Pivotal Response Treatment for School-Aged Children and Adolescents with Autism Spectrum Disorder: A Randomized Controlled Trial

Abstract

Pivotal Response Treatment (PRT) is promising for children with Autism Spectrum Disorder (ASD), but more methodologically robust designed studies are needed. In this randomized controlled trial, forty-four children with ASD, aged 9–15 years, were randomly allocated to PRT (n = 22) or treatment-as-usual (TAU; n = 22). Measurements were obtained after 12- and 20-weeks treatment, and 2-month follow-up. PRT resulted in significant greater improvements on parent-rated social-communicative skills after 12 weeks treatment (p = .004, partial η2 = 0.22), compared to TAU. Furthermore, larger gains in PRT compared to TAU were observed on blindly rated global functioning, and parent-rated adaptive socialization skills and attention problems. Implications for clinical practice and suggestions for future research are discussed.

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Acknowledgments

The authors gratefully acknowledge all of the families who participated in this study. We also like to thank all the clinicians of Karakter who made this research possible, specifically Marloes Rikken, Jenny den Boer and Iris Servatius-Oosterling who were involved in designing the PRT protocol. Furthermore we would like to thank Anoek Lusseveld, Nikki Rulof, Lotte Gosens, Julianne Joosten, and Anne Schruijer for their help in recruitment and data collection. IBS, MDB, JKB, and WGS contributed to the study conception and design. Material preparation, and data collection were performed by MWPK and IBS. Data analysis was performed by MWPK. IBS, MDB, JKB and WGS were involved in interpretation of the data. The first draft of the manuscript was written by MWPK and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Funding

The study was supported by Fonds NutsOhra (project 1405-307) and by Karakter, expert center for the child- and adolescent psychiatry in The Netherlands. The study was further supported by the EU-AIMS (European Autism Interventions) and AIMS-2-TRIALS programmes which receive support from Innovative Medicines Initiative Joint Undertaking Grant No. 115300 and 777394, the resources of which are composed of financial contributions from the European Union’s FP7 and Horizon2020 Programmes, and from the European Federation of Pharmaceutical Industries and Associations (EFPIA) companies’ in-kind contributions, and AUTISM SPEAKS, Autistica and SFARI, and by the European Union Horizon2020 programme CANDY (Grant No. 847818).

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Correspondence to Manon W. P. de Korte.

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Jan K. Buitelaar has been in the past three years a consultant to/member of the advisory board of/and/or speaker for Takeda/Shire, Roche, Medice, Janssen Cilag, Angelini, and Servier. He is not an employee of any of these companies, and not a stock shareholder of any of these companies. He has no other financial or material support, including expert testimony, patents, and royalties. All other authors declare that they have no conflict of interest.

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de Korte, M.W.P., van den Berk-Smeekens, I., Buitelaar, J.K. et al. Pivotal Response Treatment for School-Aged Children and Adolescents with Autism Spectrum Disorder: A Randomized Controlled Trial. J Autism Dev Disord (2021). https://doi.org/10.1007/s10803-021-04886-0

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Keywords

  • Autism spectrum disorder (ASD)
  • Pivotal response treatment (PRT)
  • Randomized controlled trial
  • School-age
  • Adolescents