Development of Discrete Trial Training (DTT) Procedure in Smart Applied Behavior Analysis (Smart ABA) for Autism

Abstract

Lovaas was the first professional to use the principle of behavior modification for autism with a technique he called DTT (Discrete Trial Training), which later to be known as ABA (Applied Behavior Analysis). Through his study, Lovaas found that 47% of subjects had excellent results. While 42% with varying degrees, and the other 11% of subjects very little progress. In DTT, there are 2 possible responses, but the researchers' observations do not seem to be just 2 possibilities. This study's goal is to improve discrete trial training (DTT) procedures to increase the effectiveness of Smart Applied Behavior Analysis therapy for autism spectrum disorder. This study uses quantitative methods with a literature review research design. Research data is obtained through interviews, document studies, and literature reviews (journals and websites). The study focused on the researchers' findings that were adapted to earlier theories. The study was conducted at the researchers' autism clinic. During the implementation of therapy using DTT, the researchers observed that the child's response is not only 2, namely correct and incorrect. Based on the study conducted, it was obtained that there were 5 possible responses: Correct, incorrect, partial-correct, off-task, and no-response. Each of which required different feedback and its subsequent sequences, as well as the possibility of different causative factors which require different interventions. Further research with large and multi-center samples will further increase the effectiveness of DTT applications in Smart ABA for autism. This study was based on the researchers' findings while observing, mentoring, and supervising autism therapists.

Full text

Journal of Psychology and Behavior Studies
ISSN: 2753-2364
DOI: 10.32996/jpbs
Journal Homepage: www.al-kindipublisher.com/index.php/jpbs
JPBS
AL-KINDI CENTER FOR RESEARCH
AND DEVELOPMENT
Copyright: © 2022 the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons
Attribution (CC-BY) 4.0 license (https://creativecommons.org/licenses/by/4.0/). Published by Al-Kindi Centre for Research and Development,
London, United Kingdom.
Page | 63
| RESEARCH ARTICLE
Development of Discrete Trial Training (DTT) Procedure in Smart Applied Behavior Analysis
(Smart ABA) for Autism
Arneliza Anwar1 ✉ Rudy Sutadi2 and Chairita Miranda3
13Psychology Graduate Student, Persada Indonesia Y.A.I University, Jakarta, Indonesia
2Psychology Postgraduate Student, Persada Indonesia Y.A.I University, Jakarta, Indonesia
Corresponding Author: Arneliza Anwar, E-mail: liza_rudy@yahoo.com
| ABSTRACT
Lovaas was the first professional to use the principle of behavior modification for autism with a technique he called DTT (Discrete
Trial Training), which later to be known as ABA (Applied Behavior Analysis). Through his study, Lovaas found that 47% of subjects
had excellent results. While 42% with varying degrees, and the other 11% of subjects very little progress. In DTT, there are 2
possible responses, but the researchers' observations do not seem to be just 2 possibilities. This study's goal is to improve
discrete trial training (DTT) procedures to increase the effectiveness of Smart Applied Behavior Analysis therapy for autism
spectrum disorder. This study uses quantitative methods with a literature review research design. Research data is obtained
through interviews, document studies, and literature reviews (journals and websites). The study focused on the researchers'
findings that were adapted to earlier theories. The study was conducted at the researchers' autism clinic. During the
implementation of therapy using DTT, the researchers observed that the child's response is not only 2, namely correct and
incorrect. Based on the study conducted, it was obtained that there were 5 possible responses: Correct, incorrect, partial-correct,
off-task, and no-response. Each of which required different feedback and its subsequent sequences, as well as the possibility of
different causative factors which require different interventions. Further research with large and multi-center samples will further
increase the effectiveness of DTT applications in Smart ABA for autism. This study was based on the researchers' findings while
observing, mentoring, and supervising autism therapists.
| KEYWORDS
Autism, ABA, Smart Applied Behavior Analysis, Therapy, DTT, Discrete Trial Training, Response, Procedure, SOP
| ARTICLE DOI: 10.32996/jpbs.2022.2.1.7
1. Introduction
Autism is a developmental disorder characterized by difficulties in social interaction and communication (American Psychiatric
Association, 2013). This disorder is also characterized by differences in the development of intelligence and language (Sun et al.,
2019). According to a study's result, the prevalence of people with autism continues to grow; in 2000, there was an estimated 30.8
per 10,000, then increased in 2009 to 157 per 10,000, and increased to 167 per 10,000 in 2018 study (Fombonne, 2018). The
prevalence of autistic disorder in Indonesian society also continues to increase, currently at 8 per 1,000 (WHO in Savitri et al., 2020).
The disorder is characterized by persistent and diversified changes throughout life, as well as significant disruptions in social,
school, and family functioning that require intensive support for children and their families (Morales-Hidalgo et al., 2018).
Problems found in parental communication with children with autism are relatively different for each family, but among them can
arise through delays in understanding messages, unstable emotional control experienced by children, children experience
decreased confidence, have difficulty communicating verbally and experience delays in maturity in thinking (Kamps et al., 2017).
Children with autism find it difficult to express their desires to others. Communication is done one way and can not express to
others, and also can not express his desires with speech. If children with autism want something, they do it using body cues (Dadgar

