Behavioral Therapy for Autism

(M-PRT-IS Trial)

Overseen By Robin Libove, BS

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Stanford University

Disqualifiers: Non-english speaking, Reside outside US, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 3 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 12

Duration: 12 weeks

44 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to test a 12-week behavioral program designed to help children with autism who struggle with changes in routine. The treatment, called Modified Pivotal Response Treatment, will be delivered online and involve both parents and children. It suits families in the U.S. with children diagnosed or suspected to have autism, who face significant daily challenges with routine changes. Parents and their children must be able to participate consistently and speak English.

As an unphased trial, this study offers families the opportunity to access innovative support tailored to their needs.

Will I have to stop taking my current medications?

The trial requires that participants have stable medication for at least two weeks with no expected changes, so you can continue taking your current medications as long as they are stable.

What prior data suggests that this behavioral intervention program is safe for youth with autism spectrum disorder?

Research has shown that Pivotal Response Treatment (PRT) is a well-researched therapy for children with Autism Spectrum Disorder (ASD). Studies have found that PRT reduces disruptive behaviors more effectively than other treatments, such as Applied Behavior Analysis (ABA). Based on play, PRT helps improve social communication skills by encouraging children to initiate interactions during play. These studies suggest that PRT is generally safe and well-tolerated for children with ASD. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the modified Pivotal Response Treatment (PRT) for autism because it leverages telehealth to deliver behavioral therapy remotely. Unlike traditional in-person therapies, this approach provides greater accessibility and flexibility for families who may find it challenging to attend frequent, face-to-face sessions. This remote model has the potential to reach a wider audience, making it easier for children with autism to receive consistent treatment from the comfort of their homes. By integrating technology with proven behavioral techniques, this method could revolutionize the way we support and treat children with autism, especially in underserved areas.

What evidence suggests that this behavioral therapy is effective for autism?

Research has shown that Pivotal Response Treatment (PRT) works well for individuals with autism spectrum disorder (ASD). Studies have found that PRT can improve communication and social skills, which are often challenging for those with ASD. PRT targets key areas such as using language to request and respond, and it also helps reduce challenging behaviors. It has effectively brought about positive changes from childhood through adulthood. In this trial, the Modified Pivotal Response Treatment is delivered through a Remote (Telehealth) Intervention Program, providing easy and convenient access for families. Overall, PRT is a well-supported method that may benefit young people with ASD who prefer routines and sameness. ^{2 6 7 8 9}

Who Is on the Research Team?

Antonio Hardan, MD

Principal Investigator

Stanford University

Are You a Good Fit for This Trial?

This trial is for young people with autism who have a hard time dealing with changes in their routine. They should score high on a specific test for this behavior, be stable on current treatments for two weeks, live in the U.S., and both they and their parents must speak English.

Inclusion Criteria

I am over 18 and my child is between 4 and 17 years old.

Parent-reported clinically significant concerns regarding insistence on sameness and behavioral inflexibility

English-speaking parent and youth able to consistently participate in study procedures

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive a 12-week behavioral intervention program delivered via telemedicine, consisting of parent-training and parent-mediated intervention

12 weeks

12 visits (virtual)

Follow-up

Participants are monitored for safety and effectiveness after treatment

12 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Modified Pivotal Response Treatment

Trial Overview The study tests a 12-week program to help autistic youth cope better with change. It involves parent training and child-focused activities delivered online for one hour each week.

How Is the Trial Designed?

Group I: Remote (Telehealth) Intervention Program Experimental Treatment 1 Intervention

Modified Pivotal Response Treatment is already approved in United States, European Union, Canada for the following indications:

Approved in United States as Pivotal Response Treatment for:

• Autism Spectrum Disorder (ASD)
• Insistence on Sameness

Approved in European Union as Pivotal Response Treatment for:

• Autism Spectrum Disorder (ASD)

Approved in Canada as Pivotal Response Treatment for:

• Autism Spectrum Disorder (ASD)

Who Is Running the Clinical Trial?

Stanford University

Lead Sponsor

Trials

2,527

Recruited

17,430,000+

Published Research Related to This Trial

A randomized clinical trial comparing pivotal response treatment (PRT) and structured applied behavior analysis (ABA) showed that PRT was significantly more effective in improving communication skills in children with autism spectrum disorder (ASD) after 3 months.

The study highlights the importance of motivational variables in naturalistic teaching methods, suggesting that PRT can lead to faster improvements in both targeted and untargeted communication areas for children with ASD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized clinical trial comparison between pivotal response treatment (PRT) and structured applied behavior analysis (ABA) intervention for children with autism. Mohammadzaheri, F., Koegel, LK., Rezaee, M., et al.[2021]

The online model of Pivotal Response Treatment (PRT) delivered through the MindNest Health platform showed good feasibility, with 58% of participants completing the study curriculum, indicating that parents found the online training manageable and engaging.

Parents who participated in the online training reported significant improvements in their confidence and perceptions of treatment effectiveness, with 82% agreeing that the intervention was acceptable, suggesting that this telehealth approach could be a valuable resource for families of autistic children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility and Acceptability of Delivering Pivotal Response Treatment for Autism Spectrum Disorder via Telehealth: Pilot Pre-Post Study. Drapalik, KN., Grodberg, D., Ventola, P.[2023]

The case series highlights the effectiveness of Pivotal Response Treatment (PRT) in two preschool-aged children with autism spectrum disorder (ASD), suggesting a positive trajectory towards an 'optimal outcome' after intensive treatment.

