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DTT) to Improve the Non-Verbal Communication Skills in Children with Autism Spectrum Disorder (ASD

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DTT) to Improve the Non-Verbal Communication Skills in Children with Autism Spectrum Disorder (ASD INTERNATIONAL JOURNAL OF SPECIAL EDUCATION Vol.33, No.3, 2018 Developing a Proposed Training Program Based on Discrete Trial Training (DTT) to Improve the Non-verbal Communication Skills in Children with Autism Spectrum Disorder (ASD) Mohammed Akram Hamdan, Faculty of Education and Arts, Department of Special Education, University of Tabuk, K.S.A. Abstract The present study aimed to develop a proposed training program based on DTT to improve the nonverbal communication skills in children with ASD. To achieve the objective of the study, the author developed a scale of non-verbal communication skills consisted of (20 items) measures attention and eye contact, imitation and using the signal, understanding the facial expressions and tones of voice. The author also developed a DTT program by reviewing the previous literature. The study sample consisted of (26) children with ASD aged (6-11) years, were chosen deliberately and divided randomly into two groups: an experimental group consisted of (13) children, and a control group consisted of (13) children. The results showed a statistically significant difference at the level of significance (0.005) between the performance of the experimental and the control groups on the non-verbal communication skills scale in favor of the experimental group. On the other hand, the results indicated that there are no differences in the experimental group between post-test and following up phases. Keywords: training program, discrete trial training (DTT), non-verbal communication skills, children with ASD. 579 INTERNATIONAL JOURNAL OF SPECIAL EDUCATION Vol.33, No.3, 2018 Introduction Autism spectrum disorder is a complex neurological and developmental disorder that causes lifelong difficulties (the national autistic society, 2012). It is characterized by impaired in two main domains: social-communication and behavior domain (amaze, 2015). The recent estimates issued by world health organization (WHO), indicates that the prevalence of ASD is 1/160 children in the world, this estimate refers to the average and varies a lot by countries and studies (WHO, 2013). Others estimates reached 1/88 upon the center for disease control and prevention (CDC), and autism and developmental disabilities monitoring network (ASSM). In march 2013 (CDC) indicated to new estimates reached to 1/50 individual in the school community (Kira, 2014). In spite of the great scientific efforts, the causes of ASD are mysterious, so the medical reports indicate that there is no specific and convincing reason to explain the occurrence of the disorder. However, the genetic causes have emerged as a significant. On the other hand, the causes of nervousness play a significant role which indicates that there is some dysfunction in the central nervous system, which confirms that ASD accompanies many neurological disorders. Several studies have linked the relationship between metabolic, chemical and environmental factors and ASD. Although there are many interpretations about the causes of the disorder, but many of them are still hypotheses and controversial among researchers and scientists (Hallahan, Kauffman & Pullen, 2012). Discreet Trials Training (DTT) Children with ASD usually do not learn in their environments spontaneously, so they need extra cues, direct and structured teaching of new skills. They must be taught repeatedly, be engaged actively with the environment in order to acquire new skills. DTT is one of the many strategies based upon the principles of applied behavior analysis (ABA) to facilitate learning. It consists of a series of direct, systematic instruction methods, used repeatedly until the child acquires the skill. DTT focuses on the analysis of skills into small elements and units. In this method the skills are individually taught through repeated attempts (Smith, 2001). DTT is one of the types of interventions and intensive behavioral programs which proved its success for children with ASD. This type of intervention is a systematic process based on the principles of learning theory. It is an attempt to change behavior by evaluation of the functional relations between the target behavior and environmental factors (Gupta, 2004). This strategy was used to help individuals with ASD to acquire many skills, such as expressive and receptive language, imitation, playing, social, emotional, physical, academic, and daily living skills, etc. (Smith, 2001; Lovaas, 2003). Children with ASD often respond to this type of intervention, so Lovaas study indicated that the young children who have been interfered within this kind of intensive intervention, they had achieved high levels of