Short-Term Parent-Mediated PRT: Teaching Social Initiation to Children with Autism Spectrum Disorder through Question Asking

Background: Parents of children with ASD report high wait times between diagnosis and service referral (between 22-39 months (Gordon, 2015)). In addition, the financial cost of many early intervention programs can be prohibitive and are difficult to continue at home. Pivotal Response Treatment (PRT) is a naturalistic evidence-based intervention based on principles of Applied Behaviour Analysis that may occur at home, can be taught to parents, and targets a number of pivotal behaviours including social initiation. Social initiations are imperative for development; however, many children are only taught to request. Teaching social initiations allows children to advance from requesting to engaging in self-learning. There is support for the idea that parents can be taught to implement evidence-based practices, such as PRT, in the natural environment after engaging in short-term training. By increasing parents’ skills through short training, continual opportunities for learning may emerge beyond intervention.

Objectives: Investigate whether caregivers can be taught to implement PRT procedures for question-asking in the home after participating in a brief training in PRT. The study also investigated whether children increased their frequency of social initiation through question asking (specifically “What’s that?”) and whether these results maintained and generalized beyond intervention.

Methods: Participants included three mother-sons dyads. The children ranged in age from 45 to 56 months; all had a confirmed diagnosis of ASD. Prior to the study, the researcher obtained full certification as a trainer in PRT from the Koegel Autism Center. A single-subject multiple baseline design was used. After a stable baseline was obtained, training was introduced to each mother in a one-week staggered manner. Each mother completed 12 hours of training in PRT across three weeks (i.e., two hours twice a week) after which intervention was initiated. Each mother implemented the intervention with their child three times a day in 10-minute sessions with one session video-recorded daily by the researcher. Immediately succeeding intervention, the mother conducted generalization probes every day for one week. Follow-up occurred after one month.

Results: Results of visual analysis showed that all three mothers were able to successfully implement PRT procedures for question asking and achieved fidelity during intervention, with one mother attaining fidelity at follow-up. All three children showed an increase in their frequency of asking, “What’s that?” These results generalized to various novel items, family members, and environments. Follow-up data showed that all three children continued asking, “What’s that?” but at a lower rate than during the intervention.

Conclusions: Results of the study demonstrate that parents are able to learn, and effectively implement PRT procedures for question asking after completing a short training. Furthermore, all three children increased their frequency of asking “What’s that?” Short-term parental training thus offers a viable option to reduce both wait-times and costs of early intervention experienced by parents of children with ASD.