Qualitative Parent Outcomes of an Introductory Pivotal Response Treatment Parent Education Program for ASD

Background: Families whose child has recently received a diagnosis of autism spectrum disorder (ASD) are a unique population in need of specialized support and guidance. These parents frequently experience feelings of stress, fear, and uncertainty, which are often related to concerns about how to address their child’s social communication and behavioral needs. Further, parent goals and values are not often solicited and incorporated into early intervention programs. Pivotal Response Treatment (PRT) is a widely used evidence-based practice for ASD that parents are often taught to implement with their child. However, PRT education alone may not be enough to address the complex needs and multiple areas of concern these parents tend to report. Positive Behavior Support (PBS) is another gold standard for how to support families of children with ASD. What is not evident in the literature, however, is a clearly delineated process for how PRT parent education could be implemented within the context of a PBS plan to address social communication and behavioral goals in a comprehensive way. Further, there is limited information on the outcomes and experiences of parents receiving these types of early intervention services.

Objectives: The aim of the current study was to provide an in-depth understanding of parent experiences participating in a brief PRT education program delivered within the context of an individualized PBS plan. The objective was to collect qualitative interview data to supplement, triangulate, and elaborate upon quantitative measures.

Methods: Four parents whose young child had recently received a diagnosis of ASD received 20 hours across five days of PRT education within the context of an individualized PBS program. Parents received instruction in PRT and specific evidence-based strategies for addressing their reported goals for themselves and their child. Parents completed semi-structured interviews following the completion of the program. Using open-coding thematic analysis, interview transcripts were coded to identify commons themes and patterns in responses.

Results: Five main themes emerged from the interviews: 1) increase in parent self-efficacy, 2) effectiveness of approaches, 3) ease of implementation, 4) reduction (but not amelioration) of stress, and 5) minimal changes to the program. Following the parent education program, all parents reported an increase in confidence and competence with interacting with their child, which was conceptualized as ‘self-efficacy’. All parents reported that intervention strategies were effective and easy to implement. Parents reported reduced stress following the program but also reported concerns about future stressors, such as transitions in schooling. Further, parents reported minimal and superficial changes to the program.

Conclusions: The current study addresses an important issue in early intervention by providing a thorough examination of treatment outcomes for parents whose child has a recent ASD diagnosis. It appears that a short-term parent education program in PRT individualized to reflect parent goals and values can promote well-being for families. This study also provides detailed evidence that parents find this type of program to be helpful for improving their self-efficacy and empowering them to support their child.