Written by: Frank Cicero, PhD, BCBA-D
Seton Hall University

Description:

Autism Treatments SummaryBased on the principles of applied behavior analysis, Behavioral Skills Training (BST) is a structured procedure for teaching new skills consisting of four components: instruction, modeling, rehearsal, and feedback (Kirkpatrick et al., 2019). The term BST, and its four-component procedure as we know it today, was introduced by Raymond Miltenberger in his 1997 text Behavior Modification: Principles and Procedures. Based on the BST procedure described in Miltenberger (1997), Sarokoff and Sturmey (2004) conducted the first published experimental demonstration of the effectiveness of BST in a real-world context. In their study, Sarokoff and Sturmey successfully trained three teachers to correctly implement discrete trial teaching through the use of BST.

The components of instruction, modeling, rehearsal, and feedback are typically administered by a trained instructor in a simulated role-play context with a learner before being generalized to natural settings (Miltenberger et al., 2017). The first step of BST, Instruction, is when the instructor verbally explains the skill being taught to the learner. In Modeling, the instructor physically demonstrates the skill that the learner is expected to perform while the learner observes. The purpose of modeling is to provide a correct example of the skill that the learner will then practice in the third step, rehearsal. During Rehearsal, the learner performs the skill, usually in a role-play context. Multiple opportunities to practice are provided. The purpose of rehearsal is two-fold. First, repeated rehearsal allows the learner to practice the skill multiple times in quick succession. Second, it allows the instructor to assess the learner’s success with the skill and, consequently, to provide feedback accordingly. The fourth component of BST, Feedback, is information provided to the learner by the instructor after each practice opportunity in order to praise them for correct responses and provide them with corrections after responses that are not consistent with what was modeled. Effective feedback serves to shape correct responses. The goal of BST is to have the learner master the target skill and be able to perform the target skill independently (Granpeesheh et al., 2014; Miltenberger et al., 2017).

Research Summary:

Over the past three decades, BST has been effectively used to teach a variety of skills to different populations of learners. For example, BST has been shown to be effective in areas such as teacher training (Slane & Lieberman-Betz, 2021), parent training (Schaefer & Andzik, 2021), teaching gun safety skills to young children (Lee et al., 2019), and improving the ability of college students to conduct academic literature searches (Moore et al., 2026). BST has also been shown to be an effective strategy for increasing skills in children on the autism spectrum. In a systematic review, Lucchesi (2022) used a formula for evidence-based practice developed by Reichow (2011) to determine whether there is enough evidence in the research literature to support the use of BST to teach skills to individuals with ASD. Lucchesi found 24 studies, including 30 participants with autism spectrum disorder (ASD), that provided support for BST as an evidence-based practice for teaching a variety of skills to individuals with ASD Several studies targeted the acquisition of safety skills including firearm safety, poison safety, and safety from abduction. Studies also taught social skills such as conversation skills, interactive play behaviors, and responding to bullying. BST has also been used with children with autism to increase physical behaviors such as soccer skills, skateboarding, and dancing.

Ledbetter-Cho et al. (2021) effectively taught four children with ASD to safely avoid abduction lures from strangers by saying “no”, moving away, and reporting to a trusted adult. BST was implemented by trained instructors using the four-component BST model. Training sessions took between 10-12 minutes each and overall training to mastery (independent correct responding on the first attempt across four types of abduction lures) took a few days to 2 weeks depending on the child’s rate of skill acquisition. In addition to mastering the skills in BST trials, responses generalized to novel settings and people. However, some overgeneralization occurred (i.e., children displayed the abduction safety responses in the presence of safe persons such as police officers).

In the area of poison safety, Morosohk and Miltenberger (2022) effectively taught three children with ASD safety skills when in the presence of a poisonous substance. The children were between the ages of four to ten years old and were taught a three-step response when they saw unknown pills; do not touch the pills, leave the area, and tell an adult. BST was employed by trained instructors first in simulated controlled settings and then generalized to unexpected opportunities in natural settings such as the participants’ homes. Training sessions lasted between 10-20 minutes each, and the skill was learned within one to three sessions depending on the participant. These results indicate that BST was effective in teaching poison safety behaviors in less than an hour of total training time and that responses generalized to natural settings.

