Increasing social approach and decreasing social avoidance in children with autism spectrum disorder during discrete trial training

Instructions presented during discrete trial training (DTT) may evoke problem behavior and exacerbate social avoidance in children with autism spectrum disorder (ASD). Given the importance of DTT in comprehensive interventions, evaluating procedures to increase social responsiveness and approach during DTT are warranted. The effect of antecedent strategies on social avoidance during DTT in two children with ASD was examined. A pairing procedure in which one therapist removed demands and paired social interaction with access to preferred toys and activities was compared to a demand procedure in which a therapist presented instructions. Social approach was higher and social avoidance was lower in sessions with the pairing therapist compared to the non-pairing therapist during the Pairing Intervention and during post-pairing demand sessions.