Journal of Applied Behavior Analysis (Fall) 2020, 53, 2287–2302 NUMBER 4

The influence of instructive feedback presentation schedule:

A replication with children with autism spectrum disorder
Casey L. Nottingham, Jason C. Vladescu, Ruth M. DeBar and
Meghan Deshais
Caldwell University

Jaime DeQuinzio
Alpine Learning Group

Instructive feedback (IF) is a modification to discrete trial instruction that may increase instruc-
tional efficiency for individuals with autism spectrum disorder. Several variations of IF have
recently been evaluated in the literature; however, few studies have assessed the effectiveness and
efficiency of presenting secondary targets on continuous versus intermittent presentation sched-
ules. The current study evaluated the effectiveness and efficiency of various presentation sched-
ules of secondary targets during discrete trial instruction. Specifically, we replicated and
extended Griffen et al. (1998) by comparing a condition in which secondary targets were pres-
ented during each trial of a session, a condition in which secondary targets were presented every
other trial, and a condition in which secondary targets were presented about every 4 trials.
Within-subject replications were included for both participants. One of the intermittent presen-
tation schedules was associated with the most optimal outcomes in all 4 comparisons.
Key words: autism spectrum disorder, instructional efficiency, instructive feedback, secondary
targets, tacts

Instructive feedback (IF) is a variation of dis-
crete trial teaching that involves presenting
additional, nontarget stimuli within learning
trials (Reichow & Wolery, 2011). When using
IF, practitioners directly teach primary targets
and also present additional stimuli (hereafter
referred to as secondary targets) that are not
directly taught (Vladescu & Kodak, 2013).
Learners are not required to respond to second-
ary targets and, if a response is given, the prac-
titioner withholds feedback related to the
response.
This project was completed in partial fulfillment of the
requirements for a Doctor of Philosophy in Applied
Behavior Analysis by the first author, under the supervi-
sion of the second author.
Address correspondence to: Jason C. Vladescu, Depart-
ment of Applied Behavior Analysis, Caldwell University,
120 Bloomfield Avenue, Caldwell, NJ 07006,
Email: jvladescu@caldwell.edu or Casey L. Nottingham, ABA
Collective, LLC., 1 International Boulevard Ste 400, Mahwah,
NJ 07495. Email: cnottingham@abacollective.com
doi: 10.1002/jaba.706
© 2020 Society for the Experimental Analysis of Behavior
2287
The effectiveness and efficiency of IF has
been evaluated. Effective procedures are proce-
dures that result in desired learning outcomes
while efficient procedures are procedures that
result in optimal learning outcomes without
increasing instructional time (Reichow &
Wolery, 2011). The IF procedure has been
effectively used to promote skill acquisition in
1:1 (e.g., Carroll & Kodak, 2015), dyad
(e.g., Appelman et al., 2014), and small group
(e.g., Cromer et al., 1998; Leaf et al., 2017)
formats, and with individuals with a range of
disabilities, including autism spectrum disorder
(e.g., Appelman et al., 2014; Caldwell et al.,
1996; Carroll & Kodak, 2015; Cromer et al.,
1998; Dass et al., 2018; Delmolino et al.,
2013; Haq et al., 2015; Parrott et al., 2000;
Ross & Stevens, 2003; Schnell et al., 2018;
Tekin-Iftar et al., 2003; Tullis, Marya, &
Shillingsburg, 2019; Werts et al., 2011).
The IF procedure has also proven effective
across several procedural variations such as the
2288 Casey L. Nottingham et al.
location of secondary targets within a learning
trial. Secondary targets have been presented
within the antecedent portion (e.g., Haq et al.,
2015; Vladescu & Kodak, 2013) of the trial
prior to the presentation of a primary target.
Secondary targets have also been presented
within the consequence portion
(e.g., Carroll & Kodak, 2015) of the trial fol-
lowing reinforcement for a correct response
related to a primary target. Lastly, secondary
targets have been embedded within the ante-
cedent stimulus related to the primary target
(e.g., Doyle et al., 1996) of a learning trial (see
Nottingham et al., 2015 for examples).
Previous research has also evaluated the
effects of presenting multiple secondary tar-
gets within each learning trial (e.g., Gast
et al., 1994; Nottingham et al., 2017). For
example, two secondary targets have been
presented within the consequence portion of
each learning trial (e.g., Gast et al., 1994;
Nottingham et al., 2017) or one secondary
target has been presented in the antecedent
portion and one secondary target has been
presented in the consequence portion of each
learning trial (Nottingham et al., 2017).
When compared to traditional discrete trial
arrangements, IF procedures involving ante-
cedent and consequence arrangements have
been demonstrated to result in better instruc-
tional efficiency by increasing the number of
targets acquired without substantially increas-
ing instructional time (e.g., Nottingham
et al., 2017; Vladescu & Kodak, 2013).
Another variation of the arrangement of IF
that may affect both the effectiveness and effi-
ciency of instruction involves the schedule or
frequency of presentation of secondary targets.
Secondary targets may be presented on a con-
tinuous (i.e., during each trial of a session) or
intermittent (i.e., during some trials of a ses-
sion) basis. Griffen et al. (1998) evaluated the
continuous and intermittent presentation of
secondary targets with participants diagnosed
with moderate intellectual disabilities. The
experimenter presented secondary targets either
during every trial of a session (i.e., continuous
presentation) or about every four trials
(i.e., intermittent presentation). Participants
acquired the primary and secondary targets in
both conditions. The researchers reported that
the intermittent presentation condition
required less training time than the continuous
presentation condition.
Within this study, Griffen et al. (1998) eval-
uated IF procedures with individuals with mod-
erate intellectual disabilities to teach tacts as the
primary targets (e.g., Lexington Public Library)
and additional information about the primary
targets as secondary targets (e.g., “Lexington
Public Library is where we check out books”).
Secondary target probes were conducted as a
two-phase procedure. During Phase 1 of the
secondary target probes, the experimenter pres-
ented a picture of the primary target
(e.g., Lexington Pubic Library) and said, “Tell
me what we can do here.” If a correct response
was not emitted within 5 s, the experimenter
progressed to Phase 2 of the secondary target
probe and presented a fill-in-the-blank
intraverbal antecedent stimulus such as, “Lex-
ington Public Library is where we can ____.”
The researchers reported that all participants
acquired the secondary target responses in the
absence of direct teaching; however, data for
secondary target probes were combined across
Phases 1 and 2. The combined summarization
of data prevents conclusions regarding
(a) whether one secondary target probe ante-
cedent stimulus resulted in higher levels of cor-
rect responding and (b) if the findings were
consistent across participants. Additional
research is needed to assess the generality of the
findings of Griffen et al. to different skills and
different learners. For example, individuals with
ASD may benefit from discrete trial instruction
that incorporates these procedural modifica-
tions. Another potential expansion related to
this research area (Griffen et al., 1998) involves
including a presentation schedule that allows
