Trenna Sutcliffe, M.D.

Discrete trial, which is still used today and still can be very helpful when it's combined with more naturalistic forms of ABA. Discrete trial would be about teaching a child to make eye contact and they get a reinforcer every time. So make eye contact, get a reinforcer, positive reinforcer. So it's positive reinforcers. It is a lot of repetition, practicing, teaching a child a new skill.

Discrete trial, which is still used today and still can be very helpful when it's combined with more naturalistic forms of ABA. Discrete trial would be about teaching a child to make eye contact and they get a reinforcer every time. So make eye contact, get a reinforcer, positive reinforcer. So it's positive reinforcers. It is a lot of repetition, practicing, teaching a child a new skill.

And then you would add the other layers to it, the eye contact and then the greeting and the vocalization, turn your body. You would add all that together to come up with this larger thing of how do you approach someone? So discrete trial has been around for decades. That's the part that's controversial because people say, oh, this is very repetitive and it's not based on relationships.

And then you would add the other layers to it, the eye contact and then the greeting and the vocalization, turn your body. You would add all that together to come up with this larger thing of how do you approach someone? So discrete trial has been around for decades. That's the part that's controversial because people say, oh, this is very repetitive and it's not based on relationships.

So over the years, there have been more naturalistic ABA methods created. Naturalistic in that it occurs more in a child's natural environment. It is not just at a structured table where you and I are practicing eye contact. Natural environment, also trying to understand the child's natural motivators. So for example, it might happen at a park.

So over the years, there have been more naturalistic ABA methods created. Naturalistic in that it occurs more in a child's natural environment. It is not just at a structured table where you and I are practicing eye contact. Natural environment, also trying to understand the child's natural motivators. So for example, it might happen at a park.

And it might happen, we know that child loves to be on the swing. So rather than sitting at a table and me saying like, make eye contact, here's your reinforcer, make eye contact, here's your reinforcer. Now we're in a park, this child wants to be pushed on the swing. Well, we're going to help this child learn that if you want me to push you on the swing, you got to push.

And it might happen, we know that child loves to be on the swing. So rather than sitting at a table and me saying like, make eye contact, here's your reinforcer, make eye contact, here's your reinforcer. Now we're in a park, this child wants to be pushed on the swing. Well, we're going to help this child learn that if you want me to push you on the swing, you got to push.

look at me and somehow acknowledge me so I go push you. Otherwise, I don't know that you want to be pushed on the swing. And so those are more naturalistic forms. One of the most naturalistic forms is something called pivotal response treatment, PRT, which is actually training the parents in these skills, because that's really what it's about.

look at me and somehow acknowledge me so I go push you. Otherwise, I don't know that you want to be pushed on the swing. And so those are more naturalistic forms. One of the most naturalistic forms is something called pivotal response treatment, PRT, which is actually training the parents in these skills, because that's really what it's about.

It's not about whether this child can make eye contact with therapist A at the table. It's about how does this child understand how to use eye contact, when it's appropriate to use it, and the power of it in natural settings. And so when you train the parents how to do it, then they can practice at the park. At the coffee shop, on the playground, the parents.

It's not about whether this child can make eye contact with therapist A at the table. It's about how does this child understand how to use eye contact, when it's appropriate to use it, and the power of it in natural settings. And so when you train the parents how to do it, then they can practice at the park. At the coffee shop, on the playground, the parents.

So that is the most naturalistic form, teaching the parents. This comes back to parents, how powerful it is if you teach parents. But parents work with the child in a natural setting with natural motivators.

So that is the most naturalistic form, teaching the parents. This comes back to parents, how powerful it is if you teach parents. But parents work with the child in a natural setting with natural motivators.

Yes. When you said that, I'm thinking like, it's just a single parent. It's time and resources and driving to therapies. Again, it depends on how significantly impaired your child is and how many therapies they need.

Yes. When you said that, I'm thinking like, it's just a single parent. It's time and resources and driving to therapies. Again, it depends on how significantly impaired your child is and how many therapies they need.

They can be. It depends on the state. So how it's covered is different in different states. I'm from California. So in California, ABA is covered if you have a diagnosis of autism. That's where the diagnostic piece is important. So then it is covered.

They can be. It depends on the state. So how it's covered is different in different states. I'm from California. So in California, ABA is covered if you have a diagnosis of autism. That's where the diagnostic piece is important. So then it is covered.

Yeah, there's actually so many things you can say about that. So I'll first start by saying that siblings of children with autism are themselves at risk for either autism or autism-like traits or something called the broader autism phenotype. They may actually not have autism, but they may have a few traits of it. And or at risk for other developmental disabilities.

Yeah, there's actually so many things you can say about that. So I'll first start by saying that siblings of children with autism are themselves at risk for either autism or autism-like traits or something called the broader autism phenotype. They may actually not have autism, but they may have a few traits of it. And or at risk for other developmental disabilities.