scholarly journals Pivotal response treatment: A study into the relationship between therapist characteristics and fidelity of implementation

Autism ◽  
2019 ◽  
Vol 24 (2) ◽  
pp. 499-514
Author(s):  
Rianne Verschuur ◽  
Bibi Huskens ◽  
Hubert Korzilius ◽  
Leonhard Bakker ◽  
Michelle Snijder ◽  
...  
Keyword(s):  
Treatment Fidelity ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Pivotal Response Treatment ◽  
Therapist Characteristics ◽  
Evidence Based Practices ◽  
Treatment Implementation ◽  
Child Relationship ◽  
The Relationship ◽  
Therapist Personality

In this study, we investigated the relationship between fidelity of pivotal response treatment implementation and therapist characteristics, such as therapist personality, therapist–child relationship, therapist attitude toward evidence-based practices, and therapist experience. We also explored whether child age and autism symptom severity were related to pivotal response treatment fidelity. Participants were 41 level III certified pivotal response treatment therapists who recorded three 10-min pivotal response treatment sessions and completed four questionnaires to measure therapist characteristics. Results indicated that therapists’ attitude toward evidence-based practices, specifically openness to innovation, and therapists’ experience with pivotal response treatment significantly predicted fidelity of pivotal response treatment implementation. Cross-validation methods largely confirmed these findings. Therapist personality, therapist–child relationship, and child characteristics were not significantly related to pivotal response treatment fidelity. Implications for clinical practice and directions for future research are discussed. Lay abstract Pivotal response treatment is a naturalistic behavioral intervention that teaches pivotal skills to children with autism spectrum disorder to produce widespread gains in other skills. Although most children with autism spectrum disorder benefit from pivotal response treatment, intervention outcomes vary considerably among children. Fidelity of intervention implementation (i.e. the extent to which an intervention is implemented as intended) may affect intervention outcomes. In this study, we studied the relationship between fidelity of pivotal response treatment implementation and therapist characteristics, such as therapist personality, therapist–child relationship, therapist attitude toward evidence-based practices, and therapist experience. We also explored whether a child’s age and autism symptom severity were related to pivotal response treatment fidelity. Participants were 41 pivotal response treatment therapists who videotaped three pivotal response treatment sessions and completed four questionnaires to measure therapist characteristics. This study found that therapists’ openness to innovation and their experience with pivotal response treatment predicted fidelity of implementation. Therapist personality, therapist–child relationship, and child characteristics were not related to pivotal response treatment fidelity. The results of this study emphasize that it is important (1) to target therapists’ attitudes toward innovation prior to or during training in pivotal response treatment and (2) to provide therapists with ongoing supervision and feedback after training to increase fidelity of implementation and thus to improve intervention outcomes for children with autism spectrum disorder.

scholarly journals Pivotal Response Treatment with and without robot-assistance for children with autism: a randomized controlled trial

2021 ◽  
Author(s):  
Iris van den Berk-Smeekens ◽  
Manon W. P. de Korte ◽  
Martine van Dongen-Boomsma ◽  
Iris J. Oosterling ◽  
Jenny C. den Boer ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Pivotal Response Treatment ◽  
Robot Assisted ◽  
Randomized Controlled ◽  
Children With Asd ◽  
Robot Assistance

AbstractPivotal response treatment (PRT) is a promising intervention focused on improving social communication skills in children with autism spectrum disorder (ASD). Since robots potentially appeal to children with ASD and may contribute to their motivation for social interaction, this exploratory randomized controlled trial (RCT) was conducted comparing PRT (PRT and robot-assisted PRT) with treatment-as-usual (TAU). Seventy-three children (PRT: n = 25; PRT + robot: n = 25; TAU: n = 23) with ASD, aged 3–8 years were assessed at baseline, after 10 and 20 weeks of intervention, and at 3-month follow-up. There were no significant group differences on parent- and teacher-rated general social-communicative skills and blindly rated global functioning directly after treatment. However, at follow-up largest gains were observed in robot-assisted PRT compared to other groups. These results suggest that robot-assistance may contribute to intervention efficacy for children with ASD when using game scenarios for robot-child interaction during multiple sessions combined with motivational components of PRT. This trial is registered at https://www.trialregister.nl/trial/4487; NL4487/NTR4712 (2014-08-01).

scholarly journals Receptive Language in Primary-School-Aged Children with Autism Spectrum Disorder.

