A Comparison of Telehealth-Based Instruction with or without Instructive Feedback
Telehealth DTI teaches speaker skills well, and a short instructive feedback line can give half of kids extra gains without longer sessions.
01Research in Context
What this study did
Campbell and team ran two kinds of telehealth lessons for four children with autism. One kind was plain discrete-trial instruction. The other added extra comments called instructive feedback.
They used an alternating-treatments design. Each child got both lesson types in mixed order. Sessions stayed the same length so they could see if the extra comments helped without adding time.
What they found
All four kids learned the main speaker targets in both lesson types. The plain lessons worked fine.
Two of the four kids also picked up the secondary targets when instructive feedback was added. No child needed longer sessions.
How this fits with other research
Ferguson et al. (2020) showed the same thing in dyads. Six kids learned primary and secondary targets over Zoom. Their results line up with Campbell’s, but Campbell tested one child at a time.
Nottingham et al. (2017) first proved that extra targets boost efficiency in person. Campbell extends that idea to telehealth.
Yanchik et al. (2024) looks like a clash. They say NET plus DTT beats DTT alone for adaptive skills. Campbell says DTT plus feedback beats plain DTT for speaker skills. The difference is the outcome measured—adaptive versus speaker—so the papers do not truly disagree.
Why it matters
You can teach speaker skills over Zoom without losing power. If you slip in quick instructive feedback, about half of kids will pick up bonus targets for free. Try it next session: after the child labels “apple,” add, “Apples grow on trees,” then move on. No extra trials needed.
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02At a glance
03Original abstract
Language delays are commonly displayed by children on the autism spectrum. To help facilitate the development of verbal behavior, practitioners often implement intensive one-on-one, face-to-face instruction. However, the COVID-19 pandemic hindered typical face-to-face service delivery and caused practitioners to assess alternative approaches to facilitate clients’ continued progress. Instructive feedback (IF) is one teaching strategy to enhance instruction or make it more efficient. During this teaching procedure, instructors provide formal teaching of target responses and embed demonstrations of secondary target responses within sequences of instruction. In the current study, we investigated the efficacy of IF provided within telehealth instruction. Four participants on the autism spectrum participated in the study. Participants received two forms of telehealth instruction that targeted speaker-responding. The first form consisted of discrete trial instruction (DTI), and the second form combined DTI with IF. These results indicate that both forms of instruction improved speaker-responding of primary targets for all participants. Additionally, a secondary analysis of secondary targets indicated that two of the four participants acquired some secondary targets. These results suggest that including IF within DTI might be beneficial for some participants receiving DTI via telehealth.
The Analysis of Verbal Behavior, 2024 · doi:10.1007/s40616-023-00185-0