An external review of the conclusions regarding the peak direct training module

Promoting the Emergence of Advanced Knowledge—Direct Training Module (PEAK‐DTM) is a commercially available assessment and curriculum for individuals whose language skills are not developmentally adequate. In their review of PEAK‐DTM, Reed and Luiselli (2016) analyzed the extant literature on PEAK‐DTM and concluded that it has a sound and growing body of empirical support on its efficacy, usability, and psychometric properties. Similar conclusions are mirrored in the PEAK‐DTM literature and promotional material. I review these conclusions and contend that many overrate the research that backs them. Suggestions for a more rigorous research agenda on PEAK‐DTM and its related modules are provided.     

Student outcomes after 1 year of front line staff implementation of the PEAK curriculum

Systems‐level interventions built by behavior analysts often rely on others to implement, and this may be especially true in public education settings where behavior analysts are scarce. This study evaluated the effectiveness of the Promoting the Emergence of Advanced Knowledge Direct Training (PEAK‐DT) curriculum when implemented by school teachers and direct care staff. Thirty‐nine children with autism took part in the study (19 PEAK, 15 control), where the experimental group received applied behavior analytic instruction through the PEAK‐DT curriculum, and the quasi‐randomized control group received training as usual. The PEAK‐DT assessment was first administered to the participants at the onset of the study and again following 1 year. Participants who received PEAK training gained more skills on the PEAK‐DT assessment compared to the control group (PEAK: M = 16.0, SD = 17.8; control: M = 6.1, SD = 14.4, F(1,33) = 10.66, p < .05), suggesting that systems level implementation of behavior analytic procedures can be effective in teaching language skills as prescribed in a packaged curriculum designed by behavior analysts.     

Assessing long‐term maintenance of staff performance following behavior skills training in a home‐based setting

We used a multiple baseline across participant design to evaluate the effects of behavior skills training on teaching three behavior therapists to implement discrete trial teaching (DTT) and evaluate the long‐term maintenance of skills acquired through behavioral skills training. For participants whose skills did not maintain, the authors evaluated an independent self‐evaluation procedure on their performance. Following DTT implementation training, maintenance probes were assessed at 2‐, 4‐, 6‐, and 8‐week follow‐ups. The results demonstrated that one participant maintained 100% procedural integrity (PI) through all follow‐ups, one participant decreased below mastery criterion at the 2‐week follow‐up, and one participant dropped below mastery criterion at the 4‐week follow‐up. Those participants that demonstrated decreased accuracy of implementation of DTT programs and were taught to implement a self‐evaluation procedure. Following self‐evaluation, PI maintained for up to 7 weeks for one participant. Our results suggest that if PI does not maintain, self‐evaluation may be a supplementary intervention to increase and maintain PI of new employees.     

Equivalence‐based instruction of academic skills: Application to adolescents with autism

This study evaluated the efficacy of three equivalence‐based instruction procedures on the acquisition of novel academic skills by 3 adolescents diagnosed with autism in a school setting. The skills targeted for instruction were related to topics in history, science, and mathematics, and were taught using different training structures from the PEAK‐E curriculum. All participants demonstrated mastery of the trained relations and the tested derived relations following all variants of equivalence‐based instruction.     

Improving the interview skills of college students using behavioral skills training

Obtaining a job as a college graduate is partly dependent on interview performance. We used a multiple baseline design across skills to evaluate the effects of behavioral skills training with self‐evaluation for five college students. Training effects were evaluated using simulated interviews as baseline and posttraining assessments. All participants acquired targeted skills, but we observed some individual differences. Participants were satisfied with training outcomes and rated the procedures as acceptable. Furthermore, ratings from university staff who provide interview training indicated that training improved performance across several skills for the majority of participants.     