Development of Discrete Trial Training (DTT) Procedure in Smart Applied Behavior Analysis (Smart ABA) for Autism
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et al., 2017). In special situations, indifference and lack of understanding of the message conveyed by parents to autistic children
become a problem for parents. So there needs to be help for parents in understanding children with autism.
One method that is often used to help individuals with autism disorder is Applied Behavior Analysis (ABA). ABA is a science that
applies various principles of systematic behavior analysis to significantly improve social behavior through an experiment to
determine the variables that influence behavior change (Haymes et al., 2015). The ABA method was first applied by Ivar O. Lovaas,
an American psychologist, through his experiments by applying the principles of Behavior Modification which is a combination of
two major theories, namely Respondent Conditioning from I. Pavlov and Operant Conditioning theory from B.F Skinner (Baer,
2019). According to Baer (2019), the goal of the ABA approach pioneered by Lovaas is to shape a variety of abilities, reduce and
eliminate problematic behaviors in people with autism, direct and change behavior in more meaningful ways, and teach
independence. Smart-ABA is a cutting-edge version of the ABA approach for autism that adapts several components of the
treatment process to the child's needs, including language, location, time, and instruments (Savitri et al., 2020). According to
Savitri's (2020) research, the implementation of the smart-ABA method can improve the likelihood of people with autism being
cured.
One technique that is widely used in ABA therapy and is considered an effective technique is Discrete Trial Training (DTT) (National
Autism Center, 2015). Discrete Trial Training is an educational strategy based on the principles of applied behavioral analysis.
Discrete Trial Training involves breaking a skill into smaller parts/components and teaching each part/component individually. The
therapist performs repetitive skill exercises and can combine the necessary prompting procedures. The correct response will be
followed by a reinforcer/reinforcement procedure to facilitate the learning process.
This strategy teaches children to gradually master complex skills by breaking them down into simpler skills that are easier for
children to practice over and over again (Cardinal et al., 2017). The DTT technique uses an instructional strategy by providing
instructions one by one so that children acquire skills/abilities in a planned, controlled and systematic manner through the use of
small steps repeatedly with the use of reinforcers (Cardinal et al., 2017). DTT techniques help children with autism in their learning
process since they have difficulty in mastering a complex skill/ability that includes multiple stages/phases (Cardinal et al., 2017).
As a technique with a good level of effectiveness, DTT can be used as a standard operating procedure when working with children
with autism disorders.
2. Literature Review
2.1 Autism
Autism is a developmental disorder caused by a dysfunction or failure of nerve function that manifests as impaired social
interaction, verbal and nonverbal communication, and the presence of repetitive behavior (American Psychological Association,
2015). Autism affects a person's ability to express and comprehend their own and others' feelings, and the person is more
comfortable being in the same environment all the time. The prevalence of autism disorder in Indonesian society has increased
and is currently at 8 per 1000 (Eapen, 2012; Kodak & Bergmann, 2020). The American Psychiatric Association estimates that
individuals with autism begin to show symptoms, and their development begins to slow between the ages of 1-2 years. Generally,
there is a delay in speech accompanied by a lack of interest in socializing, difficulty making eye contact, and unusual ways of
playing (American Psychiatric Association, 2013). More precisely, Kodak & Bergmann (2020) mentioned several symptoms of
autism that appear before the child reaches the age of 3 years, including the presence of communication symptoms manifested
by difficulties in speaking or only being able to pronounce simple sentences, social interaction symptoms manifested by children's
lack of interest in interacting with others, and behavioral aspects manifested by the children's interest in playing alone as if having
their own world.
The autistic disorder can be caused by multiple factors, both environmental and genetic. Rowland (2020) mentioned several causes
of autism, including drug usage during the first trimester of pregnancy, a longer time of the delivery process, nutritional deficiency
during pregnancy, and postpartum ingestion of additives. Parents or caregivers can determine if their child has an autistic disorder,
among others, based on numerous features presented by Rowland (2020).
a. Difficulty interacting and socializing.
Children with autism prefer to remain alone and rarely interact with peers or other people around them.
b. Impairment of communication.
ASD children frequently talk late or only understand a few simple words or sentences.
c. Repetitive Behaviors or Movements with Limited Interests.
Children with autism frequently engage in repeated actions such as circling, clutching their hands, and continuously shaking
their bodies forward and backwards. Additionally, they frequently exhibit excessive, even obsessive, preferences for an object.
d. Hyperactive and aggressive.

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This hyperactive behavior may include endless running, climbing, and circling. When a youngster is requested to stop a
behavior, he or she will exhibit aggressive behavior or tantrums.
e. Have an obsession / excessive attachment to something.
Children with autism may develop an interest and attachment to an object; they spend a lot of time with it and play with it
differently, which is often considered as weird.
f. Suffering from sensory problems.
Children with autism have limited sensory abilities and cause a variety of difficulties academically and non-academically,
including the ability to help themselves.
g. Unbalanced development.
Children with autism experience delay in some aspects of development differently from other children who are the same age.
2.2 Applied Behavior Analysis (ABA)
Applied Behavior Analysis is an applied science that is used to train individuals in mastering abilities using behavior modification
procedures. Baer (2019) defines Applied Behavior Analysis conceptually as a procedure of breaking down behavior into simpler
parts/components to make it easier to learn and master so that abilities are achieved that meet the standards found in society.
Ivar O. Lovaas, an American psychologist, was the first professional to apply Behavior Modification principles to autism, which he
called DTT (Discrete Trial Training), which later became known as Applied Behavior Analysis (ABA) for autism. Behavior Modification
is a development of two major theories those are Operant Conditioning, from B.F. Skinner and Respondent Conditioning from I.
Pavlov. In Behavior Modification, undesirable behavior is eradicated, and the intended behavior is developed and improved so that
the behavior of the individual conforms to community standards (Baer, 2019).
Green (2008) stated that the goal of Lovaas's ABA technique for autism is to develop a variety of abilities, reduce and eliminate
problematic behaviors in people with autism, direct and change behavior in more meaningful ways, and train independence. In
general, this method aims to provide positive reinforcers to children when showing a response that corresponds with the direction
given. Green further mentioned that ABA therapy could also assist individuals with autism to develop active two-way
communication with other people, socialize with a variety of people, minimize/eliminate unnatural behavior, and improve academic
abilities and self-help skills. Some of the principles used in this method are to provide genuine warmth and affection throughout
the therapy process, to maintain firmness and avoid compromising when giving instructions without violence, provide help,
direction and appreciation through effective rewards such as hugs, kisses, pats, gentle rubbing, or praise (Green, 2008).
2.3 Smart Applied Behavior Analysis
Applied Behavior Analysis is an applied science that is used to train individuals in mastering abilities using behavior modification
procedures. Baer (2019) defines Applied Behavior Analysis conceptually as a procedure of breaking down behavior into simpler
parts/components to make it easier to learn and master so that abilities are achieved that meet the standards found in society.
Ivar O. Lovaas, an American psychologist, was the first professional to apply Behavior Modification principles to autism, which he
called DTT (Discrete Trial Training), which later became known as Applied Behavior Analysis (ABA) for autism. Behavior Modification
is a development of two major theories; those are Operant Conditioning from B.F. Skinner and Respondent Conditioning from I.
Pavlov. In Behavior Modification, undesirable behavior is eradicated, and the intended behavior is developed and improved so that
the behavior of the individual conforms to community standards (Baer, 2019).
While observing, mentoring, and supervising autism therapists in applying ABA to children with ASD, researchers identified
numerous things that needed to be developed and improved. The researchers then assembled and developed, and/or improved
what researchers had already known from various training, workshops, textbooks, journals, literature, and articles. Assembling,
developments/innovations, and/or improvements made by researchers such as SOP (Standard Operating Procedure) in the
implementation of therapy/teaching sessions, as well as in the curriculum. Intensive assembling, development/innovations, and/or
improvement began in 2009. In 2011, researchers launched Smart ABA for ASD. Then in 2016 was duplicated/replicated by Chairita
Miranda at Anak Cemerlang Clinic, Pekanbaru, Riau, Indonesia.
The assembling, developing/innovating, and improving include, but are not limited to, the DTT structure/SOP for the non-verbal
and verbal programs, initial prompt, immediate prompt, DT (Discrimination Training), EO (Establishing Operation), escalation
prompt, shaping/chaining, split prompt, modeling prompt, prompt-delay (delayed prompt), full prompt, partial prompt, verbal
prompt, initial visual prompt, immediate visual prompt, visual prompt, the combination of the initial and immediate prompt with
or without visual media aid, scoring system (DTT, DT, Maintenance), passed/achieved system (DTT, DT, Maintenance), maintenance
system, curriculum block, curriculum systematics, etc. and so forth that require approximately 1,000 pages of explanation, which is
certainly beyond the scope of this research discussion.

