scholarly journals Clinician Delivery of Virtual Pivotal Response Treatment with Children with Autism during the COVID-19 Pandemic

2021 ◽  
Vol 10 (11) ◽  
pp. 414
Author(s):  
Devon M. White ◽  
Claire Aufderheide-Palk ◽  
Grace W. Gengoux
Keyword(s):  
Clinical Care ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Pivotal Response Treatment ◽  
Video Conference ◽  
Motivational Strategies ◽  
Empirically Supported Treatment ◽  
Communication Practice ◽  
Autism Treatment ◽  
Wide Range

This concept paper describes how the evidence-based Pivotal Response Treatment (PRT) model of autism treatment was adapted for delivery via telehealth during the COVID-19 pandemic. Multiple features of existing video conference technology were utilized for implementation of PRT motivational strategies with young children with autism spectrum disorder (ASD). PRT is an empirically supported treatment for ASD which can be taught to parents and delivered directly by trained therapists. During the COVID-19 pandemic, when the majority of clinical care for children with ASD had to be transitioned to telehealth delivery, models for parent training had been previously established. However, no model for direct clinician delivery of virtual PRT existed. This manuscript outlines practical details of the model developed by our team and provided to a total of 17 families between April 2020 and May 2021. Key lessons from technological adaptations of the PRT motivational strategies are described in order to inform future empirical investigation of this approach. The virtual PRT delivery model can serve as a guide for engaging children in meaningful social interaction and communication practice via video conference software, with implications for expanding access to autism treatment as well as for motivating a wide range of children in distance learning activities.

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).

Individualizing and Combining Treatments in Autism Spectrum Disorder

2017 ◽  
Vol 26 (2) ◽  
pp. 114-119 ◽  
Author(s):  
Giacomo Vivanti
Keyword(s):  
Autism Spectrum Disorder ◽  
Early Intervention ◽  
Treatment Response ◽  
Research Agenda ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Intervention Programs ◽  
Rational Approach ◽  
Autism Treatment ◽  
Treatment Individualization

Although several early intervention programs can be efficacious in improving outcomes of children with autism, treatment response is variable, leading most families to enroll their child in several interventions simultaneously. Because knowledge on the effects of combining different therapies is limited, it is critically important to develop and test predictions on how the “active ingredients” of different interventions interact with child characteristics and with one another when combined. An obstacle to this research agenda is the “pre-paradigmatic” stage of the autism early intervention field, in which many practices are organized around seemingly irreconcilable vocabularies. I argue that a formalization of the explanatory structures informing different treatments—based on the four parameters of logical coherence, falsifiability, parsimony, and consilience—can provide a conceptual lingua franca for the formulation of testable hypotheses on treatment individualization and combination, thus facilitating a more coherent and rational approach to research in this area.

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.

scholarly journals Parents Perspective toward Implementing Pivotal Response Treatment in Natural Environment to Enhance Social Communication and Sensory Processing of Children with Autism

2018 ◽  
Vol 8 (3) ◽  
pp. 112 ◽  
Author(s):  
Mariam Alshirawi ◽  
Rehab Alzayer ◽  
Salman Baqer AlNajjar
Keyword(s):  
Sensory Processing ◽  
Social Communication ◽  
Behavior Management ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Pivotal Response Treatment ◽  
Horseback Riding ◽  
Focus Group Methodology ◽  
Natural Settings ◽  
Environmental Activity

Parents of children with autism face many challenges while raising such a child due to behavioral, social, and sensory related characteristics. Qualitative focus group methodology was used to examine the effects of providing Pivotal Response Treatment (PRT) intervention in the natural environmental activity of horseback riding on improving social communication, and sensory processing of children with Autism Spectrum Disorder (ASD). The purpose of this qualitative study was to describe parents’ perceptions of how this intervention affects the lives of their children at home and across various natural settings. Key influences included (a) eye contact and joint attention, (b) peers and adults’ interaction, (c) verbal and non-verbal communication, (d) behavior management, (e) eating and sleeping organized patterns, and (f) self-stimulatory behaviors. These elements were discussed across all parents who participated in the study. However, specific experiences and outcomes varied across the critical influences mentioned above.

scholarly journals Adherence and acceptability of a robot-assisted Pivotal Response Treatment protocol for children with autism spectrum disorder

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Iris van den Berk-Smeekens ◽  
Martine van Dongen-Boomsma ◽  
Manon W. P. De Korte ◽  
Jenny C. Den Boer ◽  
Iris J. Oosterling ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Treatment Protocol ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Pivotal Response Treatment ◽  
Robot Assisted

Risperidone prescription in autism spectrum disorder in Tehran, Iran

2011 ◽  
Vol 26 (S2) ◽  
pp. 1168-1168
Author(s):  
A.H. Memari ◽  
R. Kordi
Keyword(s):  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Children With Autism ◽  
Autism Spectrum ◽  
High Rate ◽  
Benefit Analysis ◽  
Autism Treatment ◽  
Children With Asd ◽  
Lower Socioeconomic ◽  
Very High

IntroductionRisperidone was one of the most popular psychotropic medications approved by FDA for Autism. It may be used to treat specific disruptive behaviors (i.e. irritability) usually associated with autism.ObjectiveDue to recent findings, about one-third of children with ASD take an antipsychotic medication and Risperidone may be responsible for the major part, but its place in autism treatment especially out of US has not been clear due to uncertainty about costs and benefits of prescription. We aimed to investigate the risperidone prescription in children with ASD in Iran.MethodsA representative sample of Students of autism specific schools aged 6-15 surveyed through the parents to provide drug list, demographic and developmental information of children; parents were also asked to indicate whether they were currently using or had just used in the past but not currently or never used the risperidone.ResultsRisperidone has been prescribed for 85.2% (98/115) children with ASD while 50.4% were currently using. Sex difference analysis showed that prescription was done for 87% of boys versus 73.9% of girls (p = 0.06). There was a significant lower socioeconomic state in families with current using of risperidone (p < 0.001). Prescription was not associated with comorbidities in children.ConclusionsWe found a very high rate of risperidone use in children with autism. It may be due to treatment approaches rely heavily on the most available psychotropic agent (i.e. risperidone). Further research is warranted in Cost-Benefit Analysis of risperidone use in Autism.

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