2021 ◽  
Vol 10 (4) ◽  
pp. 137-161
Author(s):  
D.S. Pereverzeva ◽  
U.A. Mamokhina ◽  
E.Yu. Davydova ◽  
A.A. Lopukhina ◽  
V.G. Arutiunian ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Autistic Traits ◽  
Children With Autism ◽  
Receptive Language ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Verbal Intelligence ◽  
School Aged Children ◽  
Autistic Disorders ◽  
The Relationship

The objective of the present study is to investigate the relationship between the receptive language, and the index of non-verbal intelligence and the level of severity of autistic disorders in primary-school-aged children with Autism spectrum disorder. One of the main areas influenced by autistic disorders is communication. Therefore, the study of the language abilities of such children and factors that affect them provides a better approach to the therapy and education. The sample included 50 children aged 7–11 years diagnosed with autism spectrum disorders. Children were tested using the KORABLIK method (basic linguistic skills), the Kaufman Assessment Battery for Children (KABC-II) or the Wechsler Intelligence Scale for Children ― Third Edition (WISC-III) (non-verbal intelligence), the Autism Diagnosis Observation Schedule ― Second Edition (ADOS-II) (autistic traits). The results support the hypothesis of the relationship between receptive language skills, the index of non-verbal intelligence, and symptoms of autism. The severity of autistic traits is negatively associated with some phonological and lexical levels of the receptive speech, as well as with understanding of discourse. The non-verbal intelligence index is positively associated with speech comprehension at all levels. A specific feature of receptive language in children with Autism spectrum disorder aged 7–11 years is the uneven development, which is associated with the severity of autistic traits and is not associated with the intelligence level.

Hair Cortisol and Self-Injurious Behavior Among Children With Autism Spectrum Disorder

2021 ◽  
Vol 126 (2) ◽  
pp. 158-166
Author(s):  
Andrea B. Courtemanche ◽  
William R. Black ◽  
Jerrold S. Meyer
Keyword(s):  
Autism Spectrum Disorder ◽  
Problem Behavior ◽  
Physiological Stress ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Parent Ratings ◽  
Hair Cortisol ◽  
Hpa Axis Activity ◽  
The Relationship

Abstract Elevated salivary cortisol levels have been documented in individuals who engage in self-injurious behavior (SIB), indicating acute physiological stress. Less is known about the chronicity of stress and SIB. We analyzed the relationship between parent ratings of problem behavior and hair cortisol concentrations (an index of chronic adrenocortical activity) in 23 children with autism spectrum disorder (ASD). Parent ratings of problem behavior were not significantly correlated with hair cortisol concentrations. When children were categorized into groups based on the frequency and severity of SIB, participants with the greatest frequency and severity of SIB had higher hair cortisol concentrations compared to children without SIB. Frequent and severe SIB may be associated with altered hypothalamic-pituitary-adrenal (HPA) axis activity in children with ASD.

Feeding Challenges in Children With Autism and the Relationship With Parent and Child Outcomes

2021 ◽  
Vol 75 (Supplement_2) ◽  
pp. 7512500037p1-7512500037p1
Author(s):  
Brittany St John ◽  
Muhammad Al-Heizan ◽  
Molly Hamre ◽  
Karla Ausderau ◽  
Kate Dorrance ◽  
...  
Keyword(s):  
Parenting Stress ◽  
Child Outcomes ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Children With Asd ◽  
Different Types ◽  
Sensory Responses ◽  
The Relationship ◽  
Feeding Interventions ◽  
Family Centered