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Researchers define Smart ABA (Applied Behavior Analysis Rudy Sutadi’s Method), which is an applied science/method (technical-
practical) that uses behavior modification procedures to teach someone (in this case, an ASD child) to master various
abilities/activities that conform to the standards/values in the community. By breaking down various complex activities into small
parts (if necessary to be the smallest part), according to the ability concerned, which are then taught/trained intensively and
systematically (taught/trained in scientific order), structured (the use of standard techniques in teaching/training), and measured
(the use of quantitative measurement to determine the success of children), and intervene/modify where necessary (according to
the identified problem).
What is meant systematically is that there is a defined curriculum/program that is organized linearly, beginning with the easiest
program/activity for children (smallest/simplest that is most likely to be done/achieved by the child according to his ability at that
time. If the prerequisites have not been met, then first taught/trained the prerequisites, then after being mastered then furthermore
there is a clear what programs/activities are taught/trained later, both as a continuation and combination with other
programs/activities to form complex/more complex abilities until finally, the child reaches the abilities that meet with the standards
in the community, then they can live independently and work like everyone else in society.
What is meant by structure is that there is a clear and standard structure (based on the child's response to various
stimuli/instructions given) for teaching/training various programs/activities ranging from simple to complex.
The development carried out by researchers on the structure/SOP, including but not limited to the DTT Non-Verbal Program, DTT
Verbal Program (Vocal Imitation / Syllable / Word / Sentence, Reading Cards of Vocal / Syllables / Words / Sentences, Answering,
etc.), Initial Prompt, Initial Visual Prompt, Immediate Prompt, Immediate Visual Prompt, Prompt, Visual Prompt, Split Prompt,
Modeling, Prompt, Verbal Prompt, EO (Establishing Operation), DT (Discrimination Training), Time-delay Prompt, etcetera and so
on.
The technical structure of teaching/training autistic children with Smart ABA is one of the most important things as a how-to
(technical know-how). Whatever curriculum/program/activity that will be taught/trained will be mastered by children if taught with
the right techniques according to the correct structure. Thus, not only what-to-teach, but the most important thing is how-to-
taught it. Because if the technique is incorrect, then the child may have mastered the wrong concept, which will be more difficult
to correct than teaching a new one from the start using the correct technique.
What is meant by measurable is that there are quantified scores and passed/achieved criteria so that it can be easily and clearly
stated whether a program/activity has been mastered or has not been mastered by the child.
One study (Savitri et al., 2020) found that Smart ABA was regarded as an effective and efficient method for improving language
function and skills, communication, and social skills in children with autism. In addition, in improving the various abilities of children
with ASD, the Smart ABA method is also useful for minimizing symptoms experienced by individuals. The Smart ABA method is a
fairly representative method to improve these capabilities in a measurable, purposeful, and systematic manner.
2.4 Discrete Trial Training (DTT)
Discrete Trial Training (DTT) is the most effective technique in the ABA method, even tending to be identical, so DTT is considered
another name for ABA (Lerman et al., 2016). DTT is the product of Lovaas's research. Initially, this technique was used to train
children with disabilities at UCLA. DTT techniques serve to simplify a complex skill, making it easier to teach and practice more
easily and repeatedly (Downs et al., 2008). DTT is a concept that refers to a type of training that teaches abilities repeatedly in
response to provided instructions. When the individual has mastered one simple skill, then the individual will be taught
additional/other skills to master the complex skills for which this training is intended. The DTT technique is considered appropriate
for children with autism because each child has unique abilities and a varying degree of severity. DTT is an excellent method of
developing a new response to a stimulus. Once abilities are acquired through the DTT, it is important to develop a teaching plan
with other new skills across environments, materials, and people (Bogin et al., 2010).
The DTT technique is based on behavioristic theory, in which the trainer/therapist gives instructions, and the child responds; if the
response corresponds with the instruction, then the trainer/therapist will give a reward or reinforcer for the response shown by
the child. But when the response shown by the child is not appropriate, then the trainer will say "no" or will repeat the instructions.
Reinforcer should be done as soon as possible when the child responds (Lerman et al., 2016). The goal of DTT is to increase the
emergence of desired behaviors, reduce to eliminate unwanted or inappropriate behaviors, and generate new behaviors needed
to facilitate the process of individual adaptation (Lerman et al., 2016).

