The Impact of Parent Training On Parents' Use of Specific Pivotal Response Treatment Strategies

Background: Pivotal Response Treatment (PRT) has been shown to be effective at promoting communication in children with autistic spectrum disorders (ASD; National Standards Report, 2009). Parent training is an integral component of most PRT programs (e.g. Koegel & Koegel, 2006), and brief  parent training in PRT strategies can lead to important gains (e.g., Coolican et al., 2010). More research is needed about the impact of different training models on parents’ use of specific PRT strategies.

Objectives: To evaluate the impact of a parent training model that provides individualized, in vivo coaching in the use of PRT principles for 2 hours per day over 4 consecutive days. We examined (1) how often parents were using specific PRT strategies prior to training; (2) whether training led to significant increases in parents’ use of specific PRT strategies.

Methods: Parents of 10 preschool children participated in the study (mean age 50.85 months; 9 males and 1 female). We obtained 10-minute videotaped probes of parents encouraging their children to communicate pre- and post-training. Coders used 1-minute interval recording to rate parents’ use of 6 specific PRT strategies. Inter-rater reliability was fair to moderate for all but one strategy (following children’s lead; excluded from analyses).

Results: Prior to training, parents often provided language opportunities when children were attending (60% of intervals), and sometimes provided clear language opportunities (49% of intervals). However, they rarely contingently reinforced appropriate communication, provided natural reinforcers, or reinforced good attempts at communication (all <25% of intervals). Paired-sample t-tests were used to compare pre- and post- training scores for each PRT strategy. Following training, there were significant gains in parents’ skills providing clear language opportunities (increased to 80% of opportunities), contingently reinforcing appropriate communication (increased to 51% of intervals), providing natural reinforcement (increased to 51% of intervals), and reinforcing good attempts at appropriate communication (increased to 50% of intervals; all p< .01). There was no change in parent’s skills providing language opportunities when children were attending (p = .27).

Conclusions: The present findings suggest that this model of parent training is effective at teaching parents most PRT strategies. Parents had the most difficulty with aspects of PRT related to the provision of contingent, natural reinforcers both prior to and following training. Ongoing training may be needed to maintain and extend gains. The level of parent skill in PRT that is required to improve children’s language learning remains to be determined.