Examining the Efficacy of Teacher Training Models for Pivotal Response Treatment: A Comparison of in-Person Coaching and Video-Feedback

Background:   Pivotal Response Treatment (PRT) is an evidenced-based practice of naturalistic behavioral principles that enhances social-communication and engagement behaviors of children with autism spectrum disorders (ASD).   Traditionally delivered in-person, access to PRT training remains a challenge for regions without immediate access to an expert coach.   The use of video-feedback may provide access to high-quality training to meet the needs present in rural areas and regions that traditionally have difficulties with access to care.

Objectives:  This presentation will review initial data from a nonequivalent quasi-experimental between-group design on the comparison of an in-person training model and video-feedback training model for teachers and paraprofessionals of children with autism and emergent social-communication skills.

Methods:  This study is a nonequivalent quasi-experiment between-group examination of PRT training models comparing an in-person training model group and a video-feedback training model group.   Both treatment groups were provided an in-person dyadic initial overview training of PRT principles.  The in-person treatment group was then provided weekly 25-minute in-person sessions of independent implementation, coached practice, and feedback, while the video-feedback treatment group was provided weekly typed feedback after reviewing videos of independent implementation.  Both treatment groups were considered at fidelity when the teacher achieved at least 80% fidelity of implementation across 3 consecutive feedback sessions.  Collection of maintenance and generalization data is on-going.  Participants included children with ASD and significant language delays, ages 3-10 years who are eligible for special services in public school settings.  Dependent measures include structured behavior observations of teachers’ fidelity of implementation and children’s social-communication and engagement behaviors.

Results:  To date, 40 teacher-child pairs have completed. Data collection is ongoing with an estimated n=76 (41 in-person feedback and 35 video feedback) to be completed by March 2016. Preliminary data has been analyzed for 18 participants (n=9 per training group). There were no statistically significant differences between the two training groups in regard to teachers’ baseline ability or children’s characteristics. Initial data analysis indicates there is no statistically significant difference between the average number of sessions to obtain fidelity whether the training was conducted in-person or via video feedback. Children in both treatment groups acquired similar levels of increases in social-communication and engagement skills as fidelity of PRT implementation was achieved by teachers.  No statistically significant differences were observed between training groups in regard to their maintenance levels of PRT fidelity. 

Additional analyses will be conducted to examine the potential relationship between teacher fidelity, child response to intervention and child characteristics in the domains of: cognition, communication, social engagement, toy play, self-stimulatory behavior, avoidant behavior and maladaptive behavior.  Analysis regarding social validity for both training models will also be included.

Conclusions:   These preliminary data suggests promise in reaching remote sites with high quality training through the use of video feedback.  Potential benefits and challenges of video-based feedback training models and areas in need of future research will be discussed.