International Meeting for Autism Research: Examining the Use of Multiple Cues as a Necessary Component of Pivotal Response Training

Examining the Use of Multiple Cues as a Necessary Component of Pivotal Response Training

Thursday, May 20, 2010
Franklin Hall B Level 4 (Philadelphia Marriott Downtown)
3:00 PM
S. Reed , University of California, San Diego, La Jolla, CA
A. Stahmer , Child and Adolescent Services Research Center, Rady Children's Hospital, San Diego, CA
J. Suhrheinrich , University of California, San Diego, La Jolla, CA
L. Schreibman , University of California, San Diego, La Jolla, CA
Background:     Previous research indicated that responsivity to simultaneous multiple cues is difficult for many children with autism. Therefore, teaching attention to multiple cues has been considered a ‘pivotal behavior’ in Pivotal Response Training (PRT). Clinicians report that this aspect of PRT is difficult to implement and may not be developmentally appropriate for all children. To inform best practice, this study first examined the age at which typically developing children attend to simultaneous multiple cues, then assessed responsivity to multiple cues in children with autism above this age.

Objectives:     The developmental appropriateness and necessity of training response to multiple cues (via conditional discriminations) in Pivotal Response Training will be examined and discussed.

Methods:      Participants included 35 typically developing children ages 19 to 50 months and 16 children with autism ages 39 to 89 months. Each typically developing child completed a discrimination learning assessment. Children were taught to discriminate one compound stimulus (comprised of color and shape) from another (different color and shape). Children subsequently were tested on individual components of the training stimuli and child responses to each of the components were assessed as the dependent measure. Overselectivity was defined as correctly responding to one stimulus feature (i.e., shape vs. color) with 80% or better accuracy and a level of response at least 30% less than that to the second feature. Based on the age at which typically developing children were able to reliably respond to multiple cues, children with autism above this developmental age were assessed to determine whether they remained overselective.  
Results:     Typically developing children ages 19-26 months were unable to successfully complete the tasks and/or acquire the original discrimination. A majority of children ages 28-35 months showed overselective responding to one feature. In contrast, data indicated that children over 36 months of age consistently displayed response to the simultaneous cues. Therefore, the discrimination learning assessment was conducted with children with autism at a developmental age above 36 months, as determined by standardized tests and/or psychologist report. Of the 15 children with autism ages 39 to 89 months who completed the assessment, five children displayed overselectivity. These five children range in age from 4 years, 6 months to 6 years, 11 months and represent a range of ability levels. One of the children with autism was unable to complete the assessment due to non-compliance. The majority of children with autism (9 of 15) displayed normal selective attention similar to their typically developing peers.  
Conclusions:     Findings are consistent with and expand upon previous research. Teaching responsivity to multiple cues is not developmentally appropriate until a child with autism reaches a functioning level of 36 months. There appears to be a sub-group of children with autism who have difficulty responding to simultaneous multiple cues. Assessment of the type of tasks necessary to improve this ability in this sub-group of children with autism is the next step in this research.

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