Abstract Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. This study presents the relationships between different types of feeding challenges for children with autism spectrum disorder (ASD) to specific sensory patterns, parenting stress, and overall adaptive behaviors. The findings of this study suggest children with ASD demonstrate unique patterns of feeding challenges and sensory responses that are significantly connected to parenting stress and adaptive behavior and can inform the development of targeted family-centered feeding interventions. Primary Author and Speaker: Brittany St John Additional Authors and Speakers: Muhammad Al-Heizan, Molly Hamre, and Karla Ausderau Contributing Authors: Kate Dorrance, Colleen Althoff

Mindfulness-Based Interventions and Parent-Child Relationship in Parents of Children With Autism Spectrum Disorder

2022 ◽  
pp. 110-126
Author(s):  
Kamlam Gopalkrishnan Iyer
Keyword(s):  
Autism Spectrum Disorder ◽  
Indian Subcontinent ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Age Group ◽  
Parent Child Relationship ◽  
Child Relationship ◽  
Relationship Importance ◽  
Parent Child

Mindfulness has been noticed in the domain of psychology and neuroscience for the last two decades. With the plethora of studies based on interventional benefits of mindfulness-based techniques in various populations, the present review assesses if parent-child relationship studies effectively use mindfulness-based interventions on parents of children with autism spectrum disorder (ASD). The children are in the age group of below 5 years. The aspects of ASD, mindfulness techniques, and parent-child relationship importance are explored, albeit briefly. One study could be reviewed and was assessed for its treatment fidelity. The conclusion was based on the need to conduct more mindfulness-based intervention studies for the parent population of children in the younger ages and with ASD. This review recommends such replication of studies on the parents of the Indian subcontinent as well.

Self-initiations in young children with autism during Pivotal Response Treatment with and without robot assistance

Autism ◽  
2020 ◽  
Vol 24 (8) ◽  
pp. 2117-2128 ◽  
Author(s):  
Manon WP De Korte ◽  
Iris van den Berk-Smeekens ◽  
Martine van Dongen-Boomsma ◽  
Iris J Oosterling ◽  
Jenny C Den Boer ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Pivotal Response Treatment ◽  
Robot Assisted ◽  
Communicative Skills ◽  
Robot Assistance ◽  
Social Communicative

The aim of this study was to investigate the effect of Pivotal Response Treatment versus robot-assisted Pivotal Response Treatment on self-initiations of children with autism spectrum disorder and to explore the relation between self-initiations and collateral gains in general social-communicative skills. Forty-four participants with autism spectrum disorder aged 3–8 years (Pivotal Response Treatment: n = 20, Pivotal Response Treatment + robot: n = 24), who were recruited as part of a larger randomized controlled trial (number NL4487/NTR4712, https://www.trialregister.nl/trial/4487 ), were included. Self-initiations were blindly coded, assessing video probes of all parent–child sessions using an event-recording system. General social-communicative skills were assessed with the parent- and teacher-rated Social Responsiveness Scale during intervention and at 3-month follow-up. Results using linear mixed-effects models showed overall gains in self-initiations during both Pivotal Response Treatment intervention groups (estimate = 0.43(0.15), 95% confidence interval (CI): 0.13–0.73), with larger gains in functional self-initiations in children receiving robot-assisted Pivotal Response Treatment (estimate = −0.27(0.12), 95% confidence interval: −0.50 to −0.04). Growth in self-initiations was related to higher parent-rated social awareness at follow-up compared with baseline in the total sample ( r = −0.44, p = 0.011). The clinical implications of these findings, as well as directions for future research in the utility of Pivotal Response Treatment and robot assistance in autism spectrum disorder intervention, are discussed. Lay abstract The initiation of social interaction is often defined as a core deficit of autism spectrum disorder. Optimizing these self-initiations is therefore a key component of Pivotal Response Treatment, an established intervention for children with autism spectrum disorder. However, little is known about the development of self-initiations during intervention and whether this development can be facilitated by robot assistance within Pivotal Response Treatment. The aim of this study was to (1) investigate the effect of Pivotal Response Treatment and robot-assisted Pivotal Response Treatment on self-initiations (functional and social) of young children with autism spectrum disorder over the course of intervention and (2) explore the relation between development in self-initiations and additional gains in general social-communicative skills. Forty-four children with autism spectrum disorder (aged 3–8 years) were included in this study. Self-initiations were assessed during parent–child interaction videos of therapy sessions and coded by raters who did not know which treatment (Pivotal Response Treatment or robot-assisted Pivotal Response Treatment) the child received. General social-communicative skills were assessed before start of the treatment, after 10 and 20 weeks of intervention and 3 months after the treatment was finalized. Results showed that self-initiations increased in both treatment groups, with the largest improvements in functional self-initiations in the group that received robot-assisted Pivotal Response Treatment. Increased self-initiations were related to higher parent-rated social awareness 3 months after finalizing the treatment.

