The Effect of Brief Workshop of Pivotal Response Teaching on Therapists Skills for Children with Autism Spectrum Disorder

Background:  Applied behavior analysis (ABA) has contributed to a lot of successes in early intervention for individuals with autism (Smith, et al., 2000).  While focusing on various behaviors, pivotal response training (PRT) maximizes the opportunities of receiving reinforcers in naturalistic conditions by keeping higher motivation level (Koegel & Koegel, 2006).  In order for the PRT to be used to parents and therapists widely, it is necessary to examine the effect of staff training (Suhrheinrich et al., 2007). 

Objectives:  We examined the effects of a five-hour-intensive-staff-training on two therapists and on a child with autism spectrum disorder (ASD) in a therapy session. 

Methods:  Participants were two female student therapists in a graduate school, and a boy with ASD (3 years and 9 months).  In pre-assessment and post assessment phase, we video-recorded the behavior of each therapist and the child for 10 minutes.  Then, therapists evaluated themselves about techniques of interaction with the child.  In workshop phase, a five-hour workshop was conducted.  It covered the basic knowledge of ABA and role-play sessions of 10 PRT techniques during a play condition.  Before and after the workshop, a quiz was given to the therapists in order to evaluate the acquisition of ABA and PRT knowledge.  Dependent variables were 1) the quiz score of the therapists’ basic knowledge and skills for ABA and PRT, 2) their self-evaluation score, and 3) units of interactions of the therapist and the child in a play situation.  We digitized therapist-child interactions from recorded video, and conducted 10 seconds interval-recording to analyze the time series relations on “antecedent stimulus (A) – behavior (B) – consequence (C).”  The interactions were coded as A-B unit (the child responded within five seconds after the therapist delivered the antecedent stimulus), and B-C unit (the therapist delivered a reinforcer to the child within three seconds).  A-B-C unit targeted only to the following three-term unit: when the child responded within five seconds after the therapist’s delivery of the stimulus, she reinforced him within three seconds after the occurrence of his response. 

Results:  The quiz scores between before and after the workshop showed the improvement for both therapists (40.0 to 81.4% and 61.4 to 88.6%, respectively).  Therapists’ self-evaluation scores between pre and post workshop also showed improvement (out of 50 points: 25 points to 33, and 22 to 40 points, respectively).  Analyses of the video recording showed the improvement of: each therapist’s interaction with a child (3.3 to 6.7 times per session and 0.0 to 10.0 times per session, respectively), the child’s eye contacts (3.3 to 18.3 times per session and 1.7 to 16.7 times per session, respectively), and the A-B-C unit (6.7 to 16.7 times per session and 1.7 to 18.3 times per session, respectively).  

Conclusions:  The current study indicated that even a relatively short PRT workshop could improve knowledge of early intervention, self-evaluation, and early intervention skills of therapists.  It also indicated that the time series analyses of A-B, B-C, and A-B-C were effective units to objectively evaluate the efficacy of early intervention.