Abstract
Accumulating studies are documenting specific motivational variables that, when combined into a naturalistic teaching paradigm, can positively influence the effectiveness of interventions for children with autism spectrum disorder (ASD). The purpose of this study was to compare two applied behavior analysis (ABA) intervention procedures, a naturalistic approach, pivotal response treatment (PRT) with a structured ABA approach in a school setting. A randomized clinical trial design using two groups of children, matched according to age, sex and mean length of utterance was used to compare the interventions. The data showed that the PRT approach was significantly more effective in improving targeted and untargeted areas after 3 months of intervention. The results are discussed in terms of variables that produce more rapid improvements in communication for children with ASD.
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References
American Psychological Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, D.C.
Bishop, D. V. M. (2006). Children’s communication checklist (2nd ed., U.S. ed.). San Antonio, TX: Psychological Corporation.
Blumburg, S. J., Bramlett, M. D., Kogan, M. D., Schieve, L. A., Jones, J. R., & Lu, M. C. (2013). Changes in prevalence of parent-reported autism spectrum disorder in school-aged U.S. children: 2007-2011-1012. National Health Statistics Reports. 65, http://www.cdc.gov/nchs/data/nhsr/nhsr065.pdf.
Boettcher, M. A. (2004). Teaching social conversation skills to children with autism through self-management: An analysis of treatment gains and meaningful outcomes.
Bryson, S. E., Koegel, L. K., Koegel, R. L., Openden, D., Smith, I. M., & Nefdt, N. (2007). Large scale dissemination and community implementation of Pivotal Response Treatment: Program description and preliminary data. Research & Practice for Persons with Severe Disabilities, 32(2), 142–153.
Carr, E. G., & Durand, V. M. (1985). Reducing behavior problems through functional communication training. Journal of Applied Behavior Analysis, 18(2), 111–126.
Catts, H. W. (1996). The relationship between speech-language impairments and reading disabilities. Journal of Speech and Hearing Research, 1993(36), 948–958.
Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., et al. (2010). Randomized, controlled trial of an intervention for toddlers with autism: The early start Denver model. Pediatrics, 125(1), e17–e23.
DeMyer, M., Hingtgen, J., & Jackson, R. (1981). Infantile autism reviewed: A decade of research. Schizophrenia Review, 7(3), 388–451.
Donno, R., Parker, G., Gilmour, J., & Skuse, D. H. (2010). Social communication deficits in disruptive primary-school children. The British Journal of Psychiatry, 196(4), 282–289.
Dunlap, G. (1984). The influence of task variation and maintenance tasks on the learning and affect of autistic children. Journal of Experimental Child Psychology, 37(1), 41–64.
Greenspan, S. I., & Wieder, S. (1999). A functional developmental approach to autism spectrum disorders. The Journal of the Association for Persons with Severe Handicaps, 24(3), 147–161.
Greenspan, S. I., Wieder, S., & Simons, R. (1998). The child with special needs: Encouraging intellectual and emotional growth. Reading, MA: Addison Wesley Longman 1998.
Hancock, T. B., & Kaiser, A. P. (2002). The effects of trainer-implemented enhanced milieu teaching on the social communication of children with autism. Topics in Early Childhood Special Education, 22(1), 39–54.
Handleman, J. S., & Harris, S. L. (Eds.). (2001). Preschool education programs for children with autism. Austin, TX: Pro-ed.
Ingersoll, B., & Schreibman, L. (2006). Teaching reciprocal imitation skills to young children with autism using a naturalistic behavioral approach: Effects on language, pretend play, and joint attention. Journal of Autism and Developmental Disorders, 36(4), 487–505.
Koegel, L. K. (2011). Pivotal response treatment: Using motivation as a pivotal response. Santa Barbara: University of California.
Koegel, R. L., Bimbela, A., & Schreibman, L. (1996a). Collateral effects of parent training on family interactions. Journal of Autism and Developmental Disorders, 26(3), 347–359.
Koegel, R. L., Camarata, S., Koegel, L. K., Ben-Tall, A., & Smith, A. E. (1998). Increasing speech intelligibility in children with autism. Journal of Autism and Developmental Disorders, 28(3), 241–251.
Koegel, K., Green-Hopkins, I., & Barnes, C. C. (2010a). Brief report: Question-asking and collateral language acquisition in children with autism. Journal of Autism and Developmental Disorders, 40, 509–515.
Koegel, R. L., & Koegel, L. K. (2006). Pivotal response treatments. Baltimore, MD: Paul H. Brookes Publishing Co.
Koegel, L. K., Koegel, R. L., Ashbaugh, K., & Bradshaw, J. (2014). The importance of early identification and intervention for children with or at risk for autism spectrum disorders. International Journal of Speech-Language Pathology, 0, 1–7.
Koegel, L. K., Koegel, J. K., Harrower, J. K., & Carter, C. M. (1996b). Pivotal response intervention I: Overview of approach. The Journal of the Association for Persons with Severe Handicaps, 24(3), 174–185.
Koegel, L. K., Koegel, J. K., Harrower, J. K., & Carter, C. M. (1999a). Pivotal response intervention I: Overview of approach. The Journal of the Association for Persons with Severe Handicaps, 24(3), 174–185.
Koegel, L. K., Koegel, R. L., Shoshan, Y., & McNerney, E. (1999b). Pivotal response intervention II: Preliminary long-term outcome data. The Journal of the Association for Persons with Severe Handicaps, 24(3), 186–198.