scholarly journals Effects of pivotal response treatment on reciprocal vocal contingency in a randomized controlled trial of children with autism spectrum disorder

Autism ◽  
2020 ◽  
Vol 24 (6) ◽  
pp. 1566-1571
Author(s):  
Jena McDaniel ◽  
Paul Yoder ◽  
Madison Crandall ◽  
Maria Estefania Millan ◽  
Christina Mich Ardel ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Children With Autism ◽  
Parent Report ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Pivotal Response Treatment ◽  
Control Group ◽  
Child Interaction ◽  
Parent Child Interaction ◽  
Treatment Package

A pivotal response treatment package consisting of clinician-delivered and parent-implemented strategies was recently found to be effective in improving language and social communication deficits in children with autism spectrum disorder. Reciprocal vocal contingency, an automated measure of vocal reciprocity, may provide stronger and complementary evidence of the effects of the pivotal response treatment package. Reciprocal vocal contingency is derived through an automated process from daylong audio samples from the child’s natural environment. Therefore, reciprocal vocal contingency is at lower risk for detection bias than parent report and brief parent–child interaction measures. Although differences were non-significant at baseline and after 12 weeks of intervention for the 48 children with autism spectrum disorder who were randomly assigned to the pivotal response treatment package or a delayed treatment control group, the pivotal response treatment package group had higher ranked reciprocal vocal contingency scores than the control group after 24 weeks ( U = 125, p = .04). These findings are consistent with results from parent report and parent–child interaction measures obtained during the trial. The participants in the pivotal response treatment package exhibited greater vocal responsiveness to adult vocal responses to their vocalizations than the control group. Findings support the effectiveness of the pivotal response treatment package on vocal reciprocity of children with autism spectrum disorder, which may be a pivotal skill for language development. Lay abstract A recent randomized controlled trial found that children with autism spectrum disorder who received a pivotal response treatment package showed improved language and social communication skills following the intervention. The pivotal response treatment package includes clinician-delivered and parent-implemented strategies. Reciprocal vocal contingency is an automated measure of vocal reciprocity derived from daylong audio samples from the child’s natural environment. It may provide stronger and complementary evidence of the effects of the pivotal response treatment package because it is at lower risk for detection bias than parent report and brief parent–child interaction measures. The current study compared reciprocal vocal contingency for 24 children with autism spectrum disorder in the pivotal response treatment package group and 24 children with autism spectrum disorder in the control group. The pivotal response treatment package group received 24 weeks of the pivotal response treatment package intervention. The control group received their usual intervention services during that time. The groups did not differ in reciprocal vocal contingency when the intervention started or after 12 weeks of intervention. However, after 24 weeks the pivotal response treatment package group had higher ranked reciprocal vocal contingency scores than the control group. These findings are consistent with results from parent report and parent–child interaction measures obtained during the trial. The participants in the pivotal response treatment package exhibited greater vocal responsiveness to adult vocal responses to their vocalizations than the control group. Findings support the effectiveness of the pivotal response treatment package on vocal reciprocity of children with autism spectrum disorder, which may be a pivotal skill for language development.

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