physical, mental, and academic skills after three years of intervention, and they have continued to generalize the skills for many years (Lovaas, 2003). These types of strategies assist the teaching of new skills in a conducive learning environment. It includes a series of distinct lessons or the attempts that are taught by a teacher to each child (1:1). Lovas defines this attempt as one unit consisting of a complex behavioral sequence which is broken down into small steps to make it easier for the child to learn and to reach the ultimate goal (Lovaas , 2003). DTT is usually applied in natural environments, such as, the home or the center. The duration of training by using this approach needs of (2-5) seconds in 580 INTERNATIONAL JOURNAL OF SPECIAL EDUCATION Vol.33, No.3, 2018 average between each attempt (Unlu & Vuran, 2012). Moreover, it requires an application period of (30-34) hours a week or (8) hours a day, and it continues for (3) years (Ekeseth Smith, Jahr & Eldivik, 2007). The training on this program also requires providing a special coach, it confirms that the family must be involved and participate in the routines. On the other hand, the training must be implemented within natural environments where the child lives (Unlu & Vuran, 2012). There are many advantages for using DTT: it is based on very short teaching units (1-5) seconds, to facilitate and speed up the process of learning and skill acquisition, which provides also more than 200 learning opportunities in one hour (Smith, 2001); it is. suitable for children in preschool age who usually have developmental delay and limited capabilities. Moreover, the intervention focuses on using prompting, shaping and positive reinforcement techniques which usually help to acquire the skill, and lead to high levels of interactivity between the teacher/coach and the child. Finally, the use of short learning units in this intervention increase the involvement of teachers’ flexibilty in learning activities with the child during the school day. This intervention does not only help the child to acquire learning opportunities quickly during the day, but also helps him/her to generalize the acquired skills at different times, in different environments and with different persons (Downs, Fossum and Rau, 2008). DTT intervention is evidence based, as data are collected on every attempt to monitor the child's progress based on continuous assessment. Data are collected on each correct and incorrect response. The correct or incorrect responses are calculated to determine the percentage of the child's performance level. The data collected are analyzed to identify relevant patterns in the response, including increasing or decreasing the target behavior. The data collection provides a basis for selecting effective teaching methods, to specify the beginning of training of skill or new behavior, and to make decisions about the identification of the appropriateness of prompting used to achieve the goal of teaching and when to begin the training for the next sequence of social, verbal, emotional behavior in order to prepare the child towards independence (Smith, 2001). The basic elements in DTT Both Al-Shami (2004) and Smith (2001) indicated that DTT includes a set of basic elements, as follow: - Discriminatory stimulus: is an antecedent stimulus that cues an organism to perform a learned behavior. - Instructions: a group of stimuli that guides the child's behavior when the response occurs, these instructions must be clear, simple and few. - Response: is what the child said or done when seeing and hearing the discriminatory stimuli, it is classified as a correct or incorrect response. - Reinforcement: is any motivation follows the response that increases the probability of occurrence the behavior and repeating it, so it must be delivered directly after the correct attempt, also must be desirable for the child. -The interval between the occurrence of responses: is the interval between occurrence of the first and second response. The goal is to move the child from the first attempt to the second. During this period, the teacher records and notes the child's response in the previous attempt, and also allows the child to interact with the reinforcement. 581 INTERNATIONAL JOURNAL OF SPECIAL EDUCATION Vol.33, No.3, 2018 Steps of DTT Bogin, Sulivan, Rogers & Stabel (2010) noted the steps of DTT, as: 1. The teacher identifies what will be taught: in this step, the teacher decides what are the expected goals and discusses the planned objectives with the teamwork, especially the parents, then s/he reviews the chosen objectives and rebuilds them, if needed. 2. The teacher analyzes each skill into sub-skills, then identifies each step in the skill, and arrange it in a sequent and clear manner to makes it easier for teamwork members to implement and monitor the teaching process, if necessary. 3. Selection of the data collection
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