Social Gains Are Maintained at 4-Month Follow-up Evaluation of Pivotal Response Treatment for Children with Autism

Poster Presentation
Friday, May 11, 2018: 11:30 AM-1:30 PM
Hall Grote Zaal (de Doelen ICC Rotterdam)
R. L. Gruen1, C. C. Kautz1, A. Pomales1, E. A. DeLucia1, L. L. Booth1 and P. E. Ventola2, (1)Yale Child Study Center, Yale School of Medicine, New Haven, CT, (2)Yale Child Study Center, Yale University School of Medicine, New Haven, CT
Background: Pivotal response treatment (PRT) is a naturalistic behavioral approach to treating autism that targets core deficits in social motivation. PRT is an evidence-based treatment which has been shown to foster improvements in social interaction, language skills, and adaptive behavior in children with autism (e.g., L. K. Koegel, Koegel, Harrower, & Carter, 1999; R. L. Koegel, Koegel, & McNerney, 2001). However, there is limited research examining whether these treatment effects are maintained over time, after treatment is concluded.

Objectives: In a sample of children with autism spectrum disorder (ASD) who had participated in a 16-week PRT treatment program, we examined the maintenance of treatment effects 16 weeks following the completion of treatment.

Methods: Twenty children, nine girls, (mean IQ 97.32; SD 19.42; range 55-128) completed a 16-week trial of PRT with a follow-up visit 16 weeks post-treatment. This study was part of a larger randomized controlled trial of PRT, but only a subset of the children--those in the PRT condition--completed the follow-up assessment measures. The trial included 7 hours per week of individual work with the child and parent training. Primary clinical outcome was assessed at baseline, endpoint, and follow-up using the SRS-2, a parent report measure of social communication.

Results: Children gained social communication skills over the course of the trial (baseline to endpoint) and, importantly, gains were maintained through the 16-week follow-up period. Over the course of PRT, children demonstrated significant improvements on the SRS Total Score and the SRS Social Communication scale (SRS Total Score baseline mean=87.471, post-treatment mean=72.235, p<.01; SRS Social Communication baseline mean=32.294, post-treatment mean=25.647, p<.01). Furthermore, skills at follow-up remained significantly improved from skills at baseline (SRS Total Score baseline mean=87.471, follow-up mean=76.118, p<.05; SRS Social Communication baseline mean=32.294, follow-up mean=27.588, p<.05). Gains made from endpoint to follow-up visit were not significant (p>.05). The remaining subscales of the SRS, including Social Awareness, Social Cognition, Social Motivation, and Autistic Mannerisms followed this pattern, but results were not significant (p>.05).

Conclusions: We aimed to investigate maintenance of social communication skills following a 16-week trial of PRT. Children in the trial made significant gains over the course of the treatment, and these gains were maintained at the follow-up time-point (16 weeks after the conclusion of treatment). These results suggest that PRT can have lasting effects on children’s development. It is likely that the parent-training component allowed parents to continue to implement PRT principles after participation in the active phase of treatment concluded. There were some limitations to this study; namely, the SRS is a parent report measure of social skills and the control group did not participate in the follow-up portion of the study, as treatment was not delayed this additional period of time.