Pivotal Response Treatment (PRT) Is Ideal for Summer Camp, and Summer Camp Is Ideal for PRT

Background: Past research supports the use of Pivotal Response Treatment (PRT) in school, day care, and home settings with young children.  Yet, there is a lack of empirical work addressing PRT’s effectiveness when used in a summer camp setting. In addition, few studies investigate the efficacy of any intervention for older children. Summer camp provides the following advantages for studying the effectiveness of PRT: 1) Unlike school, camp activities are designed primarily to provide socialization and recreation opportunities for all participants; there are no academic demands competing for time and attention from the staff or the children. 2) Activities are less structured than at school, allowing accommodations for a child with autism’s unique challenges or stereotypical interests. 3) A range of activities are available that provide varying levels of competition and socialization demands over the course of the camp experience.

Objectives: The social demands for 7-12 year-old children differ markedly from preschool-aged children. Consequently, it is necessary to examine whether strategies first developed for use with younger children are effective when applied to older child populations, in natural, inclusive settings. Our goal was to assess the feasibility and clinical benefits of providing PRT in inclusive camp settings with school-aged children.

Methods: A 9 year-old, verbal boy with autism who had never attended an inclusive summer camp was enrolled in a 4-week day camp. An undergraduate was provided a reading list of journal articles and a 2-hour, in-person training in PRT from a licensed clinical psychologist prior to beginning work as the child’s social facilitator.  Dependent variables included: a. Initiations of conversations and social interaction; b. Responsivity to initiations from adults and peers; c. Synchronous reciprocal social interaction, defined as: i. The children engaged in the same activity. ii. The children are initiating and responding to one another, iii. The interactions are continuous and related to one another’s behavior. Data were collected by in-vivo and videotaped coding of behavior. All video data were reviewed by a licensed clinical psychologist. Reliability between coders was > 90 percent. Additionally, qualitative observations were noted daily.

Results: Comparisons between the child with autism and typical peers indicated that at the beginning of camp, the child with autism demonstrated fewer initiations, had a lower rate of responsivity to adults and peers, and engaged in very low levels of synchronous reciprocal social interaction. As camp progressed, increases in all dependent variables were observed. Qualitative observations suggested that the child gained an understanding of teamwork and competition. In addition, he formed a reciprocal friendship with a non-disabled peer with whom he had two play outings outside of the structure of the camp.

Conclusions: These findings suggest the effectiveness of PRT in a summer camp setting with verbal, school-aged children with autism. Significant improvements were made in a short period of time, at low economic cost, with brief training of an undergraduate social facilitator.