 Secondary Target Presentation Schedule
for intermittent presentation of secondary tar-
gets but does not restrict presentation of those
targets to once per session (e.g., presentation of
secondary targets twice per session). Individuals
diagnosed with ASD who may require multiple
exposures to a target for the establishment of
stimulus control may benefit from a modified
intermittent presentation schedule of secondary
targets; however, no research has been con-
ducted evaluating differing intermittent presen-
tation schedules of secondary targets.
The purposes of the current study were to
systematically replicate and extend Griffen et al.
(1998). The study replicated Griffen et al. by
evaluating (a) a continuous presentation sched-
ule of secondary targets during which a second-
ary target was presented following every
primary target in a session and (b) an intermit-
tent schedule of secondary targets during which
a secondary target was presented every four tri-
als during a session. The study extended
Griffen et al. by (a) including an additional
intermittent condition during which a second-
ary target was presented every other trial in a
session, (b) evaluating various presentation
schedules with children with ASD, and
(c) including different measures of instructional
efficiency that have been more commonly used
in recent IF research.
Method
Participants
Two children diagnosed with ASD by an
independent professional participated. Parents
of all participants completed the Gilliam
Autism Rating Scale-Third Edition (Gilliam,
2013) to document characteristics associated
with an ASD diagnosis. Scores indicated that a
diagnosis of ASD was very likely. John was
7 years, 6 months old and had received inter-
vention based on the principles of applied
behavior analysis for at least 4 years at the start
of the study. Denis was 8 years, 6 months old
and had received intervention based on the
2289
principles of applied behavior analysis for at
least 5 years at the start of the study. At the
beginning of the study, both participants dem-
onstrated appropriate learning behavior
(e.g., sitting at a desk, orienting towards the
instructor, attending to instructional stimuli);
were considered to have generalized imitative
and echoic repertoires; emitted at least 1,000
tacts; vocally manded for items, information,
and the termination of aversive events; and
demonstrated intraverbals under a variety of
stimulus control categories (simple, compound,
verbal conditional discriminations; Sundberg,
2016). Both participants received low scores on
the Barriers Assessment of the Verbal Behavior-
Milestones Assessment and Placement Program
(Sundberg, 2008) (6 for John, 17 for Dennis),
and demonstrated all skills on Levels 1–3 from
the tact domain and Levels 1–2 of the echoic
domain. Prior to the current study, no addi-
tional norm- or criterion- referenced tests were
administered to either participant. Neither par-
ticipant had any substantial history with IF.
Three additional participants started the
evaluation; however, data for two participants
were not included because they developed dis-
ruptive behavior that interfered with session
completion and the acquisition of primary and
secondary target responses. Data for the third
participant was not included because a replica-
tion comparison could not be conducted.
Settings and Materials
The experimenter conducted all sessions in
an area of each participant’s home designated
for the study. Denis’ sessions took place at a
table with two chairs in a bedroom. John’s ses-
sions took place in a seating area in the living
room. Both participants had prior histories of
instruction in these locations. During all ses-
sions, data sheets, picture stimuli, timers, indi-
vidualized token systems, and a video camera
were present. Picture stimuli cards were either
7.62 by 12.7 cm (Denis) or 10.16 by
2290 Casey L. Nottingham et al.
15.24 cm (John) and depicted targets that were
individualized for each participant. The experi-
menters recorded all sessions using a video
camera.
Experimental Design and Response
Measurement
An adapted alternating treatments design
(Sindelar et al., 1985) with a no-treatment con-
trol condition was used to evaluate the effec-
tiveness and efficiency of three secondary target
presentation schedules to teach tacts to individ-
uals with ASD. During all sessions, the experi-
menter recorded data using data sheets created
for each condition. Following the identification
of primary and secondary targets for each par-
ticipant, data sheets were individualized with
primary and secondary targets and target order
was randomized using a random without
replacement method. During sessions, data
were collected on unprompted correct
responses, prompted correct responses,
unprompted incorrect responses, prompted
incorrect responses, and echoics. Unprompted
correct responses were defined as a participant
emitting a predefined response corresponding
to the antecedent stimulus prior to the experi-
menter’s delivery of a prompt. Prompted cor-
rect responses were defined as a participant
emitting a predefined response corresponding
to the antecedent stimulus following the experi-
menter’s delivery of a prompt. Unprompted
incorrect responses were defined as a partici-
pant emitting an error of commission or omis-
sion prior to the experimenter’s delivery of a
prompt. Prompted incorrect responses were
defined as a participant emitting an error of
commission or omission following the experi-
menter’s delivery of a prompt. Echoics were
defined as imitation of the experimenter’s
model of the secondary target within 3 s. In
addition, the experimenter recorded session
duration using a digital timer. The timer was
started immediately prior to establishing
attending during the first trial of a session, and
was stopped following completion of the final
discrete trial component (e.g., reinforcement,
presentation of a secondary target) of the last
trial for the session. Reinforcer consumption
duration was excluded from total session dura-
tion by pausing the session duration timer
when the participant earned the final token of
the token system. The session duration timer
remained paused throughout the reinforcement
interval. The session duration timer was then
restarted immediately prior to establishing
attending for the next trial.
The percentage of unprompted correct
responses is depicted in the figures and was cal-
culated for each session and across conditions
by dividing the number of unprompted correct
responses by the total number of trials in the
session and multiplying the resulting ratio by
100. To evaluate instructional efficiency, we
calculated the mean training time per target
across conditions by dividing the total training
time for each condition by the number of tar-
gets (i.e., primary and secondary) mastered
within the condition.
Interobserver Agreement
A second independent observer collected
data during 33% of baseline sessions across
conditions for John and Denis’ initial and repli-
cation evaluations for interobserver agreement
(IOA) purposes. Similarly, data were collected
during 50% of treatment comparison sessions
across conditions for John’s initial and replica-
tion evaluations, and 33% of treatment com-
parison sessions across conditions for Denis’
initial and replication evaluations. For trial-by-
trial IOA data, an agreement was defined as
any instance in which the primary and second-
ary observers scored a trial in the same way. A
disagreement was defined as any instance in
which the primary and secondary observers
scored a trial differently. IOA was calculated by
dividing the number of agreements by the
