Peer-Mediated Pivotal Response Treatment for Young Children with Autism Spectrum Disorder at School
Objectives: The main objective of the present single-subject design case series was to evaluate the efficacy of peer training in PRT for improving social skills of children with ASD in the first year of school.
Methods: Four children with ASD, eight TD kindergarten peers (social skill coaches), and their parents and teachers participated. A non-concurrent multiple-probe (across participants) baseline design was used, in which TD peers were individually trained in PRT with a classmate with ASD using the Kids Helping Kids Manual (Pierce & Schriebman, 1997). Outcomes for children with ASD and peer coaches were assessed before, immediately after, and 6 to 9 weeks following training using behaviour coded from video recordings as well as questionnaires. Data were analyzed using visual inspection and percentage of non-overlapping data (PND).
Results: Overall, for children with ASD, social-communication skills (rate of social initiations and peer engagement) increased following training and were maintained at 6-9 week follow-up (M = 81.25 % PND). Peer coaches’ fidelity in implementing PRT varied more, but generally increased following training. Enhanced social-communication skills of children with ASD were demonstrated in non-training locations for all children, and generalized to non-trained same-aged peers for two of the four children.
Conclusions: Few effective interventions targeting social-communication skills for students with ASD have been implemented at school. In the present study, relatively brief training of TD peers in PRT produced gains in the social-communication skills of children with ASD in the first year of school. Our findings add to the body of literature on peer-mediated PRT and suggest that this may be an effective, feasible and cost-effective approach for children with ASD at school.