Re-establishing conversational skills in overtly psychotic, chronic schizophrenic patients. Discrete trials training on the psychiatric ward.

A discrete trials procedure incorporating graduated prompts, social and consumable reinforcement, corrective feedback, delay of reinforcement, and a chaining procedure was used to teach four actively psychotic, chronic schizophrenic patients rudimentary conversational skills. In a multiple-baseline design, training was sequentially applied to the target conversational skills of giving a salutation, addressing the trainer by his or her name, making a personal inquiry, and asking a conversational question. Results showed systematic training effects in three of the four subjects. Training gains were reliable but slow, requiring over 70 trials to reach acquisition criterion on certain skills. The fourth subject exhibited only unstable gains on the first target response and minor improvements on the second target response, the latter of which disappeared when training procedures were withdrawn. All subjects displayed spontaneous recovery on the generalization measure of answering a personal inquiry.