 Secondary Target Presentation Schedule
number of agreements plus disagreements and
multiplying the resulting ratio by 100. For ses-
sion duration IOA data, the shorter duration
recorded by the two observers was divided by
the longer duration and the resulting ratio was
multiplied by 100.
For John’s initial evaluation, IOA was 100%
for all conditions as well as for echoic
responding across conditions. Mean duration
IOA was 92% (range, 78%–100%) across the
continuous, intermittent 4:1, and intermittent
4:2 conditions. For John’s replication evalua-
tion, IOA was 100% across all conditions.
Echoic IOA was 100% for the intermittent 4:1
and intermittent 4:2 conditions. Mean echoic
IOA was 95% (range, 90%–100%) for the
continuous condition. For John’s replication
evaluation, mean duration IOA was 92%
(range, 79%–100%).
For Denis’ initial evaluation, IOA was 100%
for all conditions as well as for echoic
responding across conditions. Mean duration
IOA was 93% (range, 90%–95%) across condi-
tions. For Denis’ replication evaluation, IOA
was 100% across all conditions as well as for
echoic responding across conditions. For Denis’
replication evaluation, mean duration IOA was
94% (range, 92%–97%).
Procedural Integrity and Procedural
Integrity Interobserver Agreement
A trained observer collected data on proce-
dural integrity during at least 33% of sessions
across conditions for each participant using
data sheets created for each condition. The
observer recorded whether the procedures were
implemented as planned for each condition by
recording whether the experimenter correctly or
incorrectly established attending behavior, pres-
ented the primary and secondary targets as
applicable, delivered prompts, provided or
withheld feedback for responses to primary and
secondary targets, and waited for the intertrial
interval prior to starting a new trial. Procedural
2291
integrity was calculated by dividing the total
number of correct experimenter behaviors by
the number of correct experimenter behaviors
plus the number of incorrect experimenter
behaviors and multiplying the resulting ratio by
100. For both John’s and Denis’ initial and
replication evaluations, mean procedural integ-
rity was 100% during baseline and treatment
comparison phases across all conditions.
A second independent observer recorded
procedural integrity during 100% of the proce-
dural integrity sessions to evaluate IOA related
to procedural integrity measurement. The IOA
score was calculated by dividing the number of
agreements by the number of agreements plus
disagreements and multiplying the resulting
ratio by 100. For both John and Denis, IOA
on procedural integrity was 100% across all
conditions in the baseline and treatment com-
parison phases for both the initial and replica-
tion evaluations.
Preference Assessments and Token
Economy
We conducted paired-stimulus preference
assessments (Fisher et al., 1992) prior to the
onset of the study for each participant. Either
an edible or tangible preference assessment was
conducted. Any item selected at least one time
during the preference assessment was available
during sessions. These items were available for
selection following exchange of 10 tokens, pro-
vided contingent on prompted correct and
unprompted correct responses, or appropriate
sitting and attending responses throughout the
study. Any item vocally manded for by a partic-
ipant that was not included in the preference
assessment was also available.
Target Identification and Assignment
For each participant, the experimenter con-
ducted pretests to identify potential primary
and secondary targets. Potential targets were
identified based on individualized treatment
2292 Casey L. Nottingham et al.
goals, caregiver suggestions, or participant
mands, and included tact targets for the initial
and replication phases.
During pretest trials, the experimenter pres-
ented the antecedent stimulus and allowed par-
ticipants 5 s to respond. The experimenter
withheld feedback for unprompted correct and
unprompted incorrect responses but provided a
token for appropriate sitting and attending
(e.g., hands in lap, feet on floor, sitting still,
establishing eye contact with the experimenter)
about every three trials, during the intertrial
interval. Each potential target was pretested
three times. If a participant responded correctly
to a potential target at least one time, it was
discarded. The remaining targets were entered
into a pool of targets that could potentially be
assigned to various conditions across phases of
the study using a logical analysis (Wolery et al.,
2014). Targets that were physically or phoneti-
cally similar were not included within the same
set, and the number of syllables per target were
equated across conditions. Targets that began
with the same letter were not included within
the same set. For each comparison, we assigned
six targets to the continuous condition (three
primary targets plus three secondary targets),
six targets to the intermittent conditions (three
primary targets plus three secondary targets),
and three targets to each control conditions.
See Table 1 for a list of targets.
General Procedures
The experimenter conducted sessions 1 to
4 days per week based on participant and
experimenter availability. During sessions in
conditions involving teaching of primary tar-
gets, vocal model prompts were used and faded
using a constant prompt delay procedure. Dur-
ing the first two instructional sessions, the
experimenter presented vocal prompts immedi-
ately following the delivery of the antecedent
stimuli (i.e., 0-s prompt delay). Following two
consecutive sessions with 100% prompted
correct responses, the experimenter increased
the prompt delay to 5 s. Similar to previous IF
studies (Nottingham et al., 2017; Vladescu &
Kodak, 2013), the experimenter implemented a
re-present-until-independent error correction
procedure following unprompted (5-s prompt
delay) and prompted (0-s prompt delay) incor-
rect responses. The experimenter provided a
vocal prompt of the correct response and
allowed an opportunity for the participant to
engage in the correct response. If the partici-
pant engaged in a prompted correct response,
the experimenter provided a statement of
acknowledgement (e.g., “Right”) and re-
presented the same trial until the participant
engaged in an unprompted (5-s prompt delay)
or prompted (0-s prompt delay) correct
response. Error correction data are not included
in the figures. During each treatment compari-
son condition, prompted (0-s prompt delay) or
unprompted (5-s prompt delay) correct
responses to the primary target resulted in
praise and the delivery of a token. During trials
in which secondary targets were presented, the
experimenter held up the target picture for 3 s
and said, “This is a (stated name).” Participants
were not required to respond to these targets
and if a response (e.g., echoic) was given, no
feedback was provided by the experimenter.
The mastery criterion for primary and second-
ary targets was two consecutive sessions with
unprompted correct responding at 100%. Each
comparison was conducted twice with different
stimuli for replication purposes.
Baseline and Control
During baseline and control sessions, the
experimenter established attending, presented
the antecedent stimuli (held up a picture and
said, “What is it?”), and allowed the participant
5 s to respond. The experimenter did not pro-
vide feedback for unprompted correct or
unprompted incorrect responses during baseline
sessions. Praise and a token were delivered
every other trial for appropriate attending and
 Secondary Target Presentation Schedule 2293

