Pivotal Response Treatment for Infants At-Risk for Autism Spectrum Disorders: A Pilot Study

Yale Child Study Center, 40 Temple Street, New Haven, CT, 06510, USA, .
Journal of Autism and Developmental Disorders (Impact Factor: 3.06). 05/2012; 43(1). DOI: 10.1007/s10803-012-1542-8
Source: PubMed


Presently there is limited research to suggest efficacious interventions for infants at-risk for autism. Pivotal response treatment (PRT) has empirical support for use with preschool children with autism, but there are no reports in the literature utilizing this approach with infants. In the current study, a developmental adaptation of PRT was piloted via a brief parent training model with three infants at-risk for autism. Utilizing a multiple baseline design, the data suggest that the introduction of PRT resulted in increases in the infants' frequency of functional communication and parents' fidelity of implementation of PRT procedures. Results provide preliminary support for the feasibility and utility of PRT for very young children at-risk for autism.

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    • "A total of 484 children with a mean age of 23.26 months were included in this review. Those children were diagnosed with ASD (í µí±› = 248; [34, 36–40, 42–45]) or identified as being at risk of ASD based on either the presence of early markers (í µí±› = 156; [10] [41] [46]) or because they were infant siblings of probands with ASD (í µí±› = 80; [47] [48]). Two hundred seventy-seven (57%) parent-child dyads received a parent training intervention, whereas the remaining 207 children were controls. "
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    ABSTRACT: Background. Now that early identification of toddlers with autism spectrum disorder (ASD) is possible, efforts are being made to develop interventions for children under three years of age. Most studies on early intervention have focused on intensive and individual interventions. However, parent training interventions that help parents interact and communicate with their toddlers with ASD might be a good alternative to promote the development of their child's sociocommunicative skills. Objective. This review aims to systematically examine (1) the use of parent training interventions for children with ASD under three years of age and (2) their effects on children's development, parents' well-being and parent-child interactions. Methods. Systematic searches were conducted to retrieve studies in which at least one parent was trained to implement ASD-specific techniques with their toddlers (0-36 months old) with a diagnosis of or suspected ASD. Results. Fifteen studies, involving 484 children (mean age: 23.26 months), were included in this review. Only two of them met criteria for conclusive evidence. Results show that parents were able to implement newly learned strategies and were generally very satisfied with parent training programs. However, findings pertaining to the children's communication and socioemotional skills, parent-child interactions, and parental well-being were inconclusive.
    05/2014; 2014(3):839890. DOI:10.1155/2014/839890
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    • "A modified PRT was used to assess the feasibility of rapidly increasing infant motivation to engage in social interaction. Motivation is the primary focus of PRT intervention, therefore, developmentally appropriate components of PRT that have been documented to be effective with 12-month-old infants (Steiner et al., 2012), preschoolaged children, and beyond (Koegel & Koegel, 2012; Koegel , O'Dell, & Koegel, 1987) were incorporated. These components included the use of infant preferred activities, task variation, interspersal of preferred and neutral activities , and reinforcement. "
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    ABSTRACT: Empirical studies have documented a variety of social abnormalities in infancy that indicate risk for later social and behavioral difficulties. There is very little research illustrating the presence of such behavioral vulnerabilities with frequent repeated measures, and the feasibility of designing interventions for improving social engagement in infants under one year of age. In the context of a multiple baseline research design, three young infants, ages 4, 7, and 9 months referred for concerns about social engagement were assessed for affect, social interest, eye contact avoidance, and response to name. Additionally, the feasibility of implementing an intervention to target social behaviors was examined. Results demonstrated that: (1) consistently low or erratic levels of social behavior were evident throughout the baseline assessment period; (2) these patterns could be improved with a brief intervention (a modified Pivotal Response Treatment) showing an immediate increase and stability of social engagement; and (3) social engagement remained at a stable and high level at follow-up. The results are discussed in terms of implications of early assessment and intervention for clinical populations, including infants with Autism Spectrum Disorder.
    Journal of Positive Behavior Interventions 04/2014; 16(2):69-80. DOI:10.1177/1098300713482977 · 1.69 Impact Factor
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    ABSTRACT: Background: The ability to spontaneously attend to the social overtures and activities of others is essential for the development of social cognition and communication. This ability is critically impaired in toddlers with autism spectrum disorders (ASD); however, it is not clear if prodromal symptoms in this area are already present in the first year of life of those affected by the disorder. Methods: To examine whether 6-month-old infants later diagnosed with ASD exhibit atypical spontaneous social monitoring skills, visual responses of 67 infants at high-risk and 50 at low-risk for ASD were studied using an eye-tracking task. Based on their clinical presentation in the third year, infants were divided into those with ASD, those exhibiting atypical development, and those developing typically. Results: Compared with the control groups, 6-month-old infants later diagnosed with ASD attended less to the social scene, and when they did look at the scene, they spent less time monitoring the actress in general and her face in particular. Limited attention to the actress and her activities was not accompanied by enhanced attention to objects. Conclusions: Prodromal symptoms of ASD at 6 months include a diminished ability to attend spontaneously to people and their activities. A limited attentional bias toward people early in development is likely to have a detrimental impact on the specialization of social brain networks and the emergence of social interaction patterns. Further investigation into its underlying mechanisms and role in psychopathology of ASD in the first year is warranted.
    Biological psychiatry 01/2013; 74(3). DOI:10.1016/j.biopsych.2012.11.022 · 10.26 Impact Factor
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