Advertisement

Journal of Autism and Developmental Disorders

, Volume 44, Issue 11, pp 2862–2870 | Cite as

Improvements in Social and Adaptive Functioning Following Short-Duration PRT Program: A Clinical Replication

  • Pamela Ventola
  • Hannah E. Friedman
  • Laura C. Anderson
  • Julie M. Wolf
  • Devon Oosting
  • Jennifer Foss-Feig
  • Nicole McDonald
  • Fred Volkmar
  • Kevin A. Pelphrey
Original Paper

Abstract

Pivotal Response Treatment (PRT) is an empirically validated behavioral treatment for individuals with autism spectrum disorders (ASD). The purpose of the current study was to assess the efficacy of PRT for ten cognitively-able preschool-aged children with ASD in the context of a short-duration (4-month) treatment model. Most research on PRT used individual behavioral goals as outcome measures, but the current study utilized standardized assessments of broader-based social communication and adaptive skills. The children made substantial gains; however, magnitude and consistency of response across measures were variable. The results provide additional support for the efficacy of PRT as well as evidence for improvements in higher-order social communication and adaptive skill development within the context of a short-duration PRT model.

Keywords

Pivotal Response Treatment Intervention Outcome Adaptive skills Social communication skills Early intervention 

Notes

Acknowledgments

Funding for this study came from The Deitz Family, the Harris Professorship at the Yale Child Study Center given to Kevin Archer Pelphrey, Allied World, and Autism Science Foundation. We wish to thank the families of the children included in this study for their time and participation. We also wish to thank our colleagues Cara Keifer, Avery Voos, Jonathan Tirrell, and Cara Cordeaux for their contributions to the treatment work and clinical characterization of the sample.

