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Pivotal Response Treatment Package: Combined Parent Training with Clinician-Delivered in-Home Treatment
Objectives: This presentation will review initial outcomes from a randomized controlled trial of a PRT package treatment (PRT-P) which combines parent training with clinician-delivered in-home treatment.
Methods: This study is a randomized controlled trial of PRT-P compared to a Delayed Treatment Group (DTG). The active treatment involves weekly parent training and 10 hours per week of in-home therapist-delivered treatment for 3 months, followed by a less-intensive phase with 5 hours per week of in-home treatment and monthly parent training sessions. Participants include children with ASD and significant language delay, ages 2-5 years. Dependent measures include Clinical Global Impression Improvement (CGI-I) ratings by trained raters blinded to treatment condition, as well as standardized parent questionnaires and structured behavioral observations.
Results: To date, 18 subjects have been randomized. The trial is ongoing and preliminary data are currently available from 14 participants. CGI-I ratings focused specifically on communication indicate 3 children rated as very much improved (0 in DTG), 4 children rated as much improved (2 in DTG), 1 child rated as minimally improved (3 in DTG) and no children rated “no change” (1 in DTG). Preliminary examination of changes with PRT-P revealed that children in the active group are acquiring language skills as evidenced by increased performance on the Vineland Adaptive Behavior Scales, Second Edition (Vineland-II) Expressive Language raw scores (Baseline: 28.55 ± 9.63 ; Post-treatment: 37.13 ± 14.93) and an average gain of over 100 words between baseline (M=70.67 ± 23.46) and post treatment (M=187.67 ± 46.97) on the MacArthur-Bates Communicative Development Inventories.
Conclusions: These preliminary data suggest that the PRT package approach shows promise for addressing communication deficits associated with ASD. Potential benefits and challenges of a combined parent training and clinician-delivered intervention approach will be discussed and areas in need of future research will be explored.
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