Peer-Mediated Pivotal Response Treatment for Children With Autism Spectrum Disorder: Provider Perspectives on Acceptability, Feasibility, and Fit at School

2018 ◽  
Vol 34 (4) ◽  
pp. 259-282 ◽  
Author(s):  
Ainsley M. Boudreau ◽  
Penny Corkum ◽  
Isabel M. Smith

Few effective school-based interventions that target social-communication skills are available for students with autism spectrum disorder (ASD). The growing gap between interventions designed for use in research settings and the school environment is concerning for researchers and clinicians alike. Research methods that incorporate relevant stakeholders (e.g., educators, early intervention providers [EIPs]) throughout the process from intervention design to implementation help to bridge this gap. This study used content analysis of interview data to evaluate the acceptability and feasibility of a specific peer-mediated intervention (PMI) for school use for young children with ASD. We explored educators’ and EIPs’ perspectives on evidence-based practice (EBP), the components of the proposed intervention (using Pivotal Response Treatment, PRT), and the overall acceptability and feasibility of using the intervention at school, through interviews with 29 participants (24 elementary school educators and five EIPs serving children with ASD). Results indicated that stakeholders had some knowledge of PRT and found the PMI approach to be acceptable and feasible. Several potential challenges were identified with respect to typically developing peers as intervention agents. We discuss educators’ specific recommendations for intervention adaptation and provide a model for researchers and educators to collaborate in promoting optimal use of EBPs at school.

2021 ◽  
Author(s):  
Krista Nicole Drapalik ◽  
David Grodberg ◽  
Pamela Ventola

BACKGROUND Pivotal Response Treatment (PRT), an evidence-based and parent-delivered intervention, is designed to improve social communication in individuals with autism spectrum disorder (ASD). OBJECTIVE To assess the feasibility, acceptability, and clinical effects of an online model of PRT delivered via MindNest Health that aims to provide self-directed and engaging online modules, real-time coaching and feedback, and accessible stepped-care to large populations of parents seeking resources for their children with ASD. METHODS Male and female children, ages 2-7 years old with single-word to phrase-level speech, were eligible to participate in the study. Families were randomized to the online parent training condition or control condition. The online component of the intervention consisted of eight 20-minute online courses of content describing parent training principles in PRT. Four 1-hour videoconferences were held after course 1, course 3, course 5, and course 8. Parents were given 1-2 weeks to complete each course. Parents completed the Client Expectancies Questionnaire (CCQ) at Week 2 and endpoint, as well as the Behavioral Intervention Rating Scale (BIRS) at endpoint to assess parental expectancies and treatment acceptability and effectiveness. RESULTS 9 of 14 subjects completed the study curriculum in the online parent training condition, and 6 of 12 subjects completed the control condition. A total of 58% subjects completed study curriculum by study closure. Within the online parent training condition, there was a significant increase in mean CCQ Total Scores from 25.38 ± 3.25 at baseline to 27.5 ± 3.74 at endpoint (P = .04), mean CCQ Confidence Scores from 6.0 ± 1.07 at baseline to 6.75 ± 0.89 at endpoint (P = .02), and mean CCQ Other Improvement Scores 5.25 ± 0.89 at baseline to 6.25 ± 1.28 at endpoint (P = .009). Within the control condition, a modest increase in CCQ scores existed (Confidence △M = +.25; Recommend △M = +.25; Total Score △M = +.50), but no significant results were found (Confidence P = .38; Recommend P = .36; Total Score P = .43). Out of the eleven parents that completed the BIRS at endpoint, 83% parents endorsed they slightly agree or agree with over 93% of the Acceptability factor items on the BIRS. CONCLUSIONS The feasibility of this online treatment is endorsed by the high rate of online module completion and attendance to videoconferences within the online parent training group. Acceptability of treatment is supported by strong ratings on the CCQ and significant improvements in scores as well as strong ratings on the BIRS. This study’s small sample size limits the conclusions that can be drawn, however, the PRT MindNest Health platform holds promise to support parents of children with ASD who are unable to access traditional, in-person parent-mediated intervention for their child.


2017 ◽  
Author(s):  
Lisa Lokshina ◽  
Alexander Faisman ◽  
Jonah Elgart ◽  
Edward Khokhlovich ◽  
Yuriy Gankin ◽  
...  

In this manuscript, we present data from an ongoing study of a tablet-based therapeutic application designed for newly diagnosed children with autism spectrum disorder (ASD) and modeled on Pivotal Response Treatment (PRT), a technique known to be effective in educating children with ASD. We describe the creation of a variety of analogous tasks that were presented both verbally and nonverbally within the application. This work presents our hypothesis that children with ASD perform better when a command is presented nonverbally. This approach may have important implication for the most effective way of delivering early therapeutic interventions to children with ASD.


