Using Pivotal Response Treatment to Improve Language Functions of Autistic Children in Special Schools: A Randomized Controlled Trial

Language difficulties exert profound negative effects on the cognitive and social development of autistic children. Pivotal Response Treatment (PRT) is a promising intervention for improving social communication in autistic children, but there is a lack of a comprehensive examination of language functions. This study aimed to investigate the effectiveness of PRT in promoting the primary language functions (requesting, labeling, repeating, responding) defined by (Skinner, B. F. (1957). Verbal behavior. Martino Publishing.) theory of verbal behavior in autistic children. Thirty autistic children were randomly divided into the PRT group (Mage = 6.20, SDage = 1.21) and control group (Mage = 6.07, SDage = 1.49). The PRT group were provided with an 8-week training of the PRT motivation component in addition to treatment as usual (TAU) in their schools, whereas the control group only received TAU. Parents of the PRT group were also trained to practice the PRT motivation procedures at home. The PRT group demonstrated greater improvements in all four measured language functions compared to the control group. The improvement in language functions in the PRT group was generalized and maintained at the follow-up assessment. In addition, the PRT intervention enhanced untargeted social and communicative functioning, cognition, motor skills, imitation, and adaptive behaviors in the autistic children. In conclusion, language intervention using the motivation component of PRT is effective in promoting language functions as well as widespread untargeted cognitive and social functions in autistic children.

A demonstration of how to do a meta-analysis that combines single-case designs with between-groups experiments: The effects of choice making on challenging behaviors performed by people with disabilities

OBJECTIVE

This paper demonstrates how to conduct a meta-analysis that includes both between-group and single-case design (SCD) studies. The example studies whether choice-making interventions decrease challenging behaviors performed by people with disabilities.

METHODS

We used a between-case d-statistic to conduct a meta-analysis of 15 between-group and SCD studies of 70 people with a disability, who received a choice intervention or control. We used robust variance estimation to adjust for dependencies caused by multiple effect sizes per study, and conducted moderator, sensitivity, influence, and publication bias analyses.

RESULTS

The random-effects average was d = 1.02 (standard error of 0.168), so the 95% confidence interval (CI) suggests choice-making reduces challenging behaviors by 0.65 to 1.38 standard deviations. Studies that provided choice training produced a significantly larger intervention effect.

CONCLUSION

Choice-making reduces challenging behaviors performed by people with disabilities.

Embedding perseverative interest of a child with autism in text may result in improved reading comprehension: A pilot study

OBJECTIVE

We investigated the effects of embedding the perseverative interest (PI) of a child with autism (i.e. cars) within texts on reading comprehension.

METHODS

A PI text condition (text altered to include cars) was compared with a non-PI text condition (same story without cars inserted) in an alternating treatment design. Dependent variables were responses to reading comprehension questions and number of words uttered during an oral retell (i.e. curriculum-based measures [CBMs]). The reading level, instructional routines, and therapist where held constant across the randomly alternated conditions.

RESULTS

Both CBMs suggested that reading comprehension was enhanced when the story included the child's PI.

CONCLUSIONS

These preliminary findings suggest that embedding the PIs of students with autism spectrum disorder within readings may result in more accurate responses to reading comprehension questions and more detailed oral retelling. These findings are discussed in terms of potential directions for future research.

The relationship between self-determination and academic achievement for adolescents with intellectual disabilities

Previous research has demonstrated that for students with intellectual disabilities, improved self-determination skills are positively correlated with productivity and organization during school and quality of life outcomes in adulthood. Despite extensive investigation in these areas, the predictive relationship between self-determination and academic achievement for students with intellectual disabilities has not been fully established. This study utilized the sample from the National Longitudinal Transition Study-2 of 480 adolescents with intellectual disabilities in the United States in an attempt to provide a possible empirical explanation of the relationship between academic achievement and self-determination, taking into account the covariates of gender, family income and urbanicity. The structural equation model was found to closely fit the data: all path coefficients were statistically significant. The results of this study identify a strong correlation between self-determination and academic achievement for adolescents with intellectual disabilities, indicating a linear relationship of these skills and supporting an increased focus on the teaching of self-determination skills.

Four Methods for Analyzing Partial Interval Recording Data, with Application to Single-Case Research

Partial interval recording (PIR) is a procedure for collecting measurements during direct observation of behavior. It is used in several areas of educational and psychological research, particularly in connection with single-case research. Measurements collected using partial interval recording suffer from construct invalidity because they are not readily interpretable in terms of the underlying characteristics of the behavior. Using an alternating renewal process model for the behavior under observation, we demonstrate that ignoring the construct invalidity of PIR data can produce misleading inferences, such as inferring that an intervention reduces the prevalence of an undesirable behavior when in fact it has the opposite effect. We then propose four different methods for analyzing PIR summary measurements, each of which can be used to draw inferences about interpretable behavioral parameters. We demonstrate the methods by applying them to data from two single-case studies of problem behavior.

