Aubyn C Stahmer1, Jessica Suhrheinrich2, Scott Roesch3, Sasha M Zeedyk4, Tiffany Wang5, Neilson Chan6, Hyon Soo Lee7. 1. University of California, Davis MIND Institute and Department of Psychiatry and Behavioral Sciences, 2825 50thSt., Sacramento, CA, 95817, United States; Child and Adolescent Services Research Center, 3020 Children's Way, MC5033, San Diego, CA 92123, United States. Electronic address: astahmer@ucdavis.edu. 2. Child and Adolescent Services Research Center, 3020 Children's Way, MC5033, San Diego, CA 92123, United States; San Diego State University, Special Education Department, United States. Electronic address: jsuhrhenrich@sdsu.edu. 3. Child and Adolescent Services Research Center, 3020 Children's Way, MC5033, San Diego, CA 92123, United States; San Diego State University, Psychology Department, United States. Electronic address: sroesch@sdsu.edu. 4. Child and Adolescent Services Research Center, 3020 Children's Way, MC5033, San Diego, CA 92123, United States; California State University, Fullerton, Department of Child and Adolescent Studies, United States. Electronic address: szeedyk@fullerton.edu. 5. Child and Adolescent Services Research Center, 3020 Children's Way, MC5033, San Diego, CA 92123, United States; University of California, Psychology Department, San Diego, United States. Electronic address: tiffanywang8@ucsd.edu. 6. Child and Adolescent Services Research Center, 3020 Children's Way, MC5033, San Diego, CA 92123, United States. Electronic address: neilsonchan@gmail.com. 7. Child and Adolescent Services Research Center, 3020 Children's Way, MC5033, San Diego, CA 92123, United States. Electronic address: gustnsoo@gmail.com.
Abstract
BACKGROUND: Research in autism spectrum disorders (ASD) has identified a need to understand key components of complex evidence-based practices (EBP). One approach involves examining the relationship between component use and child behavior. AIMS: This study provides initial evidence for identifying key components in a specific EBP, Pivotal Response Training (PRT). We examined which components were related to child response and evaluated relationships between provider characteristics, child characteristics and component intensity. METHODS: Trained coders reviewed archival videos (n = 278) for PRT fidelity and child behavior. We completed multi-level regression and latent profile analysis to examine relationships between intensity of individual or combinations of PRT components and child behavior, and moderators of component use. RESULTS: Analyses indicated differential relationships between specific components and child behaviors which may support methods of altering intensity of components to individualize intervention. Profile analysis suggested relatively intensive use of most PRT components, especially antecedent strategies, may maximize child responsivity. Providers with postgraduate education trended toward higher intensity component use. Child characteristics did not moderate use. IMPLICATIONS: Careful examination of key components of ASD interventions may helps clarify the mechanisms of action. Recommendations specific to PRT implementation and use of the methodology for other interventions are discussed.
BACKGROUND: Research in autism spectrum disorders (ASD) has identified a need to understand key components of complex evidence-based practices (EBP). One approach involves examining the relationship between component use and child behavior. AIMS: This study provides initial evidence for identifying key components in a specific EBP, Pivotal Response Training (PRT). We examined which components were related to child response and evaluated relationships between provider characteristics, child characteristics and component intensity. METHODS: Trained coders reviewed archival videos (n = 278) for PRT fidelity and child behavior. We completed multi-level regression and latent profile analysis to examine relationships between intensity of individual or combinations of PRT components and child behavior, and moderators of component use. RESULTS: Analyses indicated differential relationships between specific components and child behaviors which may support methods of altering intensity of components to individualize intervention. Profile analysis suggested relatively intensive use of most PRT components, especially antecedent strategies, may maximize child responsivity. Providers with postgraduate education trended toward higher intensity component use. Child characteristics did not moderate use. IMPLICATIONS: Careful examination of key components of ASD interventions may helps clarify the mechanisms of action. Recommendations specific to PRT implementation and use of the methodology for other interventions are discussed.