Pivotal Response Treatment: Effectiveness of Group Versus Individual Parent Training on Pivotal and Collateral Skills

Background: Effective and efficient parent training is essential to meet to the increased demands for treatment services for children with Autism Spectrum Disorder (ASD). Several studies have indicated that parent training in Pivotal Response Treatment (PRT) is effective to teach parents to implement PRT with their child (e.g., Coolican et al., 2010; Hardan et al., 2015; Minjarez et al., 2011; Symon, 2005), but research comparing the effectiveness of group versus individual of parent training in PRT is lacking.

Objectives: This study investigated the effectiveness of group versus individual parent training in PRT on parent-created opportunities and children’s self-initiations, and explored collateral changes in parental stress and children’s maladaptive behavior.

Methods: Participants were 26 parents and their children with ASD, aged between 3;0 and 14;9 years. Thirteen parent-child dyads participated in group parent training in PRT and thirteen parent-child dyads participated in individual parent training. Both group and individual parent training consisted of instruction in PRT-techniques, practice, and video-feedback, but individual training also included guided practice. One multiple baseline design across groups and two multiple baseline designs across participants were used to investigate the effectiveness of group and individual parent training on parent-created opportunities and children’s self-initiations. To explore collateral changes parents completed two questionnaires during baseline and post-intervention. Data analysis included visual analysis (Lane & Gast, 2014) and statistical analyses (i.e., Tau and Reliabilty of Change Index [RCI]; Jacobson & Truax, 1991; Parker et al., 2011)

Results: Preliminary results of 21 parent-child dyads indicated that 5 parents participating in group training (N = 11) created significantly more opportunities during intervention (overall Tau = 0.53; p < 0.001). Reliable reductions in parental stress were observed in 7 parents (RCI < -1.96); one parent reported a reliable increase in stress (RCI > 1.96). Self-initiations increased significantly for 2 children (overall Tau = 0.35; p < 0.001). Maladaptive behavior reliably decreased in 5 children, but significantly increased in 3 other children. Nine parents participating in individual training (N = 10) created significantly more opportunities during intervention (overall Tau = 0.81; p < 0.001), but only for 2 parents reductions in stress were reliable; one parent reported a reliable increase in stress. Self-initiations significantly increased for 4 children (overall Tau = 0.54; p < 0.001). Maladaptive behavior reliably decreased in 5 children, but increased significantly in 2 other children.

Conclusions: These preliminary findings suggest that individual parent training in PRT is more effective in increasing parent-created opportunities than group training, but group training appears to be more effective in reducing parental stress. In both groups only a minority of children demonstrated significant improvements in self-initiations and for both groups results concerning maladaptive behavior were mixed. Explanations for findings and recommendations for future research will be discussed.