Continuing the discussion on the efficacy of DTT and naturalistic language treatment with preschoolers presenting with severe autism, minimal speech (Paul, Campbell, Gilbert & Tsiouri, 2013).
Paul, Campbell, Gilbert & Tsiouri (2013) contended DTT over the other approaches used had facilitated in the development of early receptive and expressive language. Paul, Campbell, Gilbert & Tsiouri (2013), had the criticism of DTT as having trouble maintaining and generalizing the gains beyond the clinical training setting. This presented problems for the autistic to use the gains in a functional or spontaneous communicative way without tangible reinforcement.
We note here that tangible reinforcement (food, toys, stickers, tokens, etc) should be faded as acquisition becomes observable. Tangibles are paired with behavior specific praise (good talking, great talking, good asking etc.) from the start so that when the tangible is phased out, the praise remains. Then with consistent use of the gains, the verbal praise is faded, working toward the concept of talking solely for the intrinsic value.
Paul, Campbell, Gilbert & Tsiouri (2013) suggested MCT strives to address the DTT shortcomings. They used the following strategies:
1. Teach within natural environments to increase the chances of generalization (Kaiser et al., 1992), maintaining gains (Spradlin and Siegel 1982) spontaneity ( Yoder & Warren, 2002).
2. Mand- model the communicative act and correct child’s response (Rogers & Warren, 1980).
3. Allow 5 – 15 seconds for initiated response from the child (Kaiser, 2010).
4. Employ incidental teaching strategies (Hancock & Kaiser, 2002; Hart & Risley, 1975) such as:
a. Free play based on child’s interest
b. Adult organized environment with staged objects and situations to create opportunities to generalize; such as a favorite toy placed too high requiring the child to communicate the need for assistance; or a jar of treats shut too tightly for the child to independently open.
Paul, R., Campbell, D., Gilbert, K., & Tsiouri, I. (2013). Comparing Spoken Language Treatments for Minimally Verbal Preschoolers with Autism Spectrum Disorders. Journal Of Autism And Developmental Disorders, 43(2), 418-431.