Examining Effectiveness of Classroom Pivotal Response Teaching in Public Schools

Background: Autism interventions that are shown to be efficacious in controlled research settings are often not well integrated into schools, demonstrating the need for translation or adaptation for classroom use. These practices can be systematically adapted to ensure a fit with student and classroom characteristics while maintaining the active ingredients of the intervention. Such adaptations should improve teachers’ fidelity of implementation of the intervention (FI; the degree to which the intervention is being applied as specified in the treatment manual) and thus facilitate better outcomes for students (e.g., Durlak & DuPre, 2008; O'Donnell, 2008; Sanetti & Kratochwill, 2009; Stahmer & Gist, 2001). Classroom Pivotal Response Teaching (CPRT) is a behavioral intervention for children with ASD adapted from Pivotal Response Training through an iterative process in collaboration with researchers, teachers, and school administrators (Stahmer, Suhrheinrich, & Rieth, 2017).

Objectives: This presentation will provide teacher outcomes from a large-scale community effectiveness trail of CPRT in schools including teacher and preliminary student outcomes.

Methods: The study used a randomized waitlist-control design with 108 classrooms (including the lead teacher and paraprofessional educators) over three years. Teachers (n=109) and students (n=256) from 17 school districts participated. Training procedures included 12 hours of small group didactic instruction, including goal setting, supervised exercises and role-playing. Individual coaching followed at weekly, then monthly intervals upon completion of didactic training. During coaching, teachers worked with their own students during regular classroom activities. Teacher measures included the Professional Development Assessment (PDA), fidelity of CPRT use and satisfaction surveys. Child measures included the ADOS, cognitive assessment, Vineland Adaptive Behavior Scales (VABS) and Pervasive Developmental Disability Behavioral Index (PDDBI).

Results: On average, trained teachers reported using CPRT for 50 min/day, and 3 days per week, with 37% of teachers using CPRT at least 4 days/week. Multilevel models indicated significantly higher fidelity of CPRT (as coded by naïve observers) for teachers who completed training as compared to control teachers (B=0.27, p=.001). Seventy-three percent of teachers met fidelity criteria (trainer coded) for CPRT after an average of 7.6 coaching sessions. Preliminary student data indicate significantly greater change on PDDBI during the training compared to control year. Scores on some scales were moderated by student age, teacher experience and classroom quality.

Conclusions: Results indicate CPRT is feasible in classroom settings and classroom teachers can be trained. Preliminary student outcomes are promising. Findings suggest collaborative adaptation of evidence-based practices may facilitate fidelity of the intervention in community settings. Considerations for sustainment and improving community outcomes will be discussed.