Telehealth and in‐person training outcomes for novice discrete trial training therapists

The efficacy and efficiency of telehealth and in‐person training were compared while teaching seven undergraduate students to implement components of discrete trial training. A multiple‐baseline design across skills with elements of multiple probe and delayed multiple baseline combined with an alternating‐treatments design was used to evaluate the effects of behavioral skills training (BST) on (a) implementing a multiple stimulus without replacement preference assessment, (b) setting up an instructional context, (c) delivering antecedent prompts, and (d) delivering consequences for accurate and inaccurate responding. Two skills were trained via telehealth and two skills were trained in‐person using BST procedures with a mock student. All participants provided high acceptability ratings for both training procedures. Results also showed that telehealth training was as efficacious and efficient as in‐person training for all skills across all participants. Five of six participants showed high levels of maintenance of the newly acquired skills; these five also exhibited the skills during a novel instructional task.     

Teaching complex verbal operants to children with autism and establishing generalization using the peak curriculum

The present study evaluated the feasibility of the PEAK Relational Training System's Generalization Module (Dixon, 2014b) to teach and establish generalization of autoclitic mands, distorted tacts, and creative path finding in three children diagnosed with autism spectrum disorder. Using a multiple‐baseline design across behaviors, each participant was provided with differential reinforcement and a least‐to‐most prompting hierarchy for correct responses to a subset of stimuli, and responses to other similar stimulus sets were probed for emergent generalization. Following training, each participant successfully acquired the directly trained behaviors and demonstrated generalization to the nonreinforced test exemplars. These data support the utility of Skinner's (1957) analysis to teach complex forms of verbal operants, and suggest that a manualized curriculum such as PEAK may have utility for promoting skill development and generalization for front line staff and caregivers of children with autism.     

Training behavioral technicians to implement naturalistic behavioral interventions using behavioral skills training

Training behavioral technicians mainly focuses on teaching accurate implementation of structured behavioral intervention programs. Often behavioral technicians are unable to adequately promote their clients' learning in less structured environments, which can limit opportunities for generalization of the clients' skills to the natural environment. The aim of the present study was to evaluate the effectiveness of using behavioral skills training to coach behavioral technicians on the implementation of naturalistic behavioral interventions. Naturalistic behavioral interventions take advantage of naturally occurring situations to teach new skills and practice mastered skills in natural settings, thus promoting generalization across environments and in the presence of natural contingencies. Five behavioral technicians were trained to implement a novel protocol based on play therapy. Specifically, they were coached to engage in well‐defined positive behaviors during their interactions with clients (e.g., labeled praise). All participants reached mastery criteria, maintained skills at follow‐up, and demonstrated generalization of skills with novel clients.     

Teaching foundational perspective‐taking skills to children with autism using the PEAK‐T curriculum: single‐reversal “I–You” deictic frames

We taught basic perspective‐taking tasks to 3 children with autism and evaluated their ability to derive mutually entailed single‐reversal deictic relations of those newly established perspective‐taking skills. Furthermore, we examined the possibility of transfers of perspective‐taking function to novel untrained stimuli. The methods were taken from the PEAK‐T training curriculum, and results yielded positive gains for all 3 children to learn basic perspective taking as well as for 2 of the 3 to derive untrained single‐reversal I relations following direct training of single‐reversal You relations. All participants demonstrated a transfer of stimulus function to untrained stimuli after the single‐reversal deictic relations had been mastered.     

INCREASING INDEPENDENCE AMONG CHILDREN DIAGNOSED WITH AUTISM USING A BRIEF EMBEDDED TEACHING STRATEGY

The purpose of this study was to evaluate the effects of a brief embedded teaching procedure, involving least‐to‐most prompting for two paraprofessional staff in order to increase independent responses of two children diagnosed with autism in an inclusive setting. Training was given using a behavioral skills training approach, involving instructions, modeling, rehearsal, and feedback. A multiple‐baseline design across behaviors was used to evaluate the effects of the embedded teaching procedure. Maintenance of training effects was evaluated two weeks, following the end of the study. After training of the brief embedded prompting procedure and during following up probes, both students showed increased independence in each skill that staff were trained to teach. Copyright © 2012 John Wiley & Sons, Ltd.     