Koegel, R. L., Koegel, L. K., & Surratt, A. V. (1992). Language intervention and disruptive behavior in preschool children with autism. Journal of Autism and Developmental Disorders, 22(2), 141–153.
Koegel, R. L., O’Dell, M., & Dunlap, G. (1988). Producing speech use in nonverbal autistic children by reinforcing attempts. Journal of Autism and Developmental Disorders, 18(4), 525–538.
Koegel, R. L., O’Dell, M. C., & Koegel, L. K. (1987). A natural language teaching paradigm for nonverbal autistic children. Journal of Autism and Developmental Disorders, 17(2), 187–200.
Koegel, L. K., Singh, A. K., & Koegel, R. L. (2010b). Improving motivation for academics in children with autism. Journal of Autism and Developmental Disorders, 40(9), 1057–1066.
Koegel, R. L., & Williams, J. A. (1980). Direct versus indirect response-reinforcer relationships in teaching autistic children. Journal of Abnormal Child Psychology, 8(4), 537–547.
Landa, R. (2007). Early communication development and intervention for children with autism. Mental Retardation and Developmental Disabilities Research Reviews, 13(1), 16–25. doi:10.1002/mrdd.20134.
Leaf, R. B. (1999). A work in progress: Behavior management strategies and a curriculum for intensive behavioral treatment of autism (pp. 1417–1418). J. McEachin (Ed.). New York: Drl Books.
Locke, J., Ishijima, E. H., Kasari, C., & London, N. (2010). Loneliness, friendship quality and the social networks of adolescents with high-functioning autism in an inclusive school setting. Journal of Research in Special Education Needs, 10(3), 74–81.
Lovaas, O. I. (1981). The me book. Austin, Texas: Pro-Ed, Inc.
Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55(1), 3–9.
Mahoney, G., & Perales, F. (2003). Relationship-focused intervention to enhance the social-emotional functioning of young children with autism spectrum disorders. Topics in Early Childhood Special Education, 23(2), 74–86.
Matson, J. L., Benavidez, D. A., Compton, L. S., Paclawskyj, T., & Baglio, C. S. (1996). Behavioral treatment of autistic persons: A review of research from 1980 to the present. Research in Developmental Disabilities, 17, 433–465.
Miller, J. F. (1981). Assessing language production in children: Experimental procedures. Boston, NY: Allyn & Bacon.
National Autism Center. (2009). National standards project: Addressing the need for evidence-based practice guidelines for autism spectrum disorder. Findings and conclusions. http://www.nationalautismcenter.org/pdf/NAC%20Findings%20&%20Conclusions.pdf.
National Research Council. (2001). Educating children with autism. Washington, D.C.: The National Academy Press.
Nelson, K. E., Camarata, S. M., Welsh, J., Butkovsky, L., & Camarata, M. (1996). Effects of imitative and conversational recasting treatment on the acquisition of grammar in children with specific language impairment and younger language-normal children. Journal of Speech and Hearing Research, 39(4), 850–859.
Prizant, B. M., Wetherby, A. M., Rubin, E., & Laurent, A. C. (2003). The SCERTS model: A transactional, family-centered approach to enhancing communication and socioemotional abilities of children with autism spectrum disorder. Infants and Young Children, 16(4), 296–316.
Salt, J., Shemilt, J., Sellars, V., Boyd, S., Coulson, T., & McCool, S. (2002). The Scottish centre for autism preschool treatment programme: II. The results of a controlled treatment outcome study. Autism, 6(1), 33–46.
Short, A., & Schopler, E. (1988). Factors relating to age of onset in autism. Journal of Autism and Developmental Disorders, 18, 207–216.
Simpson, R. L. (2005). Evidence-based practices and students with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 20(3), 140–149.
Ungerer, J. A., & Sigman, M. (1984). The relation of play and sensorimotor behavior to language in the second year. Child Development, 55, 1448–1455.
Volkmar, F. R., Lord, C., Bailey, A., Schultz, R. T., & Klin, A. (2004). Autism and pervasive developmental disorders. Journal of Child Psychology and Psychiatry, 45(1), 135–170.
Williams, J. A., Koegel, R. L., & Egel, A. L. (1981). Response-reinforcer relationships and improved learning in autistic children. Journal of Applied Behavior Analysis, 14(1), 53–60.
Yoder, P. J., Kaiser, A. P., Alpert, C., & Fischer, R. (1993). Following the child’s lead when teaching nouns to preschoolers with mental retardation. Journal of Speech and Hearing Research, 36, 158–167.
Acknowledgments
This project was supported in part by the Zehne Ziba Rehabilitation Institute in Hamedan, Iran, and University of Social Welfare and Rehabilitation Sciences in Tehran, Iran, and the National Institute of Health research grant (DC010924). We are grateful to the teachers and parents who completed the measures, and the children who participated in this research. Also, we would like to thank Diane Morovati and Robert L. Koegel for their feedback during the preparation of this manuscript. We would also like to thank the Broad Foundation, the Kind World Foundation, and the Douglas foundation for their support. In addition to being employed at the University of California at Santa Barbara, Dr. Lynn Kern Koegel is also a partner in the private firm, Koegel Autism Consultants.
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Mohammadzaheri, F., Koegel, L.K., Rezaee, M. et al. A Randomized Clinical Trial Comparison Between Pivotal Response Treatment (PRT) and Structured Applied Behavior Analysis (ABA) Intervention for Children with Autism. J Autism Dev Disord 44, 2769–2777 (2014). https://doi.org/10.1007/s10803-014-2137-3
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DOI: https://doi.org/10.1007/s10803-014-2137-3