Training-the-Trainer: An Effectiveness Study of Pivotal Response Training in School Settings

Background: Pivotal Response Training (PRT) is an evidence-based, naturalistic behavioral intervention for children with autism.  Teachers have been effectively trained to implement PRT, but effective training is time consuming and expensive.  An alternative may be providing training to existing school district staff on how to train teachers and evaluate the teachers’ use of PRT.  To increase the availability and sustainability of training in PRT, this study employed a train-the-trainer model while working with school district staff and classroom teachers. 

Objectives: The purpose of the study was to assess the effectiveness of a train-the-trainer protocol for PRT.

Methods: Three school district behavior specialists (trainers), nine special-education teachers, and 18 students with autism (3-8 years old) participated.  Participants made up three training groups, each with one trainer, three teachers and six students.  A multiple baseline design was used, and data were obtained via weekly classroom observations during baseline, treatment, post-treatment and follow-up. During the treatment phase 1) trainers attended a 15 hr training workshop on how to implement PRT, assess PRT implementation and provide feedback to others, 2) staff trainers conducted a 6 hr workshop with the three teachers in their training group, and 3) staff trainers, teachers, and students participated in 6 additional observations. During each observation, the teacher worked with each student, individually, for 10 minutes while the trainer observed.  Then the trainer provided feedback to the teacher for 10 minutes. Each observation was videotaped and later coded to examine teacher implementation of PRT, trainer assessment of PRT implementation, and student behavior. Follow-up data were collected 3 months after the completion of the treatment phase.

Results: All three trainers successfully completed the trainer training, including correctly implementing all PRT components, assessing fidelity of implementation of PRT and providing feedback.  After completion of this training, the trainers’ implementation of training procedures was more varied.  Six teachers learned to correctly implement all components of PRT while the other three teachers made more limited progress.  Teachers demonstrated consistent patterns of learning with some PRT components being implemented correctly more often than others.  Seven of the nine teachers completed the follow-up procedures.   Three made some improvement in their ability to implement PRT, one maintained her ability to implement PRT, and three declined in their ability to implement PRT.

Conclusions: The train-the-trainer method resulted in notable gains by the participants.  Results indicating where specific adaptations to the training model would likely lead to further effectiveness will be discussed.  While some teachers maintain or improve their skills over time, others may lose these skills and benefit from additional training in the form of a “booster session.”