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Discrete trial training has been proven effective in teaching children with autism to develop new behaviors and has become the
most widely studied approach to teaching important discrimination abilities. Some behaviors that are generally appropriate to be
taught using this technique include those behaviors that require fine and gross motor skills, recreation, self-care, cognitive, and
academic skills, which are very suitable for DTT (Bogin et al., 2010).
Discrete Trial Training can be used to teach a variety of imitation skills, both physical and verbal. Imitating clap-hand, printing the
letter A, or producing a vowel sound are examples of behaviors that can be taught in discrete trial training. Discrete trial training
can also be used to teach language skills. A child can be trained to respond to verbal instructions such as "stand up," "touch,"
"hold the number five," or "show me the cup." (Maurice et al., 1996). Expressive language skills can be taught using a discrete trial
format to respond to verbal instructions to identify "nose", "blue", or "book". Discrete trials can also be used to teach a variety of
more complex skills, such as dressing or using the phone, by breaking down routines and then merging/chaining the
components/steps. These are just a few examples of a variety of skills/abilities and instructional/educational programs that can be
implemented in discrete trial format.
Lovaas (1981) mentioned several things that need to be considered in shaping behavior by applying discrete trial training,
including:
1. Determine the behavior you want to achieve, then break down the behavior into several parts/components of the response.
Determine the most effective way to teach this behavior. The principle is to start with something simple. Select several
behavioral goals/objectives for the child, called a target behavior or a target response. The behavior is then broken down into
smaller units/parts/components, which are taught separately. When the child masters the unit/part/component, then the
therapist helps the child to put it together into a larger or more complex package. When the child demonstrates the right
response, then the therapist gives a reinforcer (Mosier, 2011).
2. Assist the child in performing the desired behavior by providing prompts or clues, for example, by providing physical assistance
when the child has difficulty carrying out a behavior. Once the child has done the behavior, gradually reduce the aid until the
child can perform the behavior independently. Reduction of prompt should also be accompanied by reinforcer administration
(Johnson, 2014; Mosier, 2011).
3. Provide clear and consistent instructions so that children can clearly understand what to do, provide guidance and pace so that
the child can follow through on the instructions given by providing reinforcers when the child shows his efforts.
4. Use a discrete trial procedure, starting the trial with instructions from the therapist, including prompts given according to the
child's needs by paying attention to the child's response. Give reward or feedback when necessary. Reinforcer administration
will be more effective if given as soon as possible, whether the child successfully shows the correct response, requires fewer
prompts, or completes more difficult tasks than the previous one (Ghezzi, 2007).
2.5 Response in DTT (Discrete Trial Training)
According to the earlier research, when an ASD child is instructed, the child will respond to one of two possibilities, correct or
incorrect response `(Grindle & Remington, 2002; Smith, 2001). If the child responds correctly, reinforcers will be given immediately,
while incorrect responses will be ignored or given feedback in the form of an informational "no" (Grindle & Remington, 2002).
Thus, there are two possible responses in classical/traditional DTT, namely correct and incorrect responses, Where no response is
considered an incorrect response also. But, during the implementation of therapy using DTT in the researchers' clinic, while
observing, mentoring, and supervising autism therapists throughout the application of DTT, researchers noticed that the child's
response was not only 2, namely correct and incorrect. However, the researchers discovered that children's responses were more
varied and could be classified into categories other than correct and incorrect.
3. Methodology
This research uses quantitative methodology with a literature review research design. According to Sugiyono (2017), quantitative
methods are research methodologies based on the positivist ideology that are used to investigate populations or specialized
samples. Methods of literature study refer to a sequence of tasks involving the collection of library data, reading and recording, as
well as the management of research materials (Zed, 2008: 3). The data for this study were obtained through interviews, document
examinations, and a review of the literature (journals and websites). The study focused on the authors' findings that were adapted
to past theories. The study was conducted at the researchers' autism clinic, which was established in 1999. This research focuses
on findings obtained by the author that match with the theory obtained from scientific research.

