A Pilot Randomized Clinical Trial of an Enhanced Pivotal Response Treatment Approach for Young Children with Autism: The PRISM Model

  • Ty W. VernonEmail author
  • Anahita N. Holden
  • Amy C. Barrett
  • Jessica Bradshaw
  • Jordan A. Ko
  • Elizabeth S. McGarry
  • Erin J. Horowitz
  • Daina M. Tagavi
  • Tamsin C. German
Original Paper


The symptoms of autism spectrum disorder are conceptualized to alter the quality of parent–children interactions, exposure to social learning exchanges, and ultimately the course of child development. There is evidence that modifying the procedures of Pivotal Response Treatment (PRT) to explicitly target social motivation enhances child engagement and parent–child synchrony in moment-by-moment exchanges. However, it is unclear if these within session improvements ultimately yield favorable developmental outcomes over time. The current investigation presents feasibility, utility, and preliminary efficacy data of a pilot randomized clinical trial (RCT) of a Pivotal Response Intervention for Social Motivation (PRISM) model. Data on participant factors, treatment protocol acceptability, and outcome variance and effect size are highly favorable and support the pursuit of a future, large scale RCT.


Pivotal response treatment Pivotal response intervention for social motivation (PRISM) Early intervention Pilot study Randomized clinical trial (RCT) 



The authors would like to acknowledge all of the families who participated in this research, along with all of the undergraduate research assistants and clinicians that made this project possible.

Author Contributions

TWV served as PI for this RCT, trained and supervised the grant coordinators, and participated in the conceptualization, implementation, and data analysis of the clinical trial. ANH and ACB served as grant project coordinators and assisted with data analysis and the recruitment, training, and supervision of all research assistants. JB, EJH, and Co-PI TCG assisted with study conceptualization, design, and data analysis. ANH, ACB, JAK, and ESM were responsible for clinician recruitment, training, and supervision and also conducted parent training sessions. DMT assisted with major aspects of manuscript drafting and revision. All authors assisted with article preparation.


This study was funded by Autism Speaks.

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Ty W. Vernon
    • 1
    Email author
  • Anahita N. Holden
    • 1
  • Amy C. Barrett
    • 1
  • Jessica Bradshaw
    • 2
  • Jordan A. Ko
    • 1
  • Elizabeth S. McGarry
    • 1
  • Erin J. Horowitz
    • 1
  • Daina M. Tagavi
    • 1
  • Tamsin C. German
    • 1
  1. 1.University of California Santa BarbaraSanta BarbaraUSA
  2. 2.University of South CarolinaColumbiaUSA

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