Evaluating the Effectiveness of a PRT Community-Based Autism Parent Coaching Program Using LENA

Background: The gap between research and practice is wide despite increased awareness of the need to adopt evidence-based practices (EBP). A key component of effective ASD early intervention is parent coaching. Through partnership with community providers, real world implementation of parent coaching EBP’s can be evaluated. Additionally, new technologies may help bridge the gap in community practice by simplifying feedback. Parent coaching in pivotal response treatment [PRT] (Koegel et al., 2006) is an EBP currently under dissemination in Western Canada. This study extends pilot work on using the Language Environmental Analysis System (LENA), a new technology, to provide feedback on a PRT parent coaching model in community practice (Stolte & Smith, in submission).

Objectives:

1. To provide an updated description of a community based pivotal response training (PRT) parent coaching model and extend previous findings
2. To evaluate the effectiveness of the model on child, parent and parent-child interactional communication patterns using the LENA
3. To evaluate the use of LENA as a new technology to measure program effectiveness in a real world setting

Methods: Using a non-concurrent multiple-baseline single-subject research design matched with new digital language processor technology (i.e., LENA), a community-based PRT parent coaching model was evaluated for pre-schoolers with ASD. Three parent-child dyads participated in a 5 week coaching model, 2 hours per week, producing 46 independent recordings. Using LENA Advanced Data Extraction (ADEX) software, baseline, intervention and follow-up data were evaluated on child, adult, conversational turns, and ratio of child initiated conversational turns. Detailed child and parent information, PRT fidelity, content validity, and functional relationships between coaching condition and communication patterns are appraised including video analysis and standardized communication measures.

Results: A program description and detailed parent and child information was obtained. Demonstration of PRT learning improved for all parents though only one parent met full fidelity. A functional relationship between adult language and coaching condition was identified for 2 of the 3 dyads. Functional relationships between conversational turns and coaching condition were inconsistent due to high variability, though 1 child improved in vocalizations over time. Visual analysis of 33,648 LENA communication blocks suggest child and adult initiations improved for 1 dyad, but was not replicated. Extracted LENA data on controlled conditions yielded distinct communication patterns across participants.

Conclusions: This PRT parent coaching model holds promise for community practice. By using new technology paired with single subject design methodology, detailed communication information and functional relationships could be evaluated over time. Extending previous findings, LENA analysis indicated replication of a functional relationship between coaching condition and adult word count for 2 of 3 dyads. All parents demonstrated improvement in PRT though fidelity was inconsistent. Extracted ADEX analysis also indicated distinct parent-child communication patterns between dyads. This study demonstrates the importance of evaluating EBP in community settings and how new technologies, such as LENA, can support this objective.