Do Student Characteristics Affect Teachers’ Decisions to Use 1:1 Instruction?

Abstract

One-to-one instruction is a critical component of evidence-based instruction for students with autism spectrum disorder, but is not used as often as recommended. Student characteristics may affect teachers' decisions to select a treatment and/or implement it. This study examined the associations between students' clinical and demographic characteristics and teachers' reported use of discrete trial training (DTT) and pivotal response training (PRT). Children's higher sensory symptoms, lower social approach, lower verbal skills and higher self-regulation difficulties were associated with more frequent 1:1 DTT and PRT. Results suggest that teachers give more frequent 1:1 instruction to children with more observable impairments, do not match children to type of 1:1 intervention, and may inadvertently neglect other students for whom individualized intervention may still be beneficial. Keywords 1:1 instruction; child characteristics; personalized medicine; teacher decisions Evidence-based treatments for children with autism spectrum disorder (ASD) include behavioral interventions that teach communication, cognitive, social and adaptive skills. There has been a steady rise in the number of children receiving ASD intervention services through schools (U.S. Department of Education, 2017), but the type and intensity of treatment vary greatly (White, Scahill, Klin, Koenig, & Volkmar, 2007). There is little research on factors that predict the type and intensity of school-based treatment children with ASD receive. Such factors may include different school resources, such as staffing, or

Student Characteristics and Teachers’ Decisions to Use 1:1 Instruction

“…In Nuske et al (2019), age was not associated with implementation of 1:1 instruction. These findings suggest that teachers are not considering students' age when implementing either PRT or DTT.…”

“…Findings from Nuske et al (2019) also suggested that teachers did not differentially use DTT or PRT based on child characteristics, despite the theoretical notion that different profiles of children may be better suited to one over the other (Vivanti 2017). Evidence suggests that matching children with ASD to certain treatment styles based on their pretreatment behavioral profile may support positive outcomes (Schreibman et al 2009;Sherer and Schreibman 2005).…”

“…However, due to the qualitative design of the study, the study was unable to empirically test whether frequency of treatment delivery and teacher selection of treatment approach relate to their students' characteristics. The second study by Nuske et al (2019) explored this question by quantitatively examining the associations between child characteristics and teacher selection and frequency of use of PRT and/or DTT with children with ASD in their classrooms. Based on the study by Stahmer et al (2005), researchers hypothesized that teachers would be more likely to use DTT with children who had more severe ASD symptoms, lower cognitive skills, and higher regulatory difficulties.…”

“…Results from Nuske et al (2019) showed that teachers reportedly provided more 1:1 instruction in general to children who have more sensory and self-regulation difficulties, lower verbal skills, and less social approach. Findings suggest that teachers give more treatment to children with more obvious impairments.…”

“…Second, in Nuske et al (2019) while ASD symptoms were measured via teacher report, cognitive and language abilities and self-regulation difficulties were measured by study staff. Therefore the latter may not have necessarily mapped onto teacher's own perspectives of children's cognitive and language abilities and self-regulation difficulties and decisions regarding the frequency with which teachers should use 1:1 across different children in their classroom.…”