Table 1

Primary and Secondary Targets

Participant Primary Control Secondary Control CONT INT 4:2 INT 4:1
John (initial) Ana Aengus Carthage Fitz Roy Brigid
Red Beach Tamarind Starry Night Jane Goodall Melting Watch
Silver Surfer Asparagus Lotus Temple The Yellow House Praying Mantis
Morrigan Krishna Dagda
The Thinker Irises Taj Mahal
Paper Towels Golden Temple 100 Cans
John* Ohio Delaware Angel Falls Singapore Angkor Wat
Barcelona Copenhagen Pennsylvania Table Mountain North Dakota
Mexico City Philadelphia Tennessee State Flag Oregon Hawaii State Flag
Istanbul Rhode Island Vienna
Massachusetts Abu Dhabi Connecticut
New Hampshire Michigan Illinois
Denis (initial) Manatee Sea Urchin Guinea Pig Garbage Truck Jellyfish
Harvester Cable Car Katydid Centipede Mobile Home
Stink Bug Earwig Swordfish Ferret Pitchfork
Pelican Tambourine Wheelbarrow
Clarinet Screwdriver Scorpion
Forklift Puffin Golf Cart
Denis* Squid Plough Tie Screw Swan
Flute Lobster Nails Eel Worm
Artichoke Calculator Grasshopper Mosquito Hermit Crab
Scarf Clam Vase
Cockroach Beetle Urchin
Fire Hydrant Paper Towels Praying Mantis

Note. Italicized words indicate secondary targets. Asterisks (*) indicate replication treatment comparison.

sitting behaviors to approximate the schedule presented following any primary target. This
of reinforcement in effect during intervention condition was similar to the continuous presen-
conditions. tation condition in Griffen et al. (1998).

