The Effect of Brief Intervention on Spontaneous Turn-Taking in Pivotal Response Teaching for Children with Autism Spectrum Disorder

Background:  Applied behavior analysis (ABA) has contributed to a lot of successes in early intervention for individuals with autism (Smith, et al., 2000). While focusing on various behaviors, pivotal response training (PRT) maximized the opportunities of receiving reinforcers in naturalistic conditions by keeping higher motivation level (Koegel & Koegel, 2006). Turn-taking behavior is one of the components of PRT. There are many intervention studies using PRT (Pierce and Schreibman, 1995; Schreibman et al., 2009). However, there are few intervention studies of focusing on improving spontaneous turn-taking behavior. In order for individuals with autism to adjust to naturalistic conditions, not only between two persons, more studies are needed that examine turn-taking behavior among three persons.

Objectives: We examined the effects of a brief intensive intervention using visual-prompts and deferential reinforcement on spontaneous turn-taking behavior among three persons (a child and two adults) for a child with autism spectrum disorder (ASD).

Methods: Participants were three boys with ASD.  In pre-assessment, post assessment and follow up phase, we conducted two play situations using a toy for five minutes each. 1) Turn-taking between two persons: A boy and an adult took turns to play with a toy. 2) Turn-taking among three persons: A boy and two adults took turns to play with a toy. In each situation, the boy was instructed to give the toy to the person who should do next. In intervention phase, we used the toy, which was different from the one used in pre-assessment phase, but had the same functional structure. Intervention was only conducted for turn-taking among three persons situation.  During the intervention, the number written paper (1, 2, or 3) was assigned in front of the boy and the adults, and he was instructed to give the toy by looking at these papers and caring for who should do next. This intervention had three sessions. Each session consisted of 24 turns including the boy’s and the adults’. Dependent variables were the rates of correct response, which were the numbers of turns that the boy gave the toy to the correct person spontaneously over the total numbers of adult’s turns in both turn-taking between two persons and among three persons situations.

Results: The rate of correct response between pre and post assessment phase in the situation of turn-taking among three persons showed the improvement for all three boys (33.3 to 75.0%, 55.6 to 84.2% and 50.0 to 90.7%, respectively). In follow up phase, the rates of correct response in both situations were maintained in higher rate. Without intervention, the rate of correct response between pre and post assessment phase in the situation of turn-taking between two persons also showed improvement (59.1 to 80.0%, 75.0 to 100% and 87.5 to 100%, respectively).

Conclusions:  The current study indicated that even a relatively short intervention could improve the correct turn-taking behavior among three persons. It also indicated that the intervention for turn-taking among three persons could improve the boy’s spontaneous correct turn-taking behavior even in the two persons situation.