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: Standardized calibrated severity scores (CSS) have been created for Autism Diagnostic Observation Schedule, 2nd edition (ADOS-2) Modules 1-4 as a metric of the relative severity of autism-specific behaviors. Total and domain CSS were created for the Toddler Module to facilitate comparison to other modules. Analyses included 388 children with ASD age 12-30 months and were replicated on 435 repeated assessments from 127 children with ASD. Compared to raw scores, associations between total and domain CSS and participant characteristics were reduced in the original sample. Verbal IQ effects on Social Affect-CSS were not reduced in the replication sample. Toddler Module CSS increases comparability of ADOS-2 scores across modules and allows studies of symptom trajectories to extend to earlier ages.
    International Meeting for Autism Research 2011; 05/2011
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