Continuous Presentation Intermittent 4:2 Presentation

During each trial in the continuous
(CONT) presentation condition, a secondary
target was presented every time a primary target
was presented. During each trial, the experi-
menter established attending and presented the
antecedent stimuli relevant to the primary tar-
get. During this condition each of the three
primary targets was presented four times for a
total of 12 trials, and each of the three second-
ary targets was presented four times for a total
of 12 presentations, using a random without
replacement selection method for determining
the order of targets within a session. Primary
and secondary targets were not paired
(i.e., linked) when presented during this condi-
tion; that is, any secondary target could be
During each trial in the intermittent (INT)
4:2 presentation condition, each primary target
was presented four times and each secondary
target was presented two times. During each
trial within this condition, the experimenter
established attending and presented the ante-
cedent stimulus relevant to the primary target.
Each of the three primary targets was presented
four times for a total of 12 trials, and each of
the three secondary targets was presented two
times for a total of six presentations using a
random without replacement selection method
for determining the order of targets within a
session. Primary and secondary targets were not
paired (i.e., linked) when presented during this
condition.
2294 Casey L. Nottingham et al.

Intermittent 4:1 Presentation condition was similar to the intermittent sched-

During each trial in the INT 4:1 presentation ule condition from Griffen et al. (1998).
condition, each primary target was presented four
times and each secondary target was presented Secondary Target Probes
one time per session. During each trial, the Probes were conducted immediately prior to
experimenter established attending and presented every instructional session to evaluate partici-
the antecedent stimulus relevant to the primary pants’ acquisition of secondary targets. Secondary
target. Procedures during this condition were target probe procedures were identical to the pro-
identical to the INT 4:2 presentation condition; cedures outlined in the baseline and control con-
however, during the INT 4:1 presentation condi- ditions. The experimenter established attending,
tion, each of the three primary targets was pres- presented the antecedent stimulus relevant to the
ented four times for a total of 12 trials and each secondary target, allowed 5 s for the participant
of the three secondary targets was presented one to respond, withheld feedback for unprompted
time for a total of three presentations using a correct and incorrect responses, and delivered
random without replacement selection method praise and a token about every trial for appropri-
for determining the order of targets within a ses- ate sitting and attending behavior during the
sion. Primary and secondary targets were not intertrial interval. Although secondary targets
paired (i.e., linked) during this condition. This were presented at varying presentation schedules

Figure 1
John’s Unprompted Correct Responses across Conditions
Primary Targets Primary Targets
BL Treatment Comparison BL Treatment Comparison
100 100
Primary Control
80 80 Continuous
Percentage of Unprompted Correct Responses

INT 4:1
60 60 INT 4:2
Echoics
40 40

20 20

0 0
0 20 40 60 0 20 40 60
Sessions Sessions

Secondary Targets
Secondary Targets
BL Secondary Target Probes
BL Secondary Target Probes
100 100
Secondary Control
80 80 Continuous
INT 4:1
60 60 INT 4:2

40 40

20 20
John (initial) John (replication)
0 0
0 20 40 60 0 20 40 60
Sessions Sessions
 Secondary Target Presentation Schedule 2295

during instructional sessions (i.e., CONT, INT Results

4:2, INT 4:1), during secondary target probe ses- Figures 1 and 2 depict results for John and
sions, each secondary target was presented four Denis. In each graph, the percentage of
times across each condition. unprompted responses related to primary and
secondary targets are depicted in the top and
Review Sessions bottom panels, respectively. During baseline,
Review sessions were conducted for pri- the percentage of unprompted correct responses
mary targets while secondary target probes was at or near zero for both primary and sec-
continued if primary targets were mastered, ondary targets for both participants. Addition-
but secondary targets were approaching mas- ally, unprompted correct responding in the
tery. This arrangement allowed for an evalua- primary and secondary control conditions
tion of whether additional exposure would remained at or near zero for both participants
result in mastery of the secondary targets. across phases.
Review sessions would have also been con- Figure 1 displays results for John’s initial and
ducted, although were not necessary, for sec- replication comparisons. During the treatment
ondary targets as needed while continued comparison phase, John acquired the primary
teaching to mastery was ongoing for primary targets in all three instructional conditions in
targets in a condition. four training sessions. He engaged in correct

Figure 2
Denis’ Unprompted Correct Responses across Conditions
Primary Targets Primary Targets
BL Treatment Comparison BL Treatment Comparison
100 100

80 Primary Control
Percentage of Unprompted Correct Responses

80
Continuous
60 60 INT 4:1
INT 4:2
40 40 Echoic

20 20

0 0
20 40 60 80 100 20 40 60
Sessions Sessions

Secondary Targets Secondary Targets

BL Secondary Target Probes BL Secondary Target Probes
100 100

80 80 Secondary Control
Continuous
60 60 INT 4:1
INT 4:2
40 40

20 20
Denis (initial) Denis - Replication
0 0
20 40 60 80 100 20 40 60
Sessions Sessions
2296 Casey L. Nottingham et al.