References

  1. Barlow, D. H., Nock, M. K., & Hersen, M. (2009). Single case experimental designs: Strategies for studying behavior change (3rd ed.). USA: Pearson.Google Scholar
  2. Bryson, S. E., Koegel, L. K., Koegel, R. L., Openden, D., Smith, I. M., & Nefdt, N. (2007). Large scale dissemination and community implementation of pivotal response treatment: Program description and preliminary data. Research and Practice for Persons with Severe Disabilities, 32, 142–153.CrossRefGoogle Scholar
  3. Constantino, J. N. (2012). Social responsiveness scale (2nd ed.). Los Angeles: Western Psychological Services.Google Scholar
  4. Coolican, J., Smith, I. M., & Bryson, S. E. (2010). Brief parent training in pivotal response treatment for preschoolers with autism. Journal of Child Psychology and Psychiatry, 51, 1321–1330.PubMedCrossRefGoogle Scholar
  5. Dawson, G., Jones, E. J., Merkle, K., Venema, K., Lowy, R., Faja, S., et al. (2012). Early behavioral intervention is associated with normalized brain activity in young children with autism. Journal of the American Academy of Child and Adolescent Psychiatry, 51, 1150–1159.PubMedCrossRefPubMedCentralGoogle Scholar
  6. Dimidjian, S., Hollon, S. D., Dobson, K. S., Schmaling, K. B., Kohlenberg, R. J., Addis, M. E., et al. (2006). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology, 74, 658.PubMedCrossRefGoogle Scholar
  7. Doggett, R. A., Krasno, A. M., Koegel, L. K., & Koegel, R. L. (2013). Acquisition of multiple questions in the context of social conversation in children with autism. Journal of Autism and Developmental Disorders, 43, 2015–2025.Google Scholar
  8. Dunlap, G. (1984). The influence of task variation and maintenance tasks on the learning and affect of autistic children. Journal of Experimental Child Psychology, 37, 41–64.PubMedCrossRefGoogle Scholar
  9. Dunlap, G., & Egel, A. L. (1982). Motivational techniques. Educating and Understanding Autistic Children, 106–126.Google Scholar
  10. Dunlap, G., & Koegel, R. L. (1980). Motivating autistic children through stimulus variation. Journal of Applied Behavior Analysis, 13, 619–627.PubMedCrossRefPubMedCentralGoogle Scholar
  11. Elliott, C. D. (2006). Differential ability scales—second edition (DAS-II). San Antonio: Psychological Corporation.Google Scholar
  12. Gotham, K., Risi, S., Dawson, G., Tager-Flusberg, H., Joseph, R., Carter, A., et al. (2008). A replication of the autism diagnostic observation schedule (ADOS) revised algorithms. Journal of the American Academy of Child and Adolescent Psychiatry, 47, 642–651.PubMedCrossRefPubMedCentralGoogle Scholar
  13. Green, J., Charman, T., McConachie, H., Aldred, C., Slonims, V., Howlin, P., et al. (2010). Parent-mediated communication-focused treatment in children with autism. Lancet, 19, 2152–2160.CrossRefGoogle Scholar
  14. Guy, W. (1976). Clinical global impression scale. The ECDEU assessment manual for psychopharmacology-revised. Volume DHEW Publ No ADM 76, 28–222.Google Scholar
  15. Ilardi, S. S., & Craighead, W. E. (1994). The role of nonspecific factors in cognitive-behavior therapy for depression. Clinical Psychology: Science and Practice, 1, 138–155.Google Scholar
  16. Koegel, R. L., Camarata, S., Koegel, L. K., Ben-Tall, A., & Smith, A. E. (1998). Increasing speech intelligibility in children with autism. Journal of Autism and Developmental Disorders, 28, 241–251.PubMedCrossRefGoogle Scholar
  17. Koegel, R. L., & Egel, A. L. (1979). Motivating autistic children. Journal of Abnormal Psychology, 88, 418.PubMedCrossRefGoogle Scholar
  18. Koegel, R. L., & Frea, W. D. (1993). Treatment of social behavior in autism through the modification of pivotal social skills. Journal of Applied Behavior Analysis, 26, 369–377.PubMedCrossRefPubMedCentralGoogle Scholar
  19. Koegel, R. L., & Koegel, L. K. (2006). Pivotal response treatments for autism: Communication, social, and academic development. Brookes Publishing Company. PO Box 10624, Baltimore, MD 21285.Google Scholar
  20. Koegel, R. L., & Koegel, L. K. (2012). The PRT pocket guide: Pivotal response treatment for autism spectrum disorders. Brookes Publishing Company. PO Box 10624, Baltimore, MD 21285.Google Scholar
  21. Koegel, R. L., Koegel, L. K., & Brookman, L. I. (2003). Empirically supported pivotal response interventions for children with autism. In A. E. Kazdin (Ed.), Evidence-based psychotherapies for children and adolescents: evidence-based psychotherapies for children and adolescents (pp. 341–357). Yale University School of Medicine & Child Study Center. Google Scholar
  22. Koegel, R. K., Koegel, L. K., Green-Hopkins, I., & Barnes, C. C. (2010). Brief report: Question-asking and collateral language acquisition in children with autism. Journal of Autism and Developmental Disorders, 40, 509–515.CrossRefPubMedCentralGoogle Scholar
  23. Koegel, R. L., O’Dell, M. C., & Koegel, L. K. (1987). A natural language teaching paradigm for nonverbal autistic children. Journal of Autism and Developmental Disorders, 17, 187–200.PubMedCrossRefGoogle Scholar
