Improvements in micro level indices of social communication following Pivotal Response Treatment (PRT)

Pivotal Response Treatment (PRT) is an evidence-based treatment for individuals with ASD that targets social communication skills, most notably social motivation. The aim of the current study was to map microanalytic changes in social communication during dyadic child-therapist interactions following a 16-week trial of PRT. We proposed that a microanalytic approach would allow us to meticulously outline the dynamics of the “building blocks” of children’s discourse, stressing certain aspect that might go unnoticed in global methods of coding. We hypothesized that PRT would improve measures of linguistic social communication in children.

We utilized continuous microanalysis of behavior to explore changes in social communication during PRT sessions in 20 high-functioning children with ASD (ages 4–7 years). For each child, two videotaped PRT sessions – at the beginning and end of these 16 weeks – were coded for vocalizations and verbalizations. This allowed us to compare the amount, fluency, adequacy and reciprocity of social communication between child and therapist at the early versus final stages of PRT.

Results

Compared to baseline, at endpoint, children increased their overall use of vocalizations as well as the congruency of their responses to those of the therapist. The amount of non-congruent responses also dropped significantly. Additionally, children improved in measures of conversational fluency and use of self-referential pronouns.

Conclusions

These results provide a mapping of microanalytic changes in social and linguistic communication that occur during PRT and point to children’s improvement in social communication behavior leading to greater social reciprocity and conversational synchrony following treatment.