Figure 3
Mean Training Time
150 150
2 min
1 min 1s
100

S eco n d s
100
S eco n ds

44 s
1 min 19 s 1 min 13 s 1 min 14 s 1 min 8 s

50 50

John (initial) John (replication)

0 0

us

1
4:
4:
1

2
us

uo
4:

4:

T
T
uo

tin

IN
IN
T

T
tin

on
IN

IN

C
on

C ondition
C

C ondition

200
200
2 min 36 s
150
2 min 1 min 59 s 150 2 min
Seconds

20 s
Seconds

100 1 min 48 s
100
1 min 15 s
50
50
Denis (initial) Denis (replication)
0 0
us

2
4:

4:

us

1
uo

4:

4:
uo
T

T
tin

T
IN

IN

in

IN

IN
on

nt
Co
C

C on d ition Condition

echoic responding following the presentation of
secondary targets during a mean of 98% of tri-
als (range, 92%-100%) in the CONT condi-
tion and 100% of trials in the INT 4:2 and
INT 4:1 conditions. John demonstrated mas-
tery of the secondary targets in all conditions in
three secondary target probe sessions, prior to
demonstrating mastery of the primary targets in
all conditions. For John’s replication compari-
son, during the treatment comparison phase,
he demonstrated mastery of the primary targets
in the INT 4:1 and INT 4:2 conditions in four
sessions each. He demonstrated mastery of the
primary targets in the CONT condition in five
sessions. During instructional sessions, John
engaged in correct echoic responses following
the experimenter’s presentation of the second-
ary target during 100% of trials across the
CONT, INT 4:2, and INT 4:1 conditions.
During secondary target probes, John again
demonstrated mastery of the secondary targets
in all conditions in three sessions, prior to mas-
tery of the primary targets in all conditions.
Figure 2 displays results for Denis’ initial
and replication comparisons. During the initial
treatment comparison, Denis demonstrated
mastery of the primary targets in the CONT
and INT 4:2 conditions in five sessions each
and in the INT 4:1 condition in six sessions.
Denis engaged in correct echoic responding
during 100% of trials across the CONT, INT
4:2, and INT 4:1 conditions. During secondary
target probes of the initial treatment compari-
son, Denis did not demonstrate mastery-level
responding to the secondary targets prior to
mastering the primary targets; however,
 Secondary Target Presentation Schedule
increasing or variable trends were observed in
all conditions at the time primary targets were
mastered in the corresponding conditions. The
experimenter conducted review sessions for the
primary targets while continuing secondary tar-
get probes to determine whether additional
exposure would result in mastery of the second-
ary targets. Denis demonstrated mastery of the
secondary targets in the INT 4:1 condition in
nine probe sessions, in the CONT condition in
ten probe sessions, and in the INT 4:2 condi-
tion in 12 probe sessions.
For Denis’ replication comparison, during
the treatment comparison, Denis mastered the
primary targets in the INT 4:1 condition in
four sessions and in the INT 4:2 and CONT
conditions in five sessions each. Denis engaged
in correct echoic responding during 100% of
trials across the CONT, INT 4:2, and INT 4:1
conditions. During secondary target probes,
Denis acquired the secondary targets in the
INT 4:2 condition in four probe sessions, prior
to mastery of the primary targets in that condi-
tion. He acquired the secondary targets in the
CONT condition in five probe sessions, equal
to the number of instructional sessions that
were required for him to acquire the primary
targets in that condition. He acquired the sec-
ondary targets in the INT 4:1 condition in
seven probe sessions, after mastery of the pri-
mary targets.
Figure 3 depicts mean training time per tar-
get across instructional conditions for John’s
and Denis’ initial and replication evaluations.
The mean training times per target for John’s
initial evaluation were 1 min 44 s, 1 min 19 s,
and 1 min 13 s for the CONT, INT 4:1, and
INT 4:2 conditions, respectively. The mean
training times per target for John’s replication
evaluation (Figure 3) were 2 min 1 s, 1 min
14 s, and 1 min 8 s for the CONT, INT 4:2,
and INT 4:1 conditions, respectively. The
mean training times per target for Denis’ initial
evaluation were 2 min 36 s, 2 min, and 1 min
59 s for the CONT, INT 4:1, and INT 4:2
2297
conditions, respectively. The mean training
times per target for Denis’ replication compari-
son were 2 min 20 s, 1 min 48 s, and 1 min
15 s for the CONT, INT 4:2, and INT 4:1
conditions, respectively.
Discussion
The current study evaluated the effectiveness
and efficiency of presenting secondary targets
on continuous and intermittent presentation
schedules with two participants diagnosed with
ASD. Both participants acquired the primary
targets using a constant prompt delay proce-
dure, reinforcement, and a re-presentation-
until-independent error correction teaching
procedure, with the incorporation of secondary
targets. Both participants also acquired the sec-
ondary targets in the absence of direct teaching,
suggesting that IF was an effective procedure in
this study. Similar to the findings of Griffen
et al. (1998), the current study found that
intermittent presentation of secondary targets
during IF was more efficient than a continuous
presentation schedule of secondary targets. The
current study allowed for further investigation
of intermittent presentation schedules by
including both the INT 4:1 and INT 4:2
schedules. Across all four comparisons with
both participants, results showed that one of
the intermittent presentation conditions was
associated with the lowest mean training time
per target. However, differences (albeit, mini-
mal) were observed regarding which intermit-
tent presentation schedule resulted in the most
efficient acquisition. Importantly, experi-
menters also found that there was no detrimen-
tal impact on participants’ acquisition of
primary targets regardless of whether secondary
targets were presented continuously or
intermittently.
Although measures were taken to equate
stimulus sets across conditions in each treat-
ment comparison, differences among target sets
may have contributed to which intermittent
2298 Casey L. Nottingham et al.
condition resulted in the least amount of train-
ing time per target. Regardless, an intermittent
presentation of secondary targets (i.e., INT 4:2
or INT 4:1) resulted in the least amount of
training time per target and the most efficient
acquisition across all participants and treatment
