ASSESSING THE WITHIN-TRIAL TREATMENT
INTEGRITY OF DISCRETE-TRIAL TEACHING
PROGRAMS USING SEQUENTIAL ANALYSIS
Denys Brand*, Oliver C. Mudford, Angela Arnold-Saritepe and Douglas Elliffe
University of Auckland, Auckland, New Zealand
Discrete-trial teaching is a strategy frequently used to teach functional skills to individuals with de-
velopmental and intellectual disabilities. Research has shown that the within-trial components of the
procedure should be administered with ≥90% treatment integrity to facilitate optimal learning. Usually
within-trial treatment integrity is measured using whole-session methods such as percentage of trials
correctly administered. This study demonstrated one-step Markov transition matrices as a method of
assessing within-trial treatment integrity. All components of discrete trials were coded and time-
stamped from video recordings of therapist–learner dyads in their typical setting (home or school). Sev-
eral types of within-trial treatment integrity errors were identified using the Markov transition matrices,
error sequences that could not be identified using a percentage correct analysis. Better identification of
errors has the potential both to enhance treatment integrity and to gain efficiency by targeted retraining
of therapists. Copyright © 2016 John Wiley & Sons, Ltd.
Discrete trial teaching (DTT) is a strategy frequently used to teach functional skills
to individuals with developmental and intellectual disabilities. DTT is a critical com-
ponent of early intensive behavioral intervention programs. Most skills taught during
the initial stages of early intensive behavioral intervention use a DTT format. DTT
consists of five distinct within-trial components (Koegel, Russo, & Rincover,
1977). These components are the discriminative stimulus (S
D
), a prompt if necessary,
a response (correct, incorrect, or no response), a consequence determined by the type
of learner response, and an intertrial interval (ITI). Discrete teaching trials have a
distinct beginning and end. The presentation of the S
D
constitutes the beginning of
the trial and the start of the ITI the end. In the early stages of teaching, DTT takes
place in a structured and controlled environment consisting of one-to-one teaching
sessions between therapists and learners. DTT involves breaking down particular
skills into smaller parts and teaching each one of these smaller skills individually.
*Correspondence to: Denys Brand, 4001 Dole Human Development Center, 1000 Sunnyside Avenue, Department of
Applied Behavioral Science, University of Kansas, Lawrence, KS 66045, USA. E-mail: denys.brand@ku.edu
Copyright © 2016 John Wiley & Sons, Ltd.
Behavioral Interventions
Behav. Intervent. 32: 54–69 (2017)
Published online 15 July 2016 in Wiley Online Library
(wileyonlinelibrary.com) DOI: 10.1002/bin.1455