  24. Koegel, R. L., Schreibman, L., Good, A., Cerniglia, L., Murphy, C., & Koegel, L. K. (1989). How to teach pivotal behaviors to children with autism: A training manual. University of California, Graduate School of Education.Google Scholar
  25. Laski, K. E., Charlop, M. H., & Schreibman, L. (1988). Training parents to use the natural language paradigm to increase their autistic children’s speech. Journal of Applied Behavior Analysis, 21, 391–400.PubMedCrossRefPubMedCentralGoogle Scholar
  26. LeBlanc, L. A., Geiger, K. B., Sautter, R. A., & Sidener, T. M. (2007). Using the natural language paradigm (NLP) to increase vocalizations of older adults with cognitive impairments. Research in Developmental Disabilities, 28, 437–444.PubMedCrossRefGoogle Scholar
  27. Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Jr, Leventhal, B. L., DiLavore, P. C., et al. (2000). The autism diagnostic observation schedule—generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30, 205–223.PubMedCrossRefGoogle Scholar
  28. Lord, C., Rutter, M., DiLavore, P., & Risi, S. (1999). Autism diagnostic observation schedule-WPS edition. Los Angeles: Western Psychological Services.Google Scholar
  29. Lovaas, O. I., et al. (1973). Some generalization and follow up measures on autistic children in behavior therapy. Journal of Applied Behavior Analysis, 6, 131–165.PubMedCrossRefPubMedCentralGoogle Scholar
  30. Macmillan, D. L. (1971). The problem of motivation in the education of the mentally retarded. Exceptional Children, 37, 579–586.PubMedGoogle Scholar
  31. Majnemer, A., Shevell, M. I., Rosenbaum, P., & Abrahamowicz, M. (2002). Early rehabilitation service utilization patterns in young children with developmental delays. Child: Care, Health and Development, 28, 29–37.Google Scholar
  32. Minjarez, M. B., Williams, S. E., Mercier, E. M., & Hardan, A. Y. (2011). Pivotal response group treatment program for parents of children with autism. Journal of Autism and Developmental Disorders, 41, 92–101.PubMedCrossRefGoogle Scholar
  33. Rao, P. A., Beidel, D. C., & Murray, M. J. (2008). Social skills interventions for children with asperger’s syndrome or high-functioning autism: A review and recommendations. Journal of Autism and Developmental Disorders, 38, 353–361.PubMedCrossRefGoogle Scholar
  34. Rogers, S. J., & Dawson, G. (2010). Early start Denver model for young children with autism: Promoting language, learning, and engagement. New York: Guilford Press.Google Scholar
  35. Rutter, M., Bailey, A., & Lord, C. (2003a). SCQ: Social communication questionnaire. Los Angeles: Western Psychological Services.Google Scholar
  36. Rutter, M., Le Couteur, A., & Lord, C. (2003b). Autism diagnostic interview-revised. Los Angeles: Western Psychological Services.Google Scholar
  37. Sansosti, F. J., & Powell-Smith, K. A. (2006). High-functioning autism and asperger’s syndrome. Children’s needs III: Development, prevention, and intervention, 949–963.Google Scholar
  38. Sparrow, S. S., Cicchetti, D. V., & Balla, D. A. (2005). Vineland adaptive behavior scales: Second edition (Vineland II), survey interview form. Livonia: Pearson Assessments.Google Scholar
  39. Stahmer, A. C. (1995). Teaching symbolic play skills to children with autism using pivotal response training. Journal of Autism and Developmental Disorders, 25, 123–141.PubMedCrossRefGoogle Scholar
  40. Steiner, A. M., Gengoux, G. W., Klin, A., & Chawarska, K. (2013). Pivotal response treatment for infants at-risk for autism spectrum disorders: A pilot study. Journal of Autism and Developmental Disorders, 43, 91–102.PubMedCrossRefPubMedCentralGoogle Scholar
  41. Szatmari, P., Bartolucci, G., Bremner, R., Bond, S., & Rich, S. (1989). A follow-up study of high-functioning autistic children. Journal of Autism and Developmental Disorders, 19, 213–225.PubMedCrossRefGoogle Scholar
  42. Tachibana, M., Kagitani-Shimono, K., Mohri, I., Yamamoto, T., Sanefuji, W., Nakamura, A., et al. (2013). Long-term administration of intranasal oxytocin is a safe and promising therapy for early adolescent boys with autism spectrum disorders. Journal of Child and Adolescent Psychopharmacology, 23, 123–127.PubMedCrossRefGoogle Scholar
  43. Venter, A., Lord, C., & Schopler, E. (1992). A follow-up study of high-functioning autistic children. Journal of Child Psychology and Psychiatry, 33, 489–597.PubMedCrossRefGoogle Scholar
  44. Vernon, T., Koegel, R. L., Dauterman, H., & Stolen, K. (2012). An early social engagement intervention for young children with autism and their parents. Journal of Autism and Developmental Disorders, 42, 2702–2717.PubMedCrossRefPubMedCentralGoogle Scholar
  45. Wiig, E. H., Secord, W., & Semel, E. M. (2004). CELF Preschool 2: Clinical evaluation of language fundamentals preschool. Pearson/PsychCorp.Google Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Pamela Ventola
    • 1
  • Hannah E. Friedman
    • 1
  • Laura C. Anderson
    • 1
  • Julie M. Wolf
    • 1
  • Devon Oosting
    • 1
  • Jennifer Foss-Feig
    • 1
  • Nicole McDonald
    • 1
  • Fred Volkmar
    • 1
  • Kevin A. Pelphrey
    • 1
  1. 1.Yale Child Study CenterYale University School of MedicineNew HavenUSA

Personalised recommendations