Teacher Implemented Pivotal Response Training To Improve Communication In Children With Autism Spectrum Disorders

The primary purpose of this current investigation was to determine if a variation of Pivotal Response Training (PRT) can be effectively implemented by a preschool autism teacher in a classroom setting. The secondary purpose was to measure changes in spontaneous prompted and echoic expressive language (i.e. words and phrases) in children with autism spectrum disorders (ASD). This study included three preschool children with an educational diagnosis of autism and one classroom teacher. A multiple baseline design across participants was utilized in which the three children engaged in baseline teacher training PRT treatment and generalization phases. During the baseline phase the children engaged in teacher lesson activities teacher play activities and peer play activities to measure teacher and child behaviors in their existing state. During the teacher training phase the teacher learned to utilize PRT through a collaborative consultation model. More specifically the teacher read PRT strategy manuals discussed PRT strategies with the primary investigator and the primary investigator modeled and role played with the teacher in order to effectively implement the PRT strategies. During the treatment phase the teacher independently implemented PRT strategies during the teacher lesson activities. In the generalization phase children engaged in teacher play and peer play activities (presented in the same manner as found in the baseline phase) to determine if behavior changes (teacher and child) generalized into nontargeted activities. Throughout the course of this investigation two child measures and one teacher measure were obtained during the investigation. The first child measure reflected spontaneous prompted and echoic expressive language to determine language improvement as a result of teacher implemented PRT. The second child measure reflected the child's play behaviors to determine behavior improvement in nontargeted activities (peer play teacher play) as a result of teacher implemented PRT. The one teacher measure reflected if the classroom teacher effectively implemented PRT during the teacher lesson and teacher play. Findings from this investigation revealed several improvements relative to teacher and child behaviors. Relative to the teacher behavior the classroom teacher effectively learned how to appropriately implement all PRT strategies during the teacher lesson activities for all three children. By engaging the teacher in a collaborative consultation model the teacher's behavior systematically improved. Additionally results documented that the teacher generalized some but not all of the PRT strategies to the teacher play activities (nontargeted activities). More specifically the teacher significantly improved implementation of the following PRT strategies into teacher play activities: Child attending (Child 3) providing clear opportunities (Child 1 2 3) providing contingent reinforcement (Child 1 2 3) providing contingent reinforcement for attempts (Child 1 2 3) providing social reinforcement (child 2) maintenance tasks (approaching statistical significance for Child 3) following the child's lead (Child 1 and 2) turn taking (Child 2 3) and child's choice (Child 2). These results are promising in that the teacher effectively implemented PRT in a new setting where no direct instruction of how to utilize PRT was provided. Findings related to the child's behaviors indicated that expressive language improvements were evidenced for all three children. More specifically improvements in spontaneous words (Child 1 2 3) prompted words (Child 1 2 3) and echoic words (Child 1 2) were noted during the teacher lesson activities. Additionally improvements in spontaneous phrases (Child 1 2) prompted phrases (Child 1) and echoic phrases (Child 1 2) were evidenced during the teacher lesson activities. Findings indicate that language improvements in all three children were a direct result of teacher implemented PRT during the teacher lesson. In addition to documented language improvements during teacher lesson activities expressive language improvements were noted for Child 3 in the areas of prompted words and spontaneous phrases during teacher play activities. Generalization of expressive language skills (i.e. prompted words spontaneous phrases) from the teacher lesson activities to the teacher play activities suggest that improvements may be due to the fact that some of the PRT strategies were incorporated into the teacher play activities thus eliciting more communication from Child 3. Improvements in child play behaviors during peer and teacher play activities also evidenced. During peer play activities it was found that Child 2 and 3 demonstrated significant improvements for appropriate play and functional play. During teacher play activities Child 1 exhibited significant improvements for symbolic play whereas Child 3 demonstrated significant improvements in the areas of joint attention eye contact appropriate play and functional play and decreases in inappropriate play. Improved play skills may be a result of utilization of educational materials and toys by the teacher that were of interest to the children as well as improved manipulation of play materials by the children which generalized into play activities. These improvements suggest that the children developed play scripts and used toys more appropriately. Furthermore these increases may have motivated the children to interact and share toys with other individuals as a result of teacher implemented PRT during the teacher lesson activities.