Chambers and Radley (2020) effectively taught three adolescent males with ASD target soccer skills using peer-mediated BST. In this study, BST sessions were conducted by a 14-year-old neurotypical female peer who was trained in the implementation of BST as related to the target soccer skills being taught. Three soccer skills were taught: throwing, kicking, and defending. Each BST session consisted of ten teaching trials and lasted approximately 10-15 minutes in duration. Quick acquisition of target skills was demonstrated, within two to four sessions per skill, by all three participants and skills maintained in follow-up probes two weeks after training.

Recommendations:

Given the numerous studies that demonstrated the effectiveness of BST in teaching skills to individuals with ASD, BST can be considered an evidence-based practice and is recommended for use when following the four-step procedure of instructions, modeling, rehearsal, and feedback as outlined in the literature (e.g., Miltenberger, 2024; Moore et al., 2026). Continued research is recommended to further explore the benefits of BST across additional skills, participants, and settings, as well as to determine how to make it most effective when it comes to details, such as instructor qualifications, instructor training, length of training, and procedural variations. If there is an interest in utilizing BST, it is recommended that instructors carefully review the training procedures as outlined in Miltenberger (2024) and other published studies prior to use so that procedures are implemented ethically and effectively.

Selected References:

Systematic Reviews of Scientific Studies

Kirkpatrick, M., Akers, J., and Rivera, G. (2019). Use of behavioral skills training with teachers: A systematic review. Journal of Behavioral Education, 28, 344-361.

Lucchesi, K. E. (2022). The effects of behavioral skills training on skill acquisition in autistic children: A systematic review. Seton Hall University Dissertations and Theses (ETDs). 3010.

Schaefer, J. M., & Andzik, N. R. (2021). Evaluating behavioral skills training as an evidence-based practice when training parents to intervene with their children. Behavior Modification, 45(6), 887-910.

Slane, M., & Lieberman‐Betz, R. G. (2021). Using behavioral skills training to teach implementation of behavioral interventions to teachers and other professionals: A systematic review. Behavioral Interventions, 36(4), 984-1002.

Selected Articles and Scientific Studies

Chambers, C., & Radley, K. C. (2020). Training soccer skills to adolescents with autism spectrum disorder via peer-mediated behavioral skills training. Behavior Analysis in Practice, 13(2), 454-461.

Ledbetter-Cho, K., Lang, R., Davenport, K., Moore, M., Lee, A., O’Reilly, M., Watkins, L., & Falcomata, T. (2016). Behavioral skills training to improve the abduction-prevention skills of children with autism. Behavior Analysis in Practice, 9(3), 266-270.

Lee, N., Vladescu, J. C., Reeve, K. F., Peterson, K. M., & Giannakakos, A. R. (2019). Effects of behavioral skills training on the stimulus control of gun safety responding. Journal of Behavioral Education, 28(2), 187-203.

Moore, T. F., Diaz, D. A., Edwards, G. E., King, S. O., Mattson, S. L., & Smith, H. M. (2026). Using remote behavioral skills training to teach university students literature searching skills. Behavior Analysis in Practice, 1-21.

Morosohk, E., & Miltenberger, R. (2022). Using generalization-enhanced behavioral skills training to teach poison safety skills to children with autism. Journal of Autism and Developmental Disorders, 52(1), 283-290.

Sarokoff, R. A., & Sturmey, P. (2004). The effects of behavioral skills training on staff implementation of discrete‐trial teaching. Journal of Applied Behavior Analysis, 37(4), 535-538.

Other References

Granpeesheh, D., Tarbox, J., Najdowski, A. C., & Kornack, J. (2014). Evidence-based treatment for children with autism: The CARD model. Academic Press.

Miltenberger, R. G. (1997). Behavior modification: Principles and Procedures. Brooks/Cole.

Miltenberger, R. G. (2024). Behavior Modification: Principles and Procedures, Seventh Edition. Cengage

Miltenberger, R. G., Zerger, H. M., Novotny, M., & Livingston, C. P. (2017). Behavioral skills training to promote social behavior of individuals with autism. In Handbook of social skills and autism spectrum disorder: Assessment, curricula, and intervention (pp. 325-342). Cham: Springer International Publishing.

Reichow, B. (2011). Evidence-based practices and treatment for children with autism. Springer Science Business Media. https://doi.org/10.1007/978-1-4419-6975-0_2

Reference for this article:

Cicero, F. (2026). A treatment summary of Behavioral Skills Training (BST). Science in Autism Treatment, 23(11).

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