Effectiveness of Parent Education in Pivotal Response Treatment on Pivotal and Collateral Responses

Rianne Verschuur,Robert Didden,Bibi Huskens

doi:10.1007/s10803-019-04061-6

Rianne Verschuur, Robert Didden + Show 1 more

Open Access

https://doi.org/10.1007/s10803-019-04061-6

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Abstract

In two studies, we investigated the effectiveness of parent education in Pivotal Response Treatment (PRT) on parent-created opportunities and spontaneous child initiations in two community-based treatment facilities for children with autism spectrum disorder (ASD). Changes in parental stress and self-efficacy were explored. Participants were 26 parents and their children who participated in group (Study 1) or individual (Study 2) parent education in PRT. Results indicated that group-based parent education resulted in moderate increases in opportunities, functional initiations, and empathic social initiations. Furthermore, parental stress reduced and self-efficacy increased. Individual parent education resulted in large increases in opportunities and functional initiations, but parental stress and self-efficacy did not change. Implications for clinical practice and directions for future research are discussed.

Highlights

Parenting a child with autism spectrum disorder (ASD) is more demanding than parenting a typically developing child or a child with other developmental disabilities (Hayes and Watson 2013)
Children were included if they met the following inclusion criteria: (a) clinical diagnosis of ASD according to the DSM-IV-TR or DSM-5 criteria (American Psychiatric Association 2000, 2013) and confirmed by scores on the Social Responsiveness Scale (SRS-2; Constantino and Gruber 2012; Dutch version by Roeyers et al 2015) and/ or Autism Diagnostic Observation Schedule (ADOS; Lord et al 2012; Dutch version by De Bildt et al 2013), (b) aged between 3 and 15 years at baseline, and (c) total intelligence quotient (IQ), verbal/ reasoning IQ, or performance IQ above 70 on the Dutch version of the Wechsler Intelligence Scale for Children-III (WISC-III-NL; Kort et al 2005) or the Snijders-Oomen nonverbal intelligence scale-revised 21⁄2-7 (SON-R 21⁄2-7; Tellegen et al 1998)
Median rates of parent-created opportunities during baseline, intervention, and post-interventions and values of Tau are provided in Online Resource 3

Summary

Introduction

Parenting a child with autism spectrum disorder (ASD) is more demanding than parenting a typically developing child or a child with other developmental disabilities (Hayes and Watson 2013). The characteristics of ASD and associated challenging behaviors and comorbid psychopathology impact children with ASD and their parents (Karst and Van Hecke 2012). Parents of children with ASD report more parental stress, lower levels of parental self-efficacy, and less overall well-being (e.g., Frantz et al 2018; Hayes and Watson 2013; Karst and van Hecke 2012). Researchers have identified higher prevalence of depression and anxiety among parents of children with ASD (e.g., Bitsika and Sharpley 2004; Frantz et al 2018; Singer 2006). When the severity of ASD symptoms, challenging behaviors, or comorbid psychopathology exceed the ability of parents to cope, the likelihood of psychiatric hospitalization or inpatient treatment increases (Mandell et al 2012; Righi et al 2018). Approximately 6% of children with ASD receive inpatient treatment (Cidav et al 2013)

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