title: A randomized controlled trial of Pivotal Response Treatment Group for parents of children with autism.
abstract: BACKGROUND
  With rates of autism diagnosis continuing to rise, there is an urgent need for effective and efficient service delivery models. Pivotal Response Treatment (PRT) is considered an established treatment for autism spectrum disorder (ASD); however, there have been few well-controlled studies with adequate sample size. The aim of this study was to conduct a randomized controlled trial to evaluate PRT parent training group (PRTG) for targeting language deficits in young children with ASD.
  
  
  METHODS
  Fifty-three children with autism and significant language delay between 2 and 6 years old were randomized to PRTG (N = 27) or psychoeducation group (PEG; N = 26) for 12 weeks. The PRTG taught parents behavioral techniques to facilitate language development. The PEG taught general information about ASD (clinical trial NCT01881750; http://www.clinicaltrials.gov).
  
  
  RESULTS
  Analysis of child utterances during the structured laboratory observation (primary outcome) indicated that, compared with children in the PEG, children in the PRTG demonstrated greater improvement in frequency of utterances (F(2, 43) = 3.53, p = .038, d = 0.42). Results indicated that parents were able to learn PRT in a group format, as the majority of parents in the PRTG (84%) met fidelity of implementation criteria after 12 weeks. Children also demonstrated greater improvement in adaptive communication skills (Vineland-II) following PRTG and baseline Mullen visual reception scores predicted treatment response to PRTG.
  
  
  CONCLUSIONS
  This is the first randomized controlled trial of group-delivered PRT and one of the largest experimental investigations of the PRT model to date. The findings suggest that specific instruction in PRT results in greater skill acquisition for both parents and children, especially in functional and adaptive communication skills. Further research in PRT is warranted to replicate the observed results and address other core ASD symptoms.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA.
authors.forename: Antonio Y
authors.initials: AY
authors.lastname: Hardan
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA.
authors.forename: Grace W
authors.initials: GW
authors.lastname: Gengoux
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA.
authors.forename: Kari L
authors.initials: KL
authors.lastname: Berquist
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA.
authors.forename: Robin A
authors.initials: RA
authors.lastname: Libove
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA.
authors.forename: Christina M
authors.initials: CM
authors.lastname: Ardel
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Phillips
authors.affiliation: Center for Autism, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Frazier
authors.affiliation: Seattle Children's Hospital/Seattle Children's Research Institute, Seattle, WA, USA.
authors.forename: Mendy B
authors.initials: MB
authors.lastname: Minjarez
mesh_terms: D000367:Age Factors; D001321:Autistic Disorder / Q000150:complications*; D001521:Behavior Therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007805:Language Development Disorders / Q000150:complications* / Q000628:therapy*; D008297:Male; D010290:Parents / Q000193:education* / Q000523:psychology*; D016896:Treatment Outcome
keywords: Language deficits; group parent training; naturalistic developmental behavior intervention; social communication; treatment fidelity