WWC review of this study

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.

  • Randomized Controlled Trial
     examining 
    47
     Students
    , grade
    PK

Reviewed: December 2016

At least one statistically significant positive finding
Meets WWC standards without reservations
Communication/ Language outcomes—Indeterminate effects found
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;
47 students

80.60

72.80

No

--
More Outcomes

Total utterances

Pivotal Response Training vs. Psychoeducation group (PEG) training

1 Year

Full sample;
47 students

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;
47 students

63.40

63.00

No

--
Show Supplemental Findings

Nonverbally prompted utterances

Pivotal Response Training vs. Psychoeducation group (PEG) training

1 Year

Full sample;
47 students

3.00

0.10

Yes

 
 
35

Spontaneous utterances

Pivotal Response Training vs. Psychoeducation group (PEG) training

1 Year

Full sample;
47 students

1.30

0.40

Yes

 
 
29

Imitative utterances

Pivotal Response Training vs. Psychoeducation group (PEG) training

1 Year

Full sample;
47 students

15.80

7.10

Yes

 
 
27

Verbally prompted utterances

Pivotal Response Training vs. Psychoeducation group (PEG) training

1 Year

Full sample;
47 students

17.70

16.00

No

--

Unintelligible utterances

Pivotal Response Training vs. Psychoeducation group (PEG) training

1 Year

Full sample;
47 students

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.

Characteristics of study sample as reported by study author.


  • Female: 25%
    Male: 75%

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.

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.

  • 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.

 

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