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4. Results and Discussion
4.1 Discrete Trial Training (DTT) for ASD Children
Autism is a developmental disorder caused by a disorder or failure of nerve function characterized by impaired social interaction,
verbal and nonverbal communication, and the presence of repetitive behavior (American Psychological Association, 2015). Autism
affects a person's ability to express and understand their own and others' feelings and makes it more comfortable to stay in the
same setting all the time. According to the American Psychiatric Association, autism symptoms begin to manifest between the
ages of 1-2 years, and the individual's development begins to slow down. Generally, there is a delay in speech accompanied by a
lack of interest in socializing, difficulty making eye contact, and unusual ways of playing (Stone, 2004; Zimmerman, 2008).
Applied Behavior Analysis is one of the applied sciences that is used to train individuals to master certain abilities using behavior
modification procedures (Baer, 2019; Cooper et al., 2014). Baer (2019) defines Applied Behavior Analysis conceptually as the process
of breaking down behavior into simpler components to make it easier to learn and change according to the standards found in
society. The implementation of this method leads to a behaviorist approach that emphasizes an individual's compliance and the
ability to imitate a behavior (Baer, 2019). Ivar O. Lovaas, an American psychologist, pioneered the ABA approach for autism through
his experiments using B.F. Skinner's Operant Conditioning Theory and I. Pavlov's Respondent Conditioning. Through this method,
unwanted behavior will be eliminated so that the behavior shown by individuals will be more suitable to the standards of behavior
in society (Baer, 2019).
According to Green (2008), the objective of Lovaas's ABA approach is to develop a variety of abilities, minimize and eliminate
undesirable behaviors in individuals with autism, direct and change behavior in more meaningful ways, and teach independency.
In general, this method aims to give a positive reinforcer to the child when showing a response that is corresponded to the direction
given. Discrete Trial Training (DTT) is one of the most effective techniques in the ABA method; DTT is sometimes referred to as
ABA (Lerman et al., 2016). DTT was also developed as a result of research conducted by Lovaas, who invented the ABA method for
autism. Initially, this technique was used at UCLA to train children with disabilities. DTT techniques serve to simplify a complex skill,
making it easier to teach and practice more easily and repeatedly (Lerman et al., 2016).
Conceptually DTT is training that trains skills/abilities repeatedly in response to provided instructions. When the individual has
mastered one simple skill, then the individual will be taught additional skills in order to master the complex skills for which this
training is intended. The DTT technique is considered appropriate for children with autism because each child has unique abilities
and different severity of the disorder. This DTT technique can be adjusted to the basic abilities that have been possessed.
In Classical/Traditional Discrete Trial Training (DTT), the child's response and consequences are divided into 2 categories those are
the correct response and the incorrect response. The correct response is defined as when the autistic child performs as instructed
or follows the therapist's model/example. The correct response needs to be immediately reinforced with positive
reinforcement/rewards in the form of verbal praise and food. Before initiating the DTT procedure, the quantity and type of reward
must be specified/determined (Matson, 2009). One example of a correct response is when the child is given the instruction "touch
head", the child responds by holding the head. Another example is when the therapist gives instruction "do this" by giving an
example of hand movements upwards, then the child does the same.
An incorrect response is when the child gives another response that is not a target response (Applied Behavior Analysis Programs
Guide, n.d.). An example of an incorrect response is when the therapist gives instructions "touch head", then the child's hand is
pointed to the abdomen; this has been assessed as the incorrect response.
4.2 Development of Discrete Trial Training (DTT)
Lovaas, the Psychology Department of UCLA (University of California, Los Angeles), was the first professional to use the principles
of Behavior Modification, which he referred to as DTT (Discrete Trial Training), and later on became known as the ABA Lovaas
method for autism. Behavior modification itself is a further development of two major schools of positivist psychology, namely
Respondent Conditioning and Operant Conditioning.
From Lovaas' research, in the application of DTT in children with ASD (Autism Spectrum Disorder), Lovaas obtained 47% of the
results with full recovery, which in long-term studies, these children are indistinguishable from other children without
developmental disorders. While 42% achieved varied levels of success. And the remaining 11% made very little progress. Although
the success rate of 47% was fairly good and promising at the time, Lovaas did not know what caused the success rate of only 47%,
so further study to enhance the success rate is still highly feasible. Following Lovaas' 1967 publication (which was followed by
subsequent studies by Lovaas and colleagues), the ABA was developed by experts and practitioners. Lovaas' DTT, which he called
precision teaching or simultaneous prompting, has developed into a technique known as no-no-prompt.

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In the DTT applied by Lovaas to children with ASD, when a child with ASD is given instruction, then there will be 2 possible
responses, namely correct (right) and incorrect (wrong), where no response is also considered an incorrect response. But during
observing, mentoring, and supervising autism therapists in applying ABA to children with ASD, researchers discovered there might
be more than 2 possible responses.
Originally, there were only two possible responses (Fig.1) in the DTT used by Lovaas and later developed by ABA experts and
practitioners for autism (Tender J., 1997), namely correct and incorrect. Correct Response means that the child complies with the
instruction. For example, when the instruction is to "touch head," the child touches his head. When the instruction is "do this" with
the therapist's model of lifting both hands upward, the child also raises both hands. What is referred to as an Incorrect Response
is when the child does differently from the instructed. For example, when the instruction is "touch head", but then the child touches
his stomach when the instruction is "do this", along with the model of the therapist raising both hands, then the child performs a
movement that is not hands up, for example doing hand-flapping. While the no response occurs when there is no response from
the child, which is also referred to as the Incorrect Response.
According to the researchers' observations, the child's response to DTT can be divided into five different responses: Correct,
Incorrect, Partial Correct, Offtask, and No Response (Fig.2.). This is crucial to be distinguished because further observation reveals
that different feedback is required for the five possible responses that are the potential for children to master an ability/skill more
quickly. Additionally, the possible causes of the five responses vary, which necessitates further investigation. For example, an
Offtask response may occur as a result of instructions from the therapist with an uncomfortable tone of voice to the child due to
the hypersensitivity of hearing in the child.
Different types of feedback are required for each of these five possible responses, which researchers combine using a no-no-
prompting and simultaneous prompting procedure. Simultaneous prompting and no-no prompting are two frequently used
prompting strategies for children with autism. Simultaneous prompting is a procedure designed to minimize errors. This involves
the use of a controlling prompt (i.e., a prompt that results in the child performing the correct response 100% of the time)
immediately after the instruction. Thus, children do not have the opportunity to do incorrect and are constantly
rewarded/reinforced. The second frequently used prompting procedure is no-no-prompting. No-no-prompting involves giving
instructions followed by an opportunity for the youngster to respond independently. The therapist then gives positive
reinforcement following the correct response and corrective feedback (e.g., "no" or "try again") to incorrect or no responses and
then repeats the trial. After two consecutive "no" feedback, the therapist gives instructions then, followed by a prompt. Therefore,
the third trial of no-no-prompting is identical to simultaneous prompting. So, no-no-prompting may not minimize errors but, on
the contrary, can correct errors after two consecutive errors have occurred. (Leaf J.B. et al., 2010).
According to the researcher's observations, No Response must be distinguished from Incorrect Response since if a time delay of
3-5 seconds is applied; there are five additional possible responses: Correct, Incorrect, Partial Correct, Offtask, and No Response.
Without any doubt, it is a disadvantage if No Response is also considered as an Incorrect Response which is then given
informational feedback "no" because after being given a time delay of 3-5 seconds, then there will be 5 possible responses. As a
result, for the first trial, the researchers developed the Structure / SOP DTT, as illustrated in Fig.3.
Fig.1. Responses On Classical/Traditional DTT
Fig.2. Responses on DTT in Smart ABA

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As seen in Fig. 3, The researcher then developed the No Response; when a time-delay is applied, then there will be 5 possible
responses, namely Correct, Incorrect, Partial Correct, Offtask, and No Response.
In the classical/traditional DTT in the form of No-No-Prompt that when a child is given instruction, then there are 2 possible
responses, namely Correct and Incorrect Response. On Correct Response, the child is then given a Reward / Reinforcer, and then
the next trial is carried out, which is the 2nd package of DTT. While in the incorrect response, given feedback in the form of
informational "no", then the child is prepared again for the next trial in the same cycle (Fig.4.).
Fig.3. Further Development of Response on DTT in Smart ABA
Fig. 4. Response, Feedback, and It's Subsequent on Classical/Traditional DTT

