely impacted a language skills, they're not going to learn how to do what they need to do with one or two tries. It's going to take hundreds and hundreds and hundreds of tries. You sitting there, if you're a somewhat typical person, I don't want to say you're normal, I've never read anybody who's normal. But by four years old, the research has shown that the average person who's got a, can be exposed to around 45 million. Million, big M. 45 million language opportunities, chances to learn something to say. And that's if your parents are pretty educated, like a, you know, a college level and on up.

Speaker 1 (17:39):

But the mid range of that, kids are getting 30 million opportunities, 30 million opportunities to learn a  word, learn a song, read a book, you name it. It's a language kinda opportunity. And for folks on the lower end of the opportunities, which are mostly kids who are in poor environments, they still get 15 million opportunities. Now stop and think about it. A lot of these kids they don't talk, they don't interact, they don't kind of go very back and forth very much. So they're starting to at a deficit. So I think, you know, a lot of our kids, by the time they were four, they might've only had a few hundred thousand. It seems like a big number, right? Yeah, no, no. I sat down and I, you know, talk to them or sing to them, or we worked on a word 250,000 times.

Speaker 1 (18:38):

It seems like a crazy number, but you're up against the norm is 30 million. So yes, discrete trial is necessary to help close that gap. Cause we've said that before here. Autism is uniquely sensitive to expert intervention. There are kids sitting out there right now who don't talk at all. It might be four years old, they might be five years old, eight years old, 10 years old, not a word. And they get some good expert intervention and they will become conversational. They will not just learn a word or two. You will be able to have a conversation with them. And that is only possible through what, you know, mass instruction, you call it whatever you want, discrete trial, mass instruction and someone's going to have to sit down and spend a fair amount of time teaching these things.

Speaker 1 (19:34):

Discretely, discrete trial instruction. All right, so we are actually getting somewhat towards the end of our time. We're going to try to do these a little bit shorter. We might switch them over to YouTube. So I want to encourage you very strongly to check us out at getanswersnow.com where you can sign up for a one time video chat with a BCBA or if you would like to just kind of get started and develop that relationship and dig in to all of the questions that you might have and get assigned your own clinician that you will have in your pocket 24 hours a day, seven days a week. You can definitely do that. We've got a bunch of different options there. We've got our communities and I'm checking my notes cause there are much smarter people than me that make notes for me to keep me on track.

Speaker 1 (20:23):

I like the interactions that we're having. People send in the little smiles and stuff like that. Actually, let me see if it can tell me no, I thought I could click on that, and it would tell me who's in there. So if you don't have any questions we're gonna end here at seven 20. Again, I do encourage you to go to getanswersnow.com. There are the communities that are always open that you can go in and check out and see if the, you might have the answer to your question already done or some of the goals that we've got or some of the blogs or some of the the articles that we've got posted up. But primarily the whole point of AnswersNow is to connect you directly to your own clinician, whether that's just for one time or for a longer relationship.

Speaker 1 (21:11):

So encourage that, check that out and we will see you next week. I forget what the next thing come up, but we're going to continue with the Parent Support University during this time. Try to help you think like a behavior analyst. Put you in contact. The link that I have over in the comment section over there takes you directly to the National Professional Development Center materials on discrete trial training. So if you want to dive in there I recommend it. I want to thank Alison for helping to set all this up and we will talk to you guys next week.


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