Reduced Restricted and Repetitive Behaviors after Pivotal Response Treatment
Children with ASD show a high frequency of Restricted and Repetitive Behaviors (RRBs), and these behaviors interfere with daily functioning (Harrop et al., 2014). However, RRBs have remained largely resistant to behavioral interventions and pharmacological treatments within the context of controlled trials (Harrop, 2015; Tanner, Hand, O'Toole, & Lane, 2015). Pivotal Response Treatment (PRT) is a naturalistic behavioral treatment that focuses on increasing a child’s motivation and improving social function.
We investigated change in the severity of RRBs in children with ASD who participated in a 16-week trial of PRT.
Participants included 15 children with ASD between the ages of 4 and 7 (Mean IQ = 98.7, SD = 19.7) who took part in a 16-week PRT trial. Treatment included 6 hours per week of individual work with the child as well as training the parents in implementing PRT at home. Inclusion criteria for the study were diagnosis of ASD and IQ > 70 as measured by the Differential Abilities Scales-2nd Edition. To assess RRBs, parents completed the Repetitive Behavioral Scales- Revised (RBS-R) and Aberrant Behaviors Checklist (ABC) before and after the 16 weeks of PRT.
Results: Overall, RRBs decreased significantly following 16 weeks of PRT (RBS-R Total Score: pre-PRT M= 28.36, SD= 19.70; post-PRT M= 16.27, SD= 12.60, p<0.01). Individual RBS-R subdomains for stereotyped behavior (p < 0.01), self-injury (p < 0.02), ritualistic behavior (p < 0.05), sameness (p < 0.01) and restricted behaviors (p < 0.02) decreased significantly as did the stereotypy subdomain of the ABC (pre-PRT M= 3.57, SD= 3.23; post-PRT M= 1.43, SD = 2.71, p < 0.001).
Based on these preliminary results, RRBs significantly decreased following a 16-week trial of PRT. This improvement may be a result of greater communication competency and improved social engagement, potentially in combination with stronger emotion regulation. Further study can determine if these results hold in a broader sample and investigate the mechanisms of improvement.
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