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In contrast to the classical/traditional DTT, in developing of No-No-Prompt in Smart ABA (Fig.5.), only Offtask and Incorrect
Response received Informational “no” feedback, and the next step is to prepare the child again for a second trial in the same cycle.
It is called an Offtask Response when the child is no longer paying attention, which can range from subtle to obvious. For example,
a subtle Offtask occurs when the child looks in the other direction (no longer makes eye contact with the therapist or no longer
looks at teaching material). An example of an obvious Offtask Response is when the child throws a temper tantrum. It is called an
Incorrect Response if the child responds differently than what is instructed. For example, when the instruction is "touch head", but
the child's hand holds the stomach. It is called a Partial Correct Response when the child has made a partial response. For example,
in the "do this" instruction with the therapist model raising both hands, then both of the child's hands have traveled towards the
upward hand but stopped in part of the journey. For this response, the therapist assistant then performs a Partial Prompt which is
different from a Full Prompt which is a hand-on-hand prompt. In Partial Prompt, for example, the therapist assistant simply needs
to push the child's elbows up to produce a Correct Response according to the Target Response. After the therapist's assistant gives
a Partial Prompt to the child's Partial Correct Response, then the therapist gives a Reward/Reinforcer. Afterwards, prepare the child
again for the next trial in the next cycle. If the child immediately performs a Correct Response on the first trial of the first cycle,
then the therapist has 4 options. Those are, move to another program or to another activity which is the DT (Discrimination
Training) activity if the DT program has been carried out, or EO (Establishing Operation) is performed, or just repeat 1-3 times
randomly. The researchers developed and defined EO (Establishing Operation) as a series of activities carried out by the therapist
to establish confidence that the child has begun to master an activity during a series of DTT.
As mentioned previously, when no response occurs, then a time delay of about 3-5 seconds is applied to give an opportunity for
the child to respond. While waiting for 3-5 seconds, there will be 5 more possible child responses, namely Correct, Partial Correct,
Incorrect, Offtask, and No Response. This time the child gets informational "no" feedback whether there is an Incorrect Response,
an Offtask Response, or still No Response. Then the child is prepared again for a second trial in the same cycle. If Partial Correct
Response happens after the partial prompt is delivered, then Reward / Reinforcer is given. Then prepare the child again for the
first trial in the next cycle. And if at this time a correct response occurs, then the same as above, that is, there are 4 options for
therapists, whether to move to another program or to another activity that is a DT (Discrimination Training) activity if it has been
done DT program, or done EO (Establishing Operation), or just Repeat only 1-3 times randomly.
If the informational "no" is given on the first trial, then proceed with the second trial on the same cycle, as can be seen in Fig.6.
Fig. 5. Trial #1. Response, Feedback, and Its Subsequent on DTT in Smart ABA

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In Fig.6., after informational feedback, "no" then continue with the second trial on the same cycle. In the second trial, the
possibilities of the response that occurred and the feedback as well are almost identical to those explained in the first trial, but
with one difference. Instead of four alternatives for therapists as in the previous first trial, there is now only one option for the
therapist, which is EO (Establishing Operation) only. The purpose of EO, as previously explained by researchers, is to gain confidence
that the child has begun to master the skill/ability.
Just like in the first trial, after the child is given instructions, then there are 5 more possible responses, namely Correct, Partial
Correct, Incorrect, Offtask, and No Response. Children receive the identical feedback as in the first trial, with the exception that
when a Correct Response occurs, unlike what has been explained above. If there is a Correct Response this time, whether it occurs
immediately after the Instruction or after 3-5 seconds time delay performed, then the therapist no longer has 4 options; instead,
there is only 1 option, and that is EO (Establishing Operation) must be performed. If the child responds with Partial Correct, then
a Partial Prompt is conducted, and then the child is given Reward / Reinforcer. If the child responds with an Incorrect or Offtask
response, the child is given an Informational "no" and re-prepared to continue with the third trial. If no response occurs, then apply
the time delay for 3-5 seconds, allowing the child to respond. If a Correct Response occurs after 3-5 seconds, a Reward / Reinforcer
is provided, and then EO is performed. When there is a Partial Response, then a Partial Prompt and Reward / Reinforcer are
provided. If there is an Incorrect Response, Offtask Response, or No Response, whether it occurs immediately after the Instruction
or after 3-5 seconds time delay performed, then the child receives an Informational "no" feedback. Afterwards, prepare the child
again for the third trial.
In the third trial, the child is not allowed to respond; instead, after the therapist gives instructions, then the child is immediately
prompted by the therapist's assistant. The child is then prepared again for the first trial but in the subsequent cycle.
Fig.7. and Fig.8. are a complete comparison between classical/traditional DTT before modification (Fig.7.) and DTT on Smart ABA
(Applied Behavior Analysis Rudy Sutadi's Method), that is, DTT after modification.
Fig. 6. Trial #2. Response, Feedback, and Its Subsequent on DTT in Smart ABA

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Fig. 7. SOP of Classical/Traditional DTT

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According to Leaf (2010), researchers also include an Initial Prompt at the beginning of a DTT cycle. The term Initial Prompt in a
Non-Verbal Program is a prompt given/done to a child at the beginning of the DTT Procedure that will be done/performed by the
Therapist (before starting with DTT). But the Initial Prompt that the researchers do is not done routinely, just when indicated only,
which the researchers then develop the indication. Initial Prompt is performed only if the therapist estimates that the child is not
/ has not been able to do/carry out what is instructed by the Therapist, namely in the following things/circumstances:
1. In the beginning of a new program/activity.
2. In activities whose the last score in the previous drilling history (series of cycles), the response is other than Correct or
Partial Correct.
3. In contrast to the second criterion mentioned above, even if the last response to the previous drilling was Correct or
Partial Correct, in the previous 3 consecutive drillings, the result was that the child always responded incorrectly on every
first trial of DTT.
After developing the SOP of DTT in Smart ABA, researchers then implement it in teaching sessions. The results of the execution of
DTT Procedures in Smart ABA are shown in Fig.9., Fig.10., and Fig.11. In each teaching session, a child's success is calculated as a
percentage, i.e. the number of Correct Responses divided by the number of Opportunities, multiplied by 100 percent. Opportunity
is the chance for a child to respond, whether the result is Correct or Partial Correct or Incorrect or Offtask or No Response. So
neither initial prompt nor prompt is included in the calculation because the child is not given the opportunity at that time.
Fig. 8. SOP of DTT in Smart ABA

