ESDM/DTT

Traditional Behavioral Interventions

• Therapists teach skills in a one-on-one setting with a predetermined response. 

• Highly prescribed teaching structure. 

• May break skills down into small steps. 

• Repetitive teaching in a controlled environment. 

• Positive reinforcement of desired behaviors while working to minimize “undesired” behaviors. 

• May represent principles of operant and/or classical conditioning.

Social-Pragmatic Developmental Interventions

• The therapist follows the child’s lead. 

• Therapist fosters initiation and spontaneity. 

• Reinforcement of contingent responses. 

• Implemented as part of naturalistic communication. 

• Emphasizes the “how” and “why” of communication in everyday interactions. 

• Follows a natural developmental process.

Contemporary Behavioral Interventions

• Recognizes the value of traditional behavioral and other developmental approaches. 

• Value of giving children choices, sharing the communication opportunity, and using preferred activities and materials. 

• May combine approaches to meet the needs of the child and family. 

• Naturalistic Developmental Behavioral Interventions (NDBIs)

• Embed strategies in everyday activities 

• Encourage engagement and motivation by responding to the child’s cues. 

• Focus on Joint Attention

Early Start Denver Model

• designed for 12-60 months of age

• from no language skills to skills at 48 month level (4)

• play based activities to promote socializ ation

• parents are highly involved

Core features of ESDM

• naturalistic ABA strategies

  • prompt, behavior, some sort of interaction (instead of reward)

• sensitivity to developmental norms

  • 480 question assessment

• extensive caregiver involvement

• focus on shared affect/interaction

• shared engagement

• language and communication embedded in everyday activities

Core principles

• naturalistic teaching

  • Uses everyday activities and routines to teach skills. 

  • Makes learning more relevant and enjoyable! 

  • Could increase motivation.

• joint attention

  • focus on building child’s ability to share attention and activities

• developmental appropriateness

  • Tailored to the child's developmental level. 

  • Activities suitable for age and skills. 

  • Helps parents/caregivers to understand the child’s skills.

• family involvement

  • The family is a key member of the team and should be involved in all sessions. 

  • Focus on warm, positive interaction. 

  • Learn strategies to support skills at home.

Operant conditioning

• ESDM uses operant conditioning as a behavioral technique 

• Reinforcement of positive behaviors through social interaction and praise. 

• Can help to shape behavior 

• Can promote communication and interaction

Experiential learning

• This approach is hands-on. 

• Encourages active participation, exploration, and skill acquisition. 

• Focus on what the child is interested in and build the strategies around it. 

• We can still control the materials presented within the environment. 

Discrete trial training

• can teach any learner

• can teach a variety of skills, help maintain and/or generalize skills

• based on ABA principles

• highly structured intervention

Discrete trial training

• Breaks skills down into smaller steps and explicitly teaches them. 

• The goal is for learners to consistently provide the desired response and to generalize the response to other situations. 

• Teacher provides reinforcement and/or consequences for responses.

• Treatment focuses on building toward behavioral cusps or “the integration of subskills that lead to substantial changes” 

• Can help to promote skills in a a highly structured setting.

4 key components DTT

1. Discriminative Stimulus 

2. Response 

3. Consequence 

4. Intertrial Interval

Discriminative stimulus

• A specific cue that signals to the learner that the behavior is expected. 

• Learned may need an additional prompt to provide a correct response. 

• Fading of prompts will occur with the goal of independent performance of a skill.

Response and consequence

• The response is the learned behavior or action following the instructional cue. 

• The learners response is scripted and anticipated. 

• The consequence is the feedback or reinforcement provided by the therapist. 

• The learners response is either reinforced or error correction is provided. 

• Reinforcers should be delivered immediately! 

Discrete Trial flow chart

Intertrial Interval

• The amount of time between the conclusion of one discrete trial and the beginning of the next. 

• Usually represented by the number of trials per minute. 

• Stimuli may be presented repetitively or randomly.