Examining Outcomes and Satisfaction in a Randomized Trial of Classroom Pivotal Response Training (CPRT)

Background:  

Autism interventions that are shown to be efficacious in controlled research settings are often not well integrated into school settings, demonstrating the need for translation or adaptation for classroom use. Classroom Pivotal Response Teaching (CPRT) is a behavioral intervention for children with ASD adapted from Pivotal Response Training through an iterative process in collaboration with researchers, teachers, and school administrators. Although the effectiveness of the original PRT protocol is well established and pilot study data suggest that CPRT may be effective in classroom settings, it has not been rigorously tested in a controlled trial. 

Objectives:  

This presentation will describe an overview of a large-scale community effectiveness trail of the CPRT intervention and preliminary teacher, paraprofessional, and student outcomes.

Methods:  

The current study uses a randomized waitlist-control design with 108 classrooms (including the lead teacher and paraprofessional educators) over three years. Preliminary data will be presented for the completed first year. Participant measures were collected in the beginning and end of the school year, across training and control conditions. Teacher measures included the Professional Development Assessment (PDA) for all teachers and fidelity of implementation of CPRT and satisfaction surveys for teachers participating in the training year. Child measures included the ADOS, cognitive battery, Vineland Adaptive Behavior Scales (VABS) and Pervasive Developmental Disability Behavioral Index (PDDBI). 

Results:  

Thus far data representing 64 teachers, 43 paraprofessionals and 114 students have been analyzed. Teachers were 95% female, 54% with Masters’ degrees and 60% with 5-15 years of experience teaching special education. Paraprofessionals were 98% female, 63% with high school degrees, and 65% with 5-15 years of experience in special education.  Students were 83% male, with an average age of 5.8 yrs. All classrooms had generally high quality ratings on the PDA. Preliminary outcome data for teachers participating in training (n = 64) indicates 75% met fidelity of implementation mastery criteria for CPRT, 100% of teachers were satisfied or very satisfied with the overall quality of training they received and 89% of teachers report CPRT is a successful or very successful strategy for children in their class. On average, teachers reported using of CPRT for 50 min/day. Time to acquisition of CPRT varied by teacher/program. Student testing data demonstrate that 99% of students met criteria for autism spectrum on the ADOS. A total of 18% of students scored within one standard deviation of the mean on cognitive assessments (80% below; 2% above). A comprehensive description of teacher, paraprofessional and child characteristics including autism severity and adaptive functioning will be provided. 

Conclusions:  

Results indicate that CPRT is feasible to implement in classroom settings and is well received by participating teachers.  Teachers learned to implement the strategies in the context of training. Collaborative adaptation of evidence-based practices may facilitate community fidelity of implementation. Variability in fidelity of implementation and use of CPRT will be discussed.