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𝑆𝑢𝑐𝑐𝑒𝑠𝑠𝑓𝑢𝑙𝑙 𝑅𝑎𝑡𝑒 = 𝐶𝑅
𝑃𝐶𝑅 + 𝐼𝐶𝑅 + 𝑂𝑇𝑅 +𝑁𝑅 𝑋 100%
Then the child is declared to pass/achieve on an activity if in 3 consecutive teaching sessions gets a score greater or equal to 80%.
In the first case in Fig.9., between the first and nineteenth teaching sessions, there were 5 types of responses occurred. Throughout
the early teaching sessions, teaching sessions 1-7, the child tended to show more incorrect or off-task responses, but in the 8th
teaching session, the child began to show partially correct responses. And in the last four teaching sessions, the child showed more
correct responses. In the 16th session, a correct response began to emerge. Then in the 17th session up to the 19th, the successful
rates exceed 80%, and the child is then declared to pass/achieve on the activity after the 19th teaching session.
In the second case in Fig.10, At the beginning of the teaching session, in the first teaching session, the child shows an incorrect
and off-task response, then the child begins to show a more diversified response, including Incorrect, Off-task, Partial Correct, and
0%
20%
40%
60%
80%
100%
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
SESSIONS
DTT RESPONSES - IN SMART ABA - CASE 1
CORRECT PARTIAL CORRECT INCORRECT OFFTASK NO RESPONSE
0%
20%
40%
60%
80%
100%
12345678910 11 12 13 14 15 16
SESSIONS
DTT RESPONSES - IN SMART ABA - CASE 2
CORRECT PARTIAL CORRECT INCORRECT OFFTASK NO RESPONSE
Fig. 9. Responses on DTT in Smart ABA – Case 1
CR = Correct Response; PCR = Partial Correct Response; ICR = Incorrect Response;
OTR = Offtask Response; NR = No Response
Fig. 10. Responses on DTT in Smart ABA – Case 2

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No Response. From the 10th teaching session to the end, the dominant child response is Correct Response, but the pass criteria
are achieved in the 14th to 16th teaching session.
In the 3rd case in Fig.11. the child has demonstrated a lot of Correct Responses since the beginning of teaching sessions. Even in
the first teaching session, the child gets a score of 100%, but in the subsequent teaching session, there is a slightly varied response
so that the score fluctuates, which is generally below the 80% limit. Only in the 17th to 19th teaching session does the child reach
the pass/achieve criteria of 3 consecutive teaching sessions greater than 80%.
5. Conclusion
From the above explanation, it can be concluded that Discrete Trial Training (DTT) procedure can help autistic children in
developing their abilities. According to Lovaas' study on ASD children, who used Discrete Trial Training (DTT), if ASD children were
given instructions by a therapist, the child's possible responses were Correct and Incorrect only. But in the implementation of
therapy, researchers discovered that there were not only two possible child responses but there were five possible child responses.
The five responses are Correct, Incorrect, Partial Correct, Off task, and No Response, where each response requires different
feedback and its sequence, as well as different possible causative factors and follow-up interventions.
According to the data collected in this study, the most frequent response is the incorrect category, followed by the Correct response
and Off-task response categories. While Partial Correct and No Response are the least appeared categories. The more trials are
conducted, then the more Correct response displayed by the children will emerge often. This is one of the pieces of evidence that
DTT that has been modified in Smart ABA can help children with autism develop desirable behaviors.
6. Limitation and Further Research
This research is limited to a few subjects. Further research needs to be done with other methods, such as experimentation or
Research and Development (R&D), with larger and multi-center samples so that it will further increase the effectiveness and
efficiency of DTT applications in autism therapy.
This study is limited to a small number of subjects. Further research is needed to be done using various approaches such as
experimentation or Research and Development (R&D) study, using large samples and a multi-center approach to increase the
effectiveness and efficiency of newly/modified DTT procedure on Smart ABA in autism therapy.
Funding: This research received no external funding
Acknowledgements: The researchers would like to thank their institution for funding their research and preparing them to be
competent researchers. Furthermore, this paper would not be feasible without the unwavering assistance, support, and work of
their articles, which accompanied them in successfully completing the research. They also wish to thank their family and friends
for their unwavering support. Last but not least, they wish to express their heartfelt thanks to the Almighty for providing them
with sufficient grace, strength, and wisdom during the research.
Conflicts of Interest: The authors declare no conflict of interest.
0%
20%
40%
60%
80%
100%
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
SESSIONS
DTT RESPONSES - IN SMART ABA - CASE 3
CORRECT PARTIAL CORRECT INCORRECT OFFTASK NO RESPONSE
Fig.11. Responses on DTT in Smart ABA – Case 3