comparisons. Researchers should attempt to
replicate this finding and determine the condi-
tions under which intermittent presentation
schedules produce optimal outcomes. Partici-
pant characteristics should also be further
explored to better understand the learners for
whom intermittent schedules will be effective
when using IF. The current results should
be considered in light of the participants’ well-
developed echoic, tact, and intraverbal reper-
toires. Practitioners should consider the similar-
ity of clients when applying this type of IF
schedule in clinical practice given the lack of
clarity regarding minimally required repertoires
and limited research within this area. Future
replications should include a primary target
only condition to evaluate the extent to which
intermittent presentations of secondary targets
further increases instructional efficiency over
standard discrete trial instruction.
It should be noted that the preparation did
not allow for an evaluation of the influence of
presentation schedule distinct from the mini-
mum number of exposures necessary to achieve
mastery. That is, the number of exposures
rather than the ratio of primary to secondary
targets may play a role in acquisition of second-
ary target responses. In this study, the INT
conditions could have provided sufficient expo-
sures for secondary target responses to be
acquired whereas the CONT condition pro-
vided more exposures than necessary. Future
researchers could conduct evaluations to evalu-
ate the distinct influence of presentation sched-
ule while accounting for exposures.
The findings of the current study are similar
to those of previous IF studies in several ways.
First, like some participants in previous IF
studies (e.g., Kelly and Simon from
Nottingham et al., 2017; Dwight and Rick
from Vladescu & Kodak, 2013), John acquired
the secondary target responses prior to demon-
strating mastery of the primary target responses
in both the initial and replication evaluations.
This outcome could be a function of the differ-
ence in the minimum training sessions required
before participants could demonstrate mastery-
level responding (two consecutive sessions with
100% unprompted correct responding) for pri-
mary and secondary targets. For primary tar-
gets, the first two training sessions were
conducted with a 0-s prompt delay. Thereafter,
the prompt delay was increased to 5 s. Thus, a
minimum of four training sessions were
required before it was possible for participants
to demonstrate mastery of primary target
responses. However, because the experimenter
initiated secondary target probes prior to the
first instructional session, a minimum of three
secondary target probe sessions would seem-
ingly be required before it would be possible
for participants to demonstrate mastery of sec-
ondary target responses. Researchers could
attempt to determine the conditions under
which participants acquire secondary target
responses quicker than primary target
responses. For example, it might be useful to
eliminate the 0-s prompt delay training ses-
sions. That is, following baseline, training
could start with a 5-s prompt delay. For certain
participants, and with a particular subset of cli-
ents in clinical practice, this variation would
make it possible for participants to demonstrate
mastery of primary and secondary target
responses following the same minimum num-
ber of training sessions. For example, future
researchers or practitioners working with indi-
viduals who readily acquire targeted responses
in the absence of errorless teaching strategies
could eliminate 0-s prompt delay trials. This
arrange may help determine the conditions
under which mastery of secondary target
responses prior to mastery of primary target
responses occurs. However, this remains an
 Secondary Target Presentation Schedule
empirical question and practitioners may
choose to arrange clinical teaching practices by
individualizing instructional strategies best
suited for their clients to prevent errors early in
learning.
Second, like previous research related to IF
procedures (e.g., Schnell et al., 2018;
Vladescu & Kodak, 2013), the current study
presented primary and secondary targets that
consisted of expansion targets (Reichow &
Wolery, 2011). Expansion targets are primary
and secondary targets that are either related
conceptually, or from the same instructional
area. The current study evaluated expansion-
type targets by presenting tact targets as both
the primary and secondary targets for both par-
ticipants. One limitation to this arrangement is
that these procedures do not generally reflect
traditional instructional arrangements within
less restrictive teaching settings. For example,
the current study taught primary targets, such
as a tact of a guinea pig, and then presented a
picture of a clarinet with the accompanying
statement, “This is a clarinet.” Although these
targets are considered expansion targets because
they are both tacts, the additional information
included in the secondary target is not related
to the primary target with regard to the con-
tent, which is what may be more typical in a
less restrictive learning environment. For exam-
ple, a teacher or caregiver may similarly ask
about a picture of a guinea pig (i.e., primary
target); however, it is likely that the secondary
target—or additional information—that follows
will be conceptually related to the primary tar-
get, such as, “A guinea pig is an animal.”
Although some research (e.g., Dass et al.,
2018) has been conducted related to the effects
of IF procedures along this area of conceptual
expansion, future research is needed to deter-
mine how to best arrange these procedures for
individuals with ASD and for whom these
types of procedures may be effective.
Third, by demonstrating that the manipula-
tion of a secondary target presentation schedule
2299
led to increased instructional efficiency, the
current study adds to the small body of litera-
ture (e.g., Nottingham et al., 2017) that has
shown variations of IF hold promise as a more
optimal means of establishing new skills for
learners with ASD. Relatedly, Nottingham
et al. (2017) demonstrated that increases in
instructional efficiency may be achieved by pre-
senting multiple (as opposed to a single) sec-
ondary targets per trial. Researchers should
evaluate additional IF variations and combina-