2013 ◽  
Vol 30 (2) ◽  
pp. 159-173 ◽  
Author(s):  
Amie M King ◽  
Melissa Thomeczek ◽  
Grayce Voreis ◽  
Victoria Scott

This exploratory study was conducted to describe how children and young adults with autism spectrum disorder (ASD) are currently using iPads® and applications, to explore the role of education professionals on iPad® and application use, and to determine potential research needs regarding iPad® use in children with ASD. Naturalistic observations were conducted on six individuals (ages 6;6 to 20;8) with ASD while they were using iPads® in their school environment. The data suggest that (1) the participants used iPads® and applications for a variety of purposes, (2) there was considerable variability regarding whether or not the application was used consistent with its intended function, and (3) the presence of an education professional and the type of application impacted the variability in functional use of the application. Pertinent lines of research that are needed to expand the base of evidence regarding effective iPad® use in children with ASD are discussed.


2019 ◽  
pp. 082957351987092
Author(s):  
Ainsley M. Boudreau ◽  
Joseph M. Lucyshyn ◽  
Penny Corkum ◽  
Katelyn Meko ◽  
Isabel M. Smith

The main objective of the present study was to evaluate the efficacy of peer training in pivotal response treatment (PRT) for children with autism spectrum disorder (ASD) in their first year of school. Four 6-year-old boys with ASD and eight typically developing (TD) children (aged 4-6 years) participated in the study. A non-concurrent multiple-probe (across participants) baseline design was used. Outcomes were assessed before, immediately after, and 6 to 9 weeks following an eight-session training period. Overall, rates of peer engagement increased following training for three of the four children with ASD and rates of social initiation increased following training for two of the four children with ASD; these gains were maintained at follow-up. TD peers’ fidelity in implementing PRT techniques also improved. The present study suggests that relatively brief peer training in PRT can produce immediate and short-term sustained gains in peer-related social communication skills of children with ASD at school.


2020 ◽  
Vol 29 (1) ◽  
pp. 327-334 ◽  
Author(s):  
Allison Gladfelter ◽  
Cassidy VanZuiden

Purpose Although repetitive speech is a hallmark characteristic of autism spectrum disorder (ASD), the contributing factors that influence repetitive speech use remain unknown. The purpose of this exploratory study was to determine if the language context impacts the amount and type of repetitive speech produced by children with ASD. Method As part of a broader word-learning study, 11 school-age children with ASD participated in two different language contexts: storytelling and play. Previously collected language samples were transcribed and coded for four types of repetitive speech: immediate echolalia, delayed echolalia, verbal stereotypy, and vocal stereotypy. The rates and proportions of repetitive speech were compared across the two language contexts using Wilcoxon signed-ranks tests. Individual characteristics were further explored using Spearman correlations. Results The children produced lower rates of repetitive speech during the storytelling context than the play-based context. Only immediate echolalia differed between the two contexts based on rate and approached significance based on proportion, with more immediate echolalia produced in the play-based context than in the storytelling context. There were no significant correlations between repetitive speech and measures of social responsiveness, expressive or receptive vocabulary, or nonverbal intelligence. Conclusions The children with ASD produced less immediate echolalia in the storytelling context than in the play-based context. Immediate echolalia use was not related to social skills, vocabulary, or nonverbal IQ scores. These findings offer valuable insights into better understanding repetitive speech use in children with ASD.


2016 ◽  
Vol 9 (10) ◽  
pp. 128 ◽  
Author(s):  
Faihan Alotaibi ◽  
Nabil Almalki

<p class="apa">The present study sought to examine parents’ perceptions of early interventions and related services for children with autism spectrum disorder (ASD) in Saudi Arabia. In this study a survey was distributed to a sample of 80 parents with children who have ASD. Parents also were asked open-ended questions to enable them to provide suggestions. The findings indicate that parents have varying perceptions of early interventions and related services. However, they seem to agree that these services are important in assisting their children. Accordingly, parents have suggested that the government needs to increase these services by providing more centers for children with ASD in Saudi Arabia, providing more specialists to deal with children with ASD, promoting inclusion in regular schools and providing more information on early intervention.</p>


Author(s):  
Ana Gentil-Gutiérrez ◽  
José Luis Cuesta-Gómez ◽  
Paula Rodríguez-Fernández ◽  
Jerónimo Javier González-Bernal

(1) Background: Children with Autism Spectrum Disorder (ASD) frequently have difficulties in processing sensory information, which is a limitation when participating in different contexts, such as school. The objective of the present study was to compare the sensory processing characteristics of children with ASD in the natural context of school through the perception of professionals in the field of education, in comparison with neurodevelopmental children (2) Methods: A cross-sectional descriptive study as conducted with study population consisting of children between three and ten years old, 36 of whom were diagnosed with ASD and attended the Autismo Burgos association; the remaining 24 had neurotypical development. The degree of response of the children to sensory stimuli at school was evaluated using the Sensory Profile-2 (SP-2) questionnaire in its school version, answered by the teachers. (3) Results: Statistically significant differences were found in sensory processing patterns (p = 0.001), in sensory systems (p = 0.001) and in school factors (p = 0.001). Children with ASD who obtained worse results. (4) Conclusions: Children with ASD are prone to present sensory alterations in different contexts, giving nonadapted behavioral and learning responses.