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References
[1] American Psychiatric Association. (2013). Diagnostic And Statistical Manual of Mental Disorders. In American Psychiatric Publishing (5th
ed.). American Psychiatric Publishing. https://doi.org/10.4324/9780203772287-23
[2] American Psychological Association, A. (2015). Dictionary A–Z. In G. R. VandenBos (Ed.), Dictionary of the old low and central Franconian
psalms and glosses (Second). American Psychological Association. https://doi.org/10.1515/9783111704227.1
[3] Applied Behavior Analysis Programs Guide. (n.d.). Retrieved January 10, 2022, from https://www.appliedbehavioranalysisprograms.com/
[4] Baer, D.M. (2019). Applied Behaviour Analysis. In Companion Encyclopedia of Psychology.
[5] Bogin, J., Sullivan, L., Rogers, S., &A., S. (2010). Steps for implementation: Discrete trial training. Sacramento. The National Professional
Development Center on Autism Spectrum Disorders.
[6] Cagliani, R. R., Ayres, K.M., Ringdahl, J. E., & Whiteside, E. (2019). The effect of delay to reinforcement and response effort on response
variability for individuals with autism spectrum disorder. Journal of Developmental and Physical Disabilities, 31(1), 55–71.
[7] Cardinal, J. R., Gabrielsen, T. P., Young, E. L., Hansen, B. D., Kellems, R., H., & Knorr, J. (2017). Discrete trial teaching interventions for
students with autism: Web-based video modeling for paraprofessionals. Journal of Special Education Technology.
[8] Cooper, H, & Heward. (2014). Applied Behaviour Analysis. In Student Behaviour (Second). Pearson Education Limited.
https://doi.org/10.4324/9781003117520-4
[9] Dadgar, H., Rad, J. A., Soleymani, Z., Khorammi, A., McCleery, J., & Maroufizadeh, S. (2017). The relationship between motor, imitation, and
early social communication skills in children with autism. Iranian Journal of Psychiatry, 12(4), 236.
[10] Downs, A., Downs, R.C., & Rau, K. (2008). Effects of training and feedback on Discrete Trial Teaching skills and student performance.
Research in Developmental Disabilities, 29, 235–246. https://doi.org/10.1016/j.ridd.2007.05.001
[11] Eapen, V. (2012). Autism - A Neurodevelopmental Journey from Genes to Behaviour. In Autism - A Neurodevelopmental Journey from Genes
to Behaviour. https://doi.org/10.5772/974
[12] Fombonne, E. (2018). The rising prevalence of autism.
[13] Ghezzi, P.M. (2007). Discrete trials teaching. Psychology in the Schools, 44(7), 667–679.
[14] Green, G. (2008). Autism and ABA. Gramedia.
[15] Grindle, C. F., & Remington, B. (2002). DISCRETE-TRIAL TRAINING FOR AUTISTIC CHILDREN WHEN REWARD IS DELAYED: A COMPARISON
OF CONDITIONED CUE VALUE AND RESPONSE MARKING. JOURNAL OF APPLIED BEHAVIOR ANALYSIS, 35(2), 187–190.
https://doi.org/10.1901/jaba.2002.35-187
[16] Haymes, L. K., Storey, K., Maldonado, A., Post, M., & Montgomery, J. (2015). Using applied behavior analysis and smart technology for
meeting the health needs of individuals with intellectual disabilities. Developmental Neurorehabilitation, 18(6), 407–419.
https://doi.org/10.3109/17518423.2013.850750
[17] Johnson, K. R. (2014). An experimental analysis of proctor prompting behavior in a personalized instruction course. February.
[18] Kamps, D.M., Mason, R., & Heitzman-Powell, L. (2017). Peer mediation interventions to improve social and communication skills for
children and youth with autism spectrum disorders. In Handbook of social skills and autism spectrum disorder (pp. 257–283). Springer,
Cham.
[19] Kodak, T., & Bergmann, S. (2020). Autism spectrum disorder: Characteristics, associated behaviors, and early intervention.
[20] Leaf, J.B., Sheldon, J.B. Sherman, J.A. (2010). Comparison Of Simultaneous Prompting And No-No Prompting In Two-Choice Discrimination
Learning With Children With Autism. Journal Applied Behavior Analysis. 2010 Summer; 43(2): 215–228. DOI: 10.1901/jaba.2010.43-215
[21] Lerman, D.C., Valentino, A. L., & LeBlanc, L. A. (2016). Discrete Trial Training. 47–83. https://doi.org/10.1007/978-3-319-30925-5_3
[22] Lovas, I. O. (1981). Teaching Developmentally Disabled Children. Pro-ed.
[23] Matson, J. L. (2009). Applied Behavior Analysis for Children with Autism Spectrum Disorders. Springer.
[24] Maurice, C. E., Green, G. E., & Luce, S.C. (1996). Behavioral intervention for young children with autism: A manual for parents and
professionals. Pro-ed.
[25] Morales-Hidalgo, P., Roigé-Castellví, J., Hernández-Martínez, C., Voltas, N., & Canals, J. (2018). Prevalence and Characteristics of Autism
Spectrum Disorder Among Spanish School-Age Children. Journal of Autism and Developmental Disorders, 48(9), 3176–3190.
https://doi.org/10.1007/S10803-018-3581-2
[26] Mosier, A. K. (2011). Applied Behavior Analysis Techniques: Discrete Trial Training & Natural Environment Training.
http://opensiuc.lib.siu.edu/gs_rp/226
[27] National Autism Center. (2015). Evidence-based practice and autism in the schools: An educator's guide to providing appropriate
interventions to students with an autism spectrum disorder.
[28] Rowland, D. (2020). The Neurophysiological Cause of Autism. Journal of Neurology & Neurophysiology, 11(5), 1–4.
https://www.iomcworld.org/open-access/the-neurophysiological-cause-of-autism-56090.html
[29] Savitri, A. I., Salam, N. E., Yasir. (2020). Therapeutic Communication Between Therapists And Autistic Patients Using Smart Aba Technique At
The Brilliant Autistic Children's Therapy Center Pekanbaru. Journal of Communication Sciences, 9(4), 479–492.
[30] Smith, T. (2001). Discrete Trial Training in the Treatment of Autism. Focus on Autism and Other Developmental Disabilities, 16(2), 86–92.
[31] Stone, F. (2004). Autism – The Eighth Colour Of The R Ainbow. Jessica Kingsley.
[32] Sugiyono. (2017). Qualitative Quantitative Research Methods &RND. Alphabet.
[33] Sun, X., Allison, C., Wei, L., Matthews, F. E., Auyeung, B., Wu, Y. Y., Griffiths, S., Zhang, J., Baron-Cohen, S., & Brayne, C. (2019). Autism
prevalence in China is comparable to Western prevalence. Molecular Autism, 10(1). https://doi.org/10.1186/S13229-018-0246-0
[34] Tender, J. (1997). Understanding behaviour basics of applied behaviour analysis, Manual.Intervention Services for Autism and
Developmental Delay. ISADD, Perth.
[35] Zimmerman, A. W. (2008). Autism Current Theories and Evidence. Springer.