tions of IF variations as a means to identify the
most optimal means of incorporating IF into
acquisition programs for learners.
Fourth, like many participants in previous
studies (Dass et al., 2018; Nottingham et al.,
2017; Vladescu & Kodak, 2013), the partici-
pants of the current evaluation consistently
emitted overt echoics following the experi-
menter’s presentation of the secondary targets.
Additionally, the participants consistently dem-
onstrated behaviors consistent with attending
(e.g., looking at stimuli, orienting toward stim-
uli, pointing toward stimuli) to the secondary
targets. The occurrence of these behaviors may
suggest a naming repertoire as a mechanism rel-
evant to positive IF outcomes (e.g., Horne &
Lowe, 1996; Miguel, 2016).
Participants’ demonstration of a naming rep-
ertoire may explain why secondary target
responses are acquired in the absence of direct
teaching. When naming, the participant acts as
both a listener and speaker following the pre-
sentation of a stimulus. For example, following
the presentation of a secondary target, partici-
pants may have responded as a listener
(i.e., orienting to the picture) and speaker
(i.e., overtly or covertly echoing the name of
the picture) (e.g., Greer & Ross, 2008; Miguel,
2016). Recent IF studies have begun to incor-
porate discussions of the potential role of nam-
ing in the effectiveness of IF procedures
(e.g., Dass et al., 2018; Frampton &
Shillingsburg, 2019; Tullis et al., 2016). Prior
to the onset of the current study, naming was
2300 Casey L. Nottingham et al.
not directly assessed for either John or Denis;
however, during the study, both participants
consistently engaged in listener responding
related to the presentation of secondary targets.
Like participants in recent research
(Frampton & Shillingsburg, 2019), John and
Denis both engaged in behaviors such as
looking at, pointing to, or orienting toward the
secondary target picture cards when the experi-
menter presented these stimuli. Additionally,
both participants engaged in consistent, overt
echoic responses following the experimenter’s
presentation of the secondary targets. The
observation of both speaker and listener
responses and subsequent mastery of secondary
targets indicates the likelihood of naming reper-
toires. Future research related to IF should
incorporate evaluation of participants’ naming
repertories prior to the onset of the study and
should include measurement of echoic and
attending behaviors to inform discussion related
to the potential influence of naming
repertoires.
Additional explanations for why participants
in IF studies learn secondary target responses in
the absence of direct teaching have been pro-
posed. Indiscriminable contingencies may play
a role in the effectiveness of IF procedures
(Tullis, Gibbs et al., 2019). Contingencies for
responding to primary targets versus secondary
targets were likely indiscriminable across both
continuous and intermittent conditions. Similar
densities of reinforcement across the teaching
sessions and secondary target probe conditions
may have resulted in participants responding
similarly to both primary and secondary targets
to maximize access to reinforcement through-
out sessions.
Demand characteristics may also be relevant.
That is, across instructional sessions and sec-
ondary target probe sessions in all conditions,
sessions were conducted in the same environ-
ment by the same experimenter. Relatedly,
both participants demonstrated extensive histo-
ries with discrete trial instruction, instruction
based on the principles of behavior analysis,
and highly developed tact repertoires. These
variables in combination may have resulted in
fewer instructional trials required for the cur-
rent participants to demonstrate mastery of tar-
gets presented—including secondary targets—
resulting in more efficient mastery of targets
that were presented intermittently. Because
limited standardized assessment data are avail-
able for the current participants, future research
is needed to replicate these procedures with
participants of varying skill levels. Future
researchers should include detailed participant
characteristic profiles, particularly related to the
skill targeted for instruction within the study.
Several areas for future research are worth
noting. First, few IF evaluations have incorpo-
rated procedures to program for or assess main-
tenance of primary and secondary targets. The
current study did not assess maintenance of pri-
mary or secondary targets. Although the cur-
rent study indicated that intermittent
presentation schedules of secondary targets
resulted in more efficient learning outcomes, it
is unclear whether correct responding maintains
when acquired under intermittent presentation
schedules. Further research is necessary to eval-
uate whether maintenance of acquired targets is
impacted by the secondary target presentation
schedule used during instructional sessions.
Second, although within-subject replications
were included, both targeted tacts as primary
and secondary targets. Thus, it is unclear
whether intermittent presentation schedules
would remain the more efficient procedure
when teaching different skills (e.g., fill-in-the-
blank intraverbals; question answering). IF pro-
cedures have been used to teach a wide variety
of skills, primarily related to verbal and play-
based behavior. However, future researchers
could include within-subject replications across
different skill types (e.g., tacts, intraverbals,
play skills) to determine whether the most effi-
cient secondary target presentation schedule
persists across skill types.
 Secondary Target Presentation Schedule
Finally, to our knowledge, this is the first
study to evaluate secondary target presentation
schedules with individuals diagnosed with
ASD. Currently, procedures based on the prin-
ciples of behavior analysis are widely used and
effective for increasing skill repertoires of indi-
viduals diagnosed with ASD. To ensure these
individuals make the social, language, and other
skill-based gains needed to reflect those of their
typically developing peers, additional research
targeting specific instructional procedures that
will increase the efficiency of learning for indi-
viduals with ASD is necessary.
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Received May 9, 2019
Final acceptance February 10, 2020
Action Editor, M. Alice Shillingsburg