The Effects of Short-Term, Intensive Pivotal Response Treatment Education on Parent Self-Efficacy and Stress for Families Newly Diagnosed with Autism

Background: Parent involvement in the treatment programming of their child with autism spectrum disorder (ASD) is widely recognized as an important component for successful outcomes. Parent education programs that provide training in Pivotal Response Treatment (PRT) to families of young children with ASD have been shown to improve both child and parent outcomes. PRT is an evidence-based treatment approach that uses motivational strategies to target social communication. Benefits of educating parents in PRT include increases in child verbalizations, parent and child positive affect, and decreases in parent stress.

Objectives: There seems to be a paucity of research regarding the impact of intensive individualized parent education programs in PRT on additional dimensions of parent well being. The research also appears limited on the effects PRT programs have on parents of children who are newly diagnosed with ASD. Parent education may be particularly important for these families, as this is a period of time when parents often face great uncertainty and distress. Thus, the objective of this study was to examine how a brief, individualized parent education program impacted parent self-efficacy, hope, and stress for parents whose child had a recent diagnosis of ASD, both immediately after the treatment program and long-term.

Methods: Using a concurrent multiple baseline experimental design across participants, this study examined outcomes of an intensive 5-day, 20-hour parent education program in PRT for families whose child has recently received a diagnosis of ASD. Parents learned to implement the motivational components of PRT through observation of a clinician, practicing with their child, and receiving feedback on their implementation. The education program was characterized by a parent-clinician partnership model and used a strength-based approach to teach parents to implement PRT with their child. Standardized assessments, behavioral observation data, and brief interviews with parents were used to analyze parent measures, including stress, self-efficacy, and hope. Parent fidelity of PRT implementation was also collected, in addition to child functional utterances.

Results: Results from the pilot study indicated that all parents showed a decrease in observed stress levels and an increase in observed confidence levels after participating in the parent education program. Further, parents reported increased confidence in teaching their child and getting their child to communicate (i.e., self-efficacy) following the treatment program.

Conclusions: Brief, intensive PRT parent education appears to have positive effects on multiple constructs related to parent well being, such as self-efficacy, hope, and stress, for parents whose child recently received a diagnosis of ASD. This approach is likely an effective way to provide parents with short-term education on how to implement an evidence-based treatment with their child while they await more intensive or comprehensive services.