A randomized controlled trial of Pivotal Response Treatment Group for parents of children with autism.
Hardan, A. Y., Gengoux, G. W., Berquist, K. L., Libove, R. A., Adrel, C. M., Phillips, J., … Minjarez, M. B. (2015). Journal of Child Psychology and Psychiatry, 56(8), 884–892.
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examining47Students, gradePK
Pivotal Response Training Intervention Report - Children and Students with an Autism Spectrum Disorder
Review Details
Reviewed: December 2016
- Randomized Controlled Trial
- Meets WWC standards without reservations because it is a randomized controlled trial with low attrition.
This review may not reflect the full body of research evidence for this intervention.
Evidence Tier rating based solely on this study. This intervention may achieve a higher tier when combined with the full body of evidence.
Please see the WWC summary of evidence for Pivotal Response Training.
Findings
|
Outcome measure |
Comparison | Period | Sample |
Intervention mean |
Comparison mean |
Significant? |
Improvement index |
Evidence tier |
|
|---|---|---|---|---|---|---|---|---|---|
|
Vineland Adaptive Behavior Scales, 2nd edition: Communications subscale |
Pivotal Response Training vs. Psychoeducation group (PEG) training |
1 Year |
Full sample;
|
80.60 |
72.80 |
No |
-- | ||
|
Total utterances |
Pivotal Response Training vs. Psychoeducation group (PEG) training |
1 Year |
Full sample;
|
60.00 |
51.40 |
No |
-- | ||
|
Preschool Language Scale, 4th Edition: Expressive communication subscale |
Pivotal Response Training vs. Psychoeducation group (PEG) training |
1 Year |
Full sample;
|
63.40 |
63.00 |
No |
-- | ||
| Show Supplemental Findings | |||||||||
|
Nonverbally prompted utterances |
Pivotal Response Training vs. Psychoeducation group (PEG) training |
1 Year |
Full sample;
|
3.00 |
0.10 |
Yes |
|
||
|
Spontaneous utterances |
Pivotal Response Training vs. Psychoeducation group (PEG) training |
1 Year |
Full sample;
|
1.30 |
0.40 |
Yes |
|
||
|
Imitative utterances |
Pivotal Response Training vs. Psychoeducation group (PEG) training |
1 Year |
Full sample;
|
15.80 |
7.10 |
Yes |
|
||
|
Verbally prompted utterances |
Pivotal Response Training vs. Psychoeducation group (PEG) training |
1 Year |
Full sample;
|
17.70 |
16.00 |
No |
-- | ||
|
Unintelligible utterances |
Pivotal Response Training vs. Psychoeducation group (PEG) training |
1 Year |
Full sample;
|
21.16 |
24.60 |
No |
-- | ||
Evidence Tier rating based solely on this study. This intervention may achieve a higher tier when combined with the full body of evidence.
Sample Characteristics
Characteristics of study sample as reported by study author.
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Female: 25%
Male: 75%
Study Details
Setting
Parents were trained to implement PRT at a large academic medical center (the location is not reported). Parents implemented PRT in their home, and occasionally with their child at the medical center.
Study sample
Twenty-seven children were randomly assigned to the intervention group and 26 children were randomly assigned to the comparison group; 25 children in the intervention group and 22 in the comparison group had observed outcomes. About 75% of the participating children were boys, and the average age was 4 years 1 month. All children had been diagnosed with autism based on the Diagnostic and Statistical Manual of Mental Disorders-IV ((DSM-IV) criteria, Autism Diagnostic Interview-Revised (ADI-R), Autism Diagnostic Observation Schedule (ADOS), and expert clinical judgment.
Intervention Group
Parents in the intervention group received training once a week for 12 consecutive weeks. Trainers used the manual How to Teach Pivotal Behaviors to Children with Autism. Eight of the sessions were 90 minutes and involved small groups of 4 to 6 parents, led by 1 or 2 psychologists. The other four sessions lasted 60 minutes and each session included a parent and child meeting with a psychologist. Parents were asked to implement the intervention daily with their child.
Comparison Group
Parents in the comparison group received psychoeducation group (PEG) training. Sessions were conducted once a week for 12 consecutive weeks. Ten of the sessions were 90 minutes and involved groups of parents taught by clinical psychology graduate students and supervised by a psychologist. Two sessions lasted 60 minutes and each session included a parent and his or her child meeting with a psychologist. The curriculum was based on an existing autism parent psycho-education program at the medical center, and covered the following topics: diagnosis and symptoms of autism spectrum disorders; neurobiology of autism, basic behavior management strategies; common autism interventions; evaluating treatment effectiveness; service systems; and strategies for improving social skills and child stress reduction.
Support for implementation
Parents did not receive any additional support, aside from the training.
Additional Sources
In the case of multiple manuscripts that report on one study, the WWC selects one manuscript as the primary citation and lists other manuscripts that describe the study as additional sources.
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Gengoux, G. W., Berquist, K. L., Salzman, E., Schapp, S., Phillips, J. M., Frazier, T. W. … Hardan, A. Y. (2015). Pivotal response treatment parent training for autism: Findings from a 3-month follow-up evaluation. Journal of Autism and Developmental Disorders, 45(9), 2889–2898.
An indicator of the effect of the intervention, the improvement index can be interpreted as the expected change in percentile rank for an average comparison group student if that student had received the intervention.
For more, please see the WWC Glossary entry for improvement index.
An outcome is the knowledge, skills, and attitudes that are attained as a result of an activity. An outcome measures is an instrument, device, or method that provides data on the outcome.
A finding that is included in the effectiveness rating. Excluded findings may include subgroups and subscales.
The sample on which the analysis was conducted.
The group to which the intervention group is compared, which may include a different intervention, business as usual, or no services.
The timing of the post-intervention outcome measure.
The number of students included in the analysis.
The mean score of students in the intervention group.
The mean score of students in the comparison group.
The WWC considers a finding to be statistically significant if the likelihood that the finding is due to chance alone, rather than a real difference, is less than five percent.
The WWC reviews studies for WWC products, Department of Education grant competitions, and IES performance measures.
The name and version of the document used to guide the review of the study.
The version of the WWC design standards used to guide the review of the study.
The result of the WWC assessment of the study. The rating is based on the strength of evidence of the effectiveness of the intervention. Studies are given a rating of Meets WWC Design Standards without Reservations, Meets WWC Design Standards with Reservations, or >Does Not Meet WWC Design Standards.
A related publication that was reviewed alongside the main study of interest.
Study findings for this report.
Based on the direction, magnitude, and statistical significance of the findings within a domain, the WWC characterizes the findings from a study as one of the following: statistically significant positive effects, substantively important positive effects, indeterminate effects, substantively important negative effects, and statistically significant negative effects. For more, please see the WWC Handbook.
The WWC may review studies for multiple purposes, including different reports and re-reviews using updated standards. Each WWC review of this study is listed in the dropdown. Details on any review may be accessed by making a selection from the drop down list.
Tier 1 Strong indicates strong evidence of effectiveness,
Tier 2 Moderate indicates moderate evidence of effectiveness, and
Tier 3 Promising indicates promising evidence of effectiveness,
as defined in the
non-regulatory guidance for ESSA
and the regulations for ED discretionary grants (EDGAR Part 77).