PEAK关系训练系统：孤独症语言障碍康复的新方法

PEAK (Promoting the Emergence of Advanced Knowledge, 促进高阶知识涌现)关系训练系统是全球首个同时整合了斯金纳的《言语行为》和后斯金纳主义的“关系框架理论”, 促进孤独症谱系障碍(Autism spectrum disorders, ASD)患者的语言、学习、社交等核心技能发展的语言行为评估训练系统。截至2018年底, PEAK关系训练系统由以下4个模块组成：直接训练模块、泛化模块、等价关系模块、功能转化模块。每一模块依据难易程度分别设置了184个目标能力的评估方法及训练课程。已发表的多项实证研究表明, PEAK关系训练系统打破了《语言行为里程碑评估及安置程序》(Verbal Behavior Milestones and Placement Program, VB-MAPP) 对ASD患者进行里程碑评估时出现的“天花板效应”, 有望比VB-MAPP提供更全面、高阶的语言行为评估体系。此外, PEAK关系训练系统表现出的评估工具的信效度良好、多项效果研究显著、实践中易操作等特性, 使其不仅适用于专业人员教学, 未来在ASD患者家庭干预模式中也有潜在的应用价值。     

Promoting the emergence of advanced knowledge: A review of peak relational training system: Direct training module by Mark R. Dixon

Mark Dixon's (2014) manual, PEAK Relational Training System: Direct Training Module, proposes a novel approach to manualized evaluation and curriculum development. Dixon's PEAK system, introduced in the book as the first of four modules, translates derived relational responding methodology into a new verbal‐behavior approach. The PEAK system is firmly rooted in the basic, conceptual, and applied behavior‐analytic tradition; however, it differs substantially from the competition in its unique application of relational frame theory to produce efficient learning. The manual's accessible nature renders it a viable product for many users and readers. The growing empirical support for PEAK’s efficacy, usability, and psychometrics is impressive and provides a robust empirical basis for the system that is not described within the pages of the manual. Behavior analysts may shy away from a manualized system that explicitly omits discussion of scholarship and empirical bases but would be remiss in doing so, given the potential of PEAK to revolutionize the way clinicians and parents apply the verbal behavior approach.     

A component analysis of job interview training for young adults with autism spectrum disorder

The job interview is a vital component to acquire employment. Individuals with autism spectrum disorder may experience difficulties with job interviews due to notable deficits in social and communication skills. We evaluated the relative impact of several components of a job interview training package on six participants' responses to commonly asked interview questions. We used a multiple baseline design across participants to present the following components: written instructions, rehearsal and video self‐feedback with a commercially available training program, and verbal feedback delivered by the experimenter. Results demonstrated that all participants required an additional behavioral skills training session to meet our mastery criterion. However, once training was complete, all participants showed generalized performance when the interview questions were presented in a varied format and by a novel interviewer outside of the training environment. In addition, their performance was maintained at follow‐up.     

Evaluation of a Sexual Abuse Prevention Program for Children with Intellectual Disabilities

The present study evaluated the effectiveness of a sexual abuse prevention program for children with intellectual disabilities. Three children with mild to moderate intellectual disabilities participated in the study. They were taught skills relative to identifying body parts and discrimination between appropriate and inappropriate situations, refusal skills (verbal refusing and leaving situations), and reporting skills through this program. A multiple probe across participants design was used to determine the effects of the program. Results demonstrated that the program was effective for teaching the skills to all three children with intellectual disabilities. In addition, these skills generalized in probes conducted in real‐life settings and maintained at 10‐week follow‐up probes. Copyright © 2015 John Wiley & Sons, Ltd.     

Establishing derived categorical responding in children with disabilities using the PEAK‐E curriculum

The purpose of the study was to evaluate a procedure to generate derived categorical responding by three children with disabilities and to promote the emergence of untrained intraverbal categorical responses. In the study, three 4‐member equivalence classes including three stimuli (A, B, and C) and a category name (D) for each class were trained using a match‐to‐sample procedure. Test probes were conducted for categorical responding, including both a trained (D‐A) and two derived (D‐B, D‐C) relational responses, as well as the emergence of untrained intraverbal categorical responding (D‐A/B/C) throughout the study. Relational training was effective at promoting the emergence of categorical responding, and two of the three participants demonstrated the emergence of additional intraverbal responding without prior training. The results provide further evidence supporting the practical utility of stimulus equivalence as well as the PEAK‐E curriculum.     

