Group Pivotal Response Treatment (PRT) for Parents
More children than ever before are being
diagnosed with autism spectrum disorder (ASD). The dramatic increase in the
prevalence of children with ASD has created an urgent need
for effective and efficient service delivery models. Parents and caregivers
everywhere are eager for credible, research-based information on the most
effective treatments for ASD. Utilizing a group training format, researchers
have found that parents can learn to successfully incorporate an established
treatment for ASD into everyday interactions with their children. According to
findings published in the Journal
of Child Psychology and Psychiatry, parents learned to successfully
apply an evidence-based therapy method called Pivotal Response
Treatment (PRT), also referred to as Pivotal Response Training, and
observed meaningful improvement in their children.
PRT is one of the best studied and
validated behavioral treatments for autism. It is a naturalistic behavioral
intervention derived from the principles of Applied Behavior Analysis (ABA). PRT builds on learner initiative and
interests, and is particularly effective for developing communication,
language, play, and social behaviors. PRT was developed to create a more
efficient and effective intervention by enhancing four pivotal learning
variables: motivation, responding to multiple cues, self-management, and
self-initiations. According to theory, these skills are pivotal because they
are the foundational skills upon which learners with ASD can make widespread
and generalized improvements in many other areas.
The objective of the study was to evaluate a
PRT parent training group (PRTG) for targeting language deficits in young
children with ASD. For the study, researchers randomly assigned parents of 53
children with autism to participate in 12 weeks of classes on PRT or a
psychoeducation group (PEG). All of the children were between the ages of 2 and
6 and had language delays. The PRTG taught parents behavioral techniques to
facilitate language development. The PEG taught general information about ASD.
All of the children were assessed at the outset of the study, at six weeks and
at 12 weeks to determine their language abilities. Parents were also videotaped
at six and 12 weeks to measure how well they were applying the treatment.
The results indicated that parents were able
to learn PRT in a group format, as the majority of parents in the PRTG (84%)
were using it correctly by the end of the study. Children also demonstrated
improvement in adaptive communication skills. Children whose parents learned
the technique reported greater gains in both the number of words used and how
they used them as compared to children in the psychoeducation (control) group.
This study is considered the first randomized
controlled test of group-delivered PRT and one of the largest experimental
investigations of the PRT model to date. The findings suggest that specific
instruction in PRT results in greater skill acquisition for both parents and
children, especially in functional and adaptive communication skills. Even with
the improvements, researchers said that parent-implemented approaches are
intended to augment, not replace, autism therapies from professionals. Likewise,
further research in PRT is warranted to replicate the observed results and
address other core ASD symptoms. It should also be noted that research findings
are not the only factor involved when selecting an intervention. Professional
judgment and the values and preferences of parents, caregivers, and the
individual are also important.
Hardan, A. Y., Gengoux, G. W., Berquist, K.
L., Libove, R. A., Ardel, C. M., Phillips, J., Frazier, T. W. and Minjarez, M.
B. (2014), A randomized controlled trial of Pivotal Response Treatment Group
for parents of children with autism. Journal
of Child Psychology and Psychiatry. doi: 10.1111/jcpp.12354
Lee A. Wilkinson, PhD, CCBT, NCSP is author of
the award-winning books, A
Best Practice Guide to Assessment and Intervention for Autism and Asperger
Syndrome in Schools and Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT. He
is also editor of a best-selling text in the APA School Psychology Book Series, Autism
Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and
Intervention in Schools. His latest book is A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd edition).
