Academic journal article The Journal of Speech-Language Pathology and Applied Behavior Analysis

A Preliminary Assessment of Teachers' Implementation of Pivotal Response Training

Academic journal article The Journal of Speech-Language Pathology and Applied Behavior Analysis

A Preliminary Assessment of Teachers' Implementation of Pivotal Response Training

Article excerpt

Abstract

Many school districts and early intervention programs are struggling to provide appropriate, evidence-based services for children with autism. Pivotal Response Training (PRT) is a naturalistic behavior form of therapy shown to be effective for increasing language and play skills in children with autism. This study examines implementation of PRT in community programs where teachers have received varying levels of training. Results indicate that ongoing supervision and feedback may be a necessary component of effective training. Additionally, years of teaching experience may affect implementation in group settings. Implications for translation of evidence-based practices to community settings are discussed.

Keywords: autism, pivotal response training, teacher training.

Introduction

Autism is a pervasive developmental disorder, characterized by impairments in communication and social functioning along with restricted, repetitive, and stereotyped patterns of behavior (American Psychiatric Association, 1994). Social deficits manifest in avoidance of eye contact, failure to develop peer relationships, resistance to affection, high levels of isolated play, and limited play skills (e.g., Cox & Mesibov, 1995; Harris, Belchic, Blum & Celeberti, 1994; Rimland, 1964; Schreibman, 1988). Many children with autism do not develop language. Children who acquire speech often develop non-communicative speech patterns, use language sparingly, or the language they do develop is often quite rote in nature (Schreibman, 1988). Self-stimulatory and repetitive behaviors can interfere with learning new skills.

Over the last two decades, estimates of the prevalence of autism have increased from 4 to 5 per 10,000 children to nearly 10 times that number, with current estimates at 3 to 4 per 1000 children (Baird, Charman, et al., 2001; Fombonne, 2003). This rapid acceleration in diagnosis rate has placed significant strain on service providers. Many school districts, early intervention programs, and speech therapists are struggling to provide appropriate, evidence-based services for children with autism. The pervasive nature of the deficits associated with autism has challenged educational programs to provide intervention methods that are both intensive and practical in terms of requirements for implementation.

In response to this growing need, many early intervention programs are attempting to use evidence-based practices. Autism researchers report that translation of evidence-based interventions to service settings is important (McGee, Morrier, & Daly, 1999), but express concerns about the current quality of these interventions when applied in community programs. Due to limited funding and training researchers are skeptical about the ability and/or willingness of public programs to utilize evidence-based practices to provide quality treatment (McGee et al., 1999). There is concern that service systems attempting to replicate research models may not assess fidelity of implementation (the accuracy with which the intervention is implemented) or replicate all aspects of the program (Cohen, 1999). Interventions for young children with autism must be implemented with precision to substantially alter developmental trajectory (McGee & Morrier, 2005). Therefore, a great deal of training is needed in order to implement evidence-based practices with the precision used in a majority of research programs. Teachers, therapists and paraprofessionals who provide treatment for children with autism in public schools often have limited access to effective training in empirically based therapy methods (Lord & McGee, 2001). Although public school teachers report wanting to use empirically supported methods, their enthusiasm for using these techniques wanes when the necessary training is not provided (Norsworthy & Sievers, 1987).

One evidence-based method that teachers report using in their classrooms is Pivotal Response Training. …

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