Using International Videoconferencing to Provide Staff Training on Functional Behavioral Assessment

Videoconferencing has been successfully implemented to teach functional analysis (FA) procedures to service providers who support individuals with autism spectrum disorders. The purpose of the current study was to evaluate the acquisition of the competencies for implementing FA methodology for special education teachers after participation in a group‐format workshop via a videoconferencing program in which the training site and the remote site were located on different continents, connected through the internet. Four special education teachers in Saudi Arabia who did not have previous exposure to functional behavior assessment participated in the study. Teachers received 3 h of group‐format training via Skype followed by individualized feedback. Training involved role‐playing, video modeling, and reading materials. Results indicate that all four participants mastered the skills across at least two of the conditions with one participant demonstrating mastery across all four conditions. Copyright © 2015 John Wiley & Sons, Ltd.     

Teaching a Problem Solving Strategy to Inpatient Adolescents:

This study evaluated a recently developed program for teaching problem solving skills. Six inpatient adolescents received training in four general areas: Authority Figures; Peer Issues; Community Resources; and Alcohol and Drugs. The program featured response-specific feedback, modeling, self-monitoring, visual cues, positive reinforcement, response practice, self-correction, and individualized performance criterion levels. A multiple baseline across groups design was used in which each group (N + 3) received baseline, training, probes, and pre/post training generalization assessments. Generalization was assessed to two different sets of untrained problem situations that contained similar and dissimilar situations to those used in training. One set was assessed during probes and the other in pre/post evaluations. Both the probes and post assessment results revealed that the subjects' verbal problem solving skills had generalized to both types of situations. Furthermore, the subjects' three-month post assessment scores demonstrated partial maintenance and were comparable to those of a group of normal high school students. Issues related to these results and suggestions for future research are discussed.     

Mental rotation: cross-task training and generalization

It is well established that performance on standard mental rotation tasks improves with training (Peters et al., 1995), but thus far there is little consensus regarding the degree of transfer to other tasks which also involve mental rotation. In Experiment 1, we assessed the effect of mental rotation training on participants' Mental Rotation Test (MRT) scores. Twenty-eight participants were randomly assigned to one of three groups: a "One-Day Training," "Spaced Training," or "No Training" group. Participants who received training achieved higher scores on the MRT, an advantage that was still evident after 1 week. Distribution of training did not affect performance. Experiment 2 assessed generalization of mental rotation training to a more complex mental rotation task, laparoscopic surgery. Laparoscopic surgical skills were assessed using Fundamentals of Laparoscopic Surgery (FLS) tasks. Thirty-four participants were randomly assigned to a "Full Mental Rotation Training, MRT and FLS," "MRT and FLS," or "FLS-only" group. MRT results from Experiment 1 were replicated and mental rotation training was found to elicit higher scores on the MRT. Further, mental rotation training was found to generalize to certain laparoscopic surgical tasks. Participants who obtained mental rotation training performed significantly better on mental-rotation dependent surgical tasks than participants who did not receive training. Therefore, surgical training programs can use simple computer or paper-based mental rotation training instead of more expensive materials to enhance certain aspects of surgical performance of trainees.     

The Impact of a Precision Teaching Intervention on the Reading Fluency of Typically Developing Children

This research investigated the efficacy of precision teaching (PT) on the reading fluency of typically developing children, aged 7–8 years. Seven participants were assigned to a PT intervention group and received 6 weeks of fluency training using Say All Fast a Minute Every Day Shuffled (SAFMEDS) fluency cards (Phase 1) and a Dolch story (Phase 2). Outcomes were measured using multiple baseline design (MBD) data, Standard Celeration Charts, and pre‐intervention–post‐intervention fluency scores. The MBD data show increased correct responding for PT participants from baseline to the end of each intervention phase. These improvements were maintained at a 3‐week post‐intervention follow‐up. The MBD clearly demonstrated a replication of intervention effects across participants. The study supports prior research in this area showing that PT can lead to large and socially relevant gains in children's reading fluency. Copyright © 2015 John Wiley & Sons, Ltd.