The influence of the design matrix on treatment effect estimates in the quantitative analyses of single-subject experimental design research

The quantitative methods for analyzing single-subject experimental data have expanded during the last decade, including the use of regression models to statistically analyze the data, but still a lot of questions remain. One question is how to specify predictors in a regression model to account for the specifics of the design and estimate the effect size of interest. These quantitative effect sizes are used in retrospective analyses and allow synthesis of single-subject experimental study results which is informative for evidence-based decision making, research and theory building, and policy discussions. We discuss different design matrices that can be used for the most common single-subject experimental designs (SSEDs), namely, the multiple-baseline designs, reversal designs, and alternating treatment designs, and provide empirical illustrations. The purpose of this article is to guide single-subject experimental data analysts interested in analyzing and meta-analyzing SSED data.

Meta-analysis of studies incorporating the interests of young children with autism spectrum disorders into early intervention practices

Incorporating the interests and preferences of young children with autism spectrum disorders into interventions to promote prosocial behavior and decrease behavior excesses has emerged as a promising practice for addressing the core features of autism. The efficacy of interest-based early intervention practices was examined in a meta-analysis of 24 studies including 78 children 2 to 6 years of age diagnosed with autism spectrum disorders. Effect size analyses of intervention versus nonintervention conditions and high-interest versus low-interest contrasts indicated that interest-based intervention practices were effective in terms of increasing prosocial and decreasing aberrant child behavior. Additionally, interest-based interventions that focused on two of the three core features of autism spectrum disorders (poor communication, poor interpersonal relationships) were found most effective in influencing child outcomes. Implications for very early intervention are discussed in terms addressing the behavior markers of autism spectrum disorders before they become firmly established.

A comparison of the effects of providing activity and material choice to children with autism spectrum disorders

The present study compares the effects of providing choice between activities or between materials for completion of activities on the on-task behavior of 4 boys with autism spectrum disorders. Results showed that the participants displayed higher levels of on-task behavior during the choice conditions than in the no-choice condition. However, the type of choice opportunity did not seem to have a differential effect.

Autism and pervasive developmental disorders

The quantity and quality of research into autism and related conditions have increased dramatically in recent years. Consequently we selectively review key accomplishments and highlight directions for future research. More consistent approaches to diagnosis and more rigorous assessment methods have significantly advanced research, although the boundaries of the 'broader phenotype' remain to be defined and the validity of Asperger's disorder as a discrete syndrome remains controversial. Recent epidemiological studies have shown that Autism Spectrum Disorders are common, but there continues to be debate about the causes of the increase in the frequency with which autism is diagnosed. Psychological research has helped to develop new developmental models for the disorder and there have also been significant advances in the molecular genetics of autism and understanding of the underlying neurobiological processes. Areas important for future research include the study of autism as it first develops, i.e., in infants and very young children, and of specific processes (psychological and neurobiological) which underlie the disorder. Significant challenges lie ahead in evaluating the growing number of treatments for autism and in integrating the results of research into treatment and educational settings.

Priming as a Method of Coordinating Educational Services for Students With Autism

Purpose: The importance of coordination of educational services has been well documented in the literature. For students with disabilities, coordinated programs result in more rapid acquisition of targeted behaviors and the increased likelihood of long-term maintenance of gains. The purpose of this study was to assess whether "priming" or exposing students with autism and disruptive behaviors to school assignments before their presentation in class would affect academic performance and problem behaviors.

Method: Two students diagnosed with autism who attended general education classrooms, both of whom exhibited numerous disruptive behaviors and low academic performance, participated in this study. A repeated reversals design was used to monitor student progress.

Results: The results demonstrated decreases in problem behavior and increases in academic responding when priming sessions occurred.

Clinical Implications: Application is discussed in terms of a mechanism for speech-language pathologists to assist classroom teachers with a systematic educational coordination plan that can quickly produce improved school performance.

The influence of activity choice on problem behaviors maintained by escape versus attention

This study assessed whether the function of an individual's problem behavior was related to the effectiveness of an intervention involving choice among tasks. Analogue functional analyses were conducted with 7 students with various diagnoses to determine whether problem behaviors were maintained by escape or attention. Following identification of the function of each student's problem behavior, reversal designs were used to assess the effectiveness of an intervention that allowed the students to choose their own instructional tasks. Results showed that students who displayed escape-maintained problem behavior showed substantial reductions in such behavior when they were provided with opportunities to choose among tasks. On the other hand, students who displayed attention-maintained problem behavior did not show any effects as a result of the choice intervention. These findings are discussed in terms of the effective use of behavior management programs involving choice and the reduction of problem behavior.

Pivotal areas in intervention for autism

Discusses several core pivotal areas that appear to be influential in intervention for autism. Literature and outcome data are reviewed with respect to several core areas that appear to be particularly helpful in intervention for autism, including improving motivation, responsivity to multiple cues, self-management, and self-initiation of social interactions. A conceptual framework is described, and outcome data are reviewed suggesting that when children with autism are motivated to initiate complex social interactions, it may reverse a cycle of impairment, resulting in exceptionally favorable intervention outcomes for many children. Because the peripheral features of autism can be numerous and extensive, the concept of intervention for pivotal areas of functioning may be critical if children are to be habilitated in a time- and cost-efficient manner.