Increasing Self-Confidence and Decreasing Stress in Parents and Professionals: The Effects of One-Day Pivotal Response Treatment Training

Background: Parents of children with autism experience elevated levels of stress (Bebko, Konstantareas, & Springer, 1987), and parental stress is negatively associated with benefits obtained from services (Robbins, Dunlap, & Plienin, 2008). Training parents using Pivotal Response Treatment (PRT) has been shown to increase child-parent positive interactions, and parental interest in those interactions, as well as to decrease parental stress (koegel, Bimbela, & Schreibman, 1996). Also, increased parental positive affect was associated with PRT implementation (Schreibman, Kaneko, & Koegel, 1990). Although previous research has focused on parent training, little attention has been paid to training of professionals working with individuals with ASD.

Objectives: The current study investigated the effectiveness of training parents and professionals in dealing with challenging behaviors, increasing verbal communication, and decreasing stress levels using PRT.

Methods: Seventy-five adults (25% parents and 75% professionals) participated in the PRT training and 52 completed the study (42 females, 7 males, and 3 did not report gender) with a mean age of 39.28 (SD=11.14). This sample consisted of 82.6% Caucasian, 3.8% African American, 3.8% Hispanic, 1.9% Asian American, and 7.7% did not report ethnicity. Parents and professionals completed a 4-question form designed to obtain information about their confidence in managing difficult behaviors, and increasing verbal communication, as well as their stress levels due to their interactions with the child.

Results: A series of paired t-tests was conducted to assess self-perceived confidence and stress levels when dealing with difficult behaviors and working on the child’s verbal skills. Data from parents and professionals were analyzed independently and then combined because the same results were found for each; thus, only the whole sample statistics are reported here. After the one-day PRT training, participants’ confidence in dealing with difficult behaviors was significantly higher after (M=2.27, SD=.49) than before (M=1.83, SD=.55) the training t(4.77)=p<.00. Similarly, the level of confidence in increasing verbal abilities was significantly higher after (M=2.48, SD=.82) than before (M=2.08, SD=.613) the training t(-2.62)=p<.01. Moreover, participants’ level of stress in dealing with difficult behaviors was significantly less after (M=2.10, SD=.66) than before (M=2.56, SD=.79) the training t(-4.45)=p<.00. Finally, participants’ stress when working on verbal abilities was significantly less after (M=1.90, SD=.62) than before (M=2.29, SD=.82) training t(-3.35)=p<.00.  

Conclusions: Very little is known about parents’ and professionals’ confidence and stress level when working with individuals with ASD. This study provides some initial evidence of the effectiveness of training parents and professionals to address difficult behaviors and improve language abilities in individuals with ASD after only one day of training in PRT techniques. Thus, community outreach programs could make it a priority to reach parents and professionals and provide trainings that can ultimately increase their confidence and decrease their level of stress. A limitation of this study, however, is that it is not known whether the effects of these type of trainings are maintained over time. Moreover, it is not known whether the participants were then able to implement the newly learned techniques. Future research in those areas is needed.