Author(s):  
Mizuho Takayanagi ◽  
Yoko Kawasaki ◽  
Mieko Shinomiya ◽  
Hoshino Hiroshi ◽  
Satoshi Okada ◽  
...  

AbstractThis study was a systematic review of research using the Wechsler Intelligence Scale for Children (WISC) with Autism Spectrum Disorder (ASD) to examine cognitive characteristics of children with ASD beyond the impact of revisions based on WISC and diagnostic criteria changes. The classic “islets of ability” was found in individuals with full-scale IQs < 100. The “right-descending profiles” were observed among high IQ score individuals. High levels on the Block Design and low Coding levels were consistently found regardless of the variation in intellectual functioning or diagnosis. This review identified patterns of cognitive characteristics in ASD individuals using empirical data that researchers may have previously been aware of, based on their experiences, owing to the increased prevalence of ASD.


2021 ◽  
Vol 11 (6) ◽  
pp. 488
Author(s):  
Daniel A Rossignol ◽  
Richard E Frye

Autism spectrum disorder (ASD) is a neurodevelopmental disorder affecting approximately 2% of children in the United States. Growing evidence suggests that immune dysregulation is associated with ASD. One immunomodulatory treatment that has been studied in ASD is intravenous immunoglobulins (IVIG). This systematic review and meta-analysis examined the studies which assessed immunoglobulin G (IgG) concentrations and the therapeutic use of IVIG for individuals with ASD. Twelve studies that examined IgG levels suggested abnormalities in total IgG and IgG 4 subclass concentrations, with concentrations in these IgGs related to aberrant behavior and social impairments, respectively. Meta-analysis supported possible subsets of children with ASD with low total IgG and elevated IgG 4 subclass but also found significant variability among studies. A total of 27 publications reported treating individuals with ASD using IVIG, including four prospective, controlled studies (one was a double-blind, placebo-controlled study); six prospective, uncontrolled studies; 2 retrospective, controlled studies; and 15 retrospective, uncontrolled studies. In some studies, clinical improvements were observed in communication, irritability, hyperactivity, cognition, attention, social interaction, eye contact, echolalia, speech, response to commands, drowsiness, decreased activity and in some cases, the complete resolution of ASD symptoms. Several studies reported some loss of these improvements when IVIG was stopped. Meta-analysis combining the aberrant behavior checklist outcome from two studies demonstrated that IVIG treatment was significantly associated with improvements in total aberrant behavior and irritability (with large effect sizes), and hyperactivity and social withdrawal (with medium effect sizes). Several studies reported improvements in pro-inflammatory cytokines (including TNF-alpha). Six studies reported improvements in seizures with IVIG (including patients with refractory seizures), with one study reporting a worsening of seizures when IVIG was stopped. Other studies demonstrated improvements in recurrent infections, appetite, weight gain, neuropathy, dysautonomia, and gastrointestinal symptoms. Adverse events were generally limited but included headaches, vomiting, worsening behaviors, anxiety, fever, nausea, fatigue, and rash. Many studies were limited by the lack of standardized objective outcome measures. IVIG is a promising and potentially effective treatment for symptoms in individuals with ASD; further research is needed to provide solid evidence of efficacy and determine the subset of children with ASD who may best respond to this treatment as well as to investigate biomarkers which might help identify responsive candidates.


2021 ◽  
pp. 105381512199557
Author(s):  
Jay Buzhardt ◽  
Anna Wallisch ◽  
Dwight Irvin ◽  
Brian Boyd ◽  
Brenda Salley ◽  
...  

One of the earliest indicators of autism spectrum disorder (ASD) is delay in language and social communication. Despite consensus on the benefits of earlier diagnosis and intervention, our understanding of the language growth of children with ASD during the first years of life remains limited. Therefore, this study compared communication growth patterns of infants and toddlers with ASD to growth benchmarks of a standardized language assessment. We conducted a retrospective analysis of growth on the Early Communication Indicator (ECI) of 23 infants and toddlers who received an ASD diagnosis in the future. At 42 months of age, children with ASD had significantly lower rates of gestures, single words, and multiple words, but significantly higher rates of nonword vocalizations. Children with ASD had significantly slower growth of single and multiple words, but their rate of vocalization growth was significantly greater than benchmark. Although more research is needed with larger samples, because the ECI was designed for practitioners to monitor children’s response to intervention over time, these findings show promise for the ECI’s use as a progress monitoring measure for young children with ASD. Limitations and the need for future research are discussed.


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