Understanding how children respond to PRT can help tailor individualized treatment programs, enhancing the chances of success for each child based on their unique needs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Toward optimal outcome following pivotal response treatment: a case series. Ventola, PE., Oosting, DR., Keifer, CM., et al.[2020]

Pivotal Response Treatment (PRT) has been shown to be effective for preschool-aged children with autism spectrum disorders (ASD), leading to significant improvements in social communication and adaptive skills over a 4-month treatment period.

While the children demonstrated substantial gains, the degree of improvement varied across different measures, indicating that while PRT is beneficial, responses may differ among individuals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improvements in social and adaptive functioning following short-duration PRT program: a clinical replication. Ventola, P., Friedman, HE., Anderson, LC., et al.[2021]

The study focused on three children with autism spectrum disorder (ASD) aged 4 to 6 years and used a natural language paradigm (NLP) combined with time delay to enhance their vocal and augmented requesting skills.

Results showed that the intervention was effective, as all participants increased their spontaneous vocal requests when both vocal and augmented communication methods were available.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Naturalistic teaching approach to develop spontaneous vocalizations and augmented communication in children with autism spectrum disorder. Alzrayer, NM., Aldabas, R., Alhossein, A., et al.[2021]

Pivotal response treatment (PRT) has been shown to be an effective intervention for improving communication and social functioning in children with autism spectrum disorder (ASD), based on a systematic evaluation of 17 studies.

The studies demonstrated strong adherence to several research quality standards, such as using standardized protocols and objective evaluators, but showed variability in treatment fidelity and the use of longitudinal designs, indicating areas for improvement in future research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pivotal response treatment for children with autism spectrum disorder: a systematic review of research quality. Cadogan, S., McCrimmon, AW.[2018]

Pivotal Response Treatment (PRT) significantly improved primary language functions (requesting, labeling, repeating, responding) in 30 autistic children over an 8-week period compared to a control group that only received standard treatment.

The benefits of PRT extended beyond language, enhancing social communication, cognition, motor skills, imitation, and adaptive behaviors, indicating its broad effectiveness in supporting autistic children's development.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using Pivotal Response Treatment to Improve Language Functions of Autistic Children in Special Schools: A Randomized Controlled Trial. Wang, L., Li, S., Wang, C.[2023]

Training parents to use the Natural Language Paradigm (NLP) effectively increased the frequency of verbalizations in their nonverbal and echolalic autistic children, demonstrating the method's efficacy.

After initial training in a clinic, parents successfully implemented NLP at home, leading to improvements in their children's speech across various settings, not just during training.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Training parents to use the natural language paradigm to increase their autistic children's speech. Laski, KE., Charlop, MH., Schreibman, L.[2019]

A review of 10 controlled studies found that normalized interventions for teaching language to young children with autism were more effective than traditional operant behavioral procedures, particularly in achieving language criterion responses.

Normalized interventions also resulted in more positive parental affect compared to discrete-trial training, suggesting benefits not only for the children but also for their families.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparisons of discrete-trial and normalized behavioral language intervention for young children with autism. Delprato, DJ.[2019]

In a randomized controlled trial involving 44 children with Autism Spectrum Disorder (ASD), Pivotal Response Treatment (PRT) led to significant improvements in social-communicative skills after 12 weeks compared to treatment-as-usual (TAU).

PRT also showed larger gains in global functioning and adaptive socialization skills, indicating its potential effectiveness as a therapeutic intervention for children with ASD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pivotal Response Treatment for School-Aged Children and Adolescents with Autism Spectrum Disorder: A Randomized Controlled Trial. de Korte, MWP., van den Berk-Smeekens, I., Buitelaar, JK., et al.[2021]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5488784/

Pivotal response treatment for autism spectrum disorder PRT is an evidence-based behavioral intervention based on applied behavior analysis principles aimed to improve social communication skills in individuals with ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10132802/

Using Pivotal Response Treatment to Improve Language ... This study aimed to investigate the effectiveness of PRT in promoting the primary language functions (requesting, labeling, repeating, responding)

3. academic.oup.com academic.oup.com/book/60743/chapter/528391127

Pivotal Response Treatment PRT has been effective with individuals with ASD from infancy to adulthood in improving targeted goals as well as other concomitant improvements ...

4. psycnet.apa.org psycnet.apa.org/record/2023-11669-012

Pivotal Response Treatment (PRT): Research findings over 30 ... PRT is an evidence-based practice that focuses on key “pivotal” areas to produce improvements in targeted areas as well as untargeted areas.

5. link.springer.com link.springer.com/article/10.1007/s40489-013-0008-z

Pivotal Response Treatment for Children with Autism ... PRT results in increases in self-initiations and collateral improvements in communication and language, play skills, affect and reductions in maladaptive ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6486148/

Pivotal Response Treatment for autism spectrum disorder (ASD) Pivotal Response Treatment (PRT) is an ABA‐based intervention that focuses on the generalisation of learned skills in the child's natural ...

7. autismspeaks.org autismspeaks.org/pivotal-response-treatment-prt

Pivotal Response Treatment (PRT) Pivotal Response Treatment, or PRT, is a behavioral treatment for autism. This therapy is play-based and initiated by the child.

8. clinicaltrials.gov clinicaltrials.gov/study/NCT01908686

Pivotal Response Treatment for Children With Autism ... The purpose of this study is to evaluate the application of an evidence-based, manualized treatment for children with Autism Spectrum Disorder (ASD) (Pivotal ...

9. cebc4cw.org cebc4cw.org/program/pivotal