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Parent-Implemented Pivotal Response Treatment to Promote Social Communication Skills in Children with Autism Rehab Hassan Al-Zayer

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Parent-Implemented Pivotal Response Treatment to Promote Social Communication Skills in Children with Autism Rehab Hassan Al-Zayer University of Northern Colorado Scholarship & Creative Works @ Digital UNC Dissertations Student Research 12-1-2015 Parent-Implemented Pivotal Response Treatment to Promote Social Communication Skills in Children with Autism Rehab Hassan Al-zayer Follow this and additional works at: http://digscholarship.unco.edu/dissertations Recommended Citation Al-zayer, Rehab Hassan, "Parent-Implemented Pivotal Response Treatment to Promote Social Communication Skills in Children with Autism" (2015). Dissertations. Paper 6. This Text is brought to you for free and open access by the Student Research at Scholarship & Creative Works @ Digital UNC. It has been accepted for inclusion in Dissertations by an authorized administrator of Scholarship & Creative Works @ Digital UNC. For more information, please contact [email protected]. © 2014 REHAB ALZAYER ALL RIGHTS RESERVED UNIVERSITY OF NORTHERN COLORADO Greeley, Colorado The Graduate School PARENT-IMPLEMENTED PIVOTAL RESPONSE TREATMENT TO PROMOTE SOCIAL COMMUNICATION SKILLS IN CHILDREN WITH AUTISM A Dissertation Submitted in Partial Fulfillment of the Requirements of the Degree of Doctor of Philosophy Rehab Al-zayer College of Education and Behavioral Sciences School of Special Education December 2014 This Dissertation by: Rehab Al-zayer Entitled: Parent-Implemented Pivotal Response Treatment to Promote Social Communication Skills in Children with Autism has been approved as meeting the requirement for the Degree of Doctor of Philosophy in College of Education and Behavioral Sciences in School of Special Education Accepted by the Doctoral Committee ____________________________________________________ Lewis Jackson, Ed.D., Research Advisor ____________________________________________________ Tracy Gershwin Mueller, Ph.D., Research Co- Advisor ____________________________________________________ Harvey Rude, Ed.D., Committee Member ____________________________________________________ Lisa Rue, Ph.D., Faculty Representative Date of Dissertation Defense . Accepted by the Graduate School ____________________________________________________________ Linda L. Black, Ed.D., LPC Dean of the Graduate School and International Admissions ABSTRACT Al-zayer, Rehab. Parent-Implemented Pivotal Response Treatment to Promote Social Communication Skills in Children with Autism. Published Doctor of philosophy dissertation, University of Northern Colorado, 2014. Abstract Providing children with autism with early intensive behavioral interventions has become a research priority. Specifically, early and intensive behavioral intervention of Pivotal Response Training (PRT) has been targeted as an effective natural behavioral intervention. The present study extended the use of PRT to teaching parents to implement this intervention in their home natural settings, and is hypothesized to intensify and increase the time access to the intervention; hence, enhance maintenance and generalization of social communication skills for children with autism. A multiple-probe- across-setting design was used in this study to determine if training parents of children with autism to use Pivotal Response Treatment (PRT), specifically teaching their children to label and use query responses, enhances social communication skills and also leads to generalization in other settings. The results of this study of three distinct families who participated in this study showed that parents were able to learn, implement, and generalize the Pivotal Response Treatment (PRT) intervention. Also, the children of these parents significantly increased their communication responses at home and generalized these communication responses across different settings. Implications of the findings of this study were discussed and further lines of research were suggested. iii ACKNOWLEDGEMENT iv TABLE OF CONTENTS CHAPTER I. INTRODUCTION .......................................................................................1 Autism Spectrum Disorder ..........................................................................1 Need for Intensive Behavioral Interventions ...............................................4 Intervention Variables for Intensive Behavior Interventions .......................6 Statement of the Problem .............................................................................7 Purpose of the Study ....................................................................................9 Research Questions ......................................................................................9 Significance of the Study ...........................................................................10 Definition of Terms....................................................................................12 Limitations of the Study.............................................................................14 II. LITERTUER REVIEW .............................................................................16 Social Communication and Autism ...........................................................16 Contingent Responding in Social Communication ....................................18 Contingent query ............................................................................19 Object-label correspondence ..........................................................21 The need for empirically valid natural-based behavioral interventions .......................................................................23 Critical Elements of Pivotal Response Treatment .....................................25 Intensive and early intervention .....................................................26 Natural environment ......................................................................27 Family involvement .......................................................................29 Family-Implemented Naturalistic Communicative Intervention ...............31 Theoretical Underpinnings of Pivotal Response Treatment ......................31 Research on Pivotal Response Treatment ..................................................35 Other Evidence-based Relevant Approaches to Enhance Social Communication in Children with Autism ......................................38 Discrete Trial Training (DTT) ...................................................................38 Verbal Behavior (VB) ................................................................................41 Natural Environment Training (NET) .......................................................44 v CHAPTER II. continued Milieu Teaching .........................................................................................46 The Need for More Natural Approaches to Teaching Communication to Children with Autism ......................................49 Current Investigation .................................................................................50 Description and Justifications of the Research Design ..............................51 III. METHOD ..................................................................................................53 Recruitment and Eligibility Requirements.................................................54 Participants and Settings ............................................................................54 Study 1………. ..........................................................................................55 Study 2………. ..........................................................................................57 Study 3………. ..........................................................................................58 Procedures ..................................................................................................60 Parent Training in Pivotal Response Training ...........................................61 Pivotal Response Training Applications: Case Study 1 ............................63 Intervention procedures for Andy ..................................................65 Pivotal Response Training Applications: Case Study 2 ............................66 Intervention procedures for Sami...................................................67 Pivotal Response Training Applications: Case Study 3 ............................68 Intervention procedures for Clayton ..............................................69 Measurement ..............................................................................................71 Child Outcome Measures ...........................................................................71 Measures in case Study 1 ...............................................................72 Measures in case Study 2 ...............................................................72 Measures in case Study 3 ...............................................................74 Social validation.............................................................................76 Study Design ..............................................................................................76 Data Collection ..........................................................................................77 Data Analysis .............................................................................................78 Inter-Observer Reliability Agreement .......................................................79 Case Study 1….. ........................................................................................81 Case Study 2….. ........................................................................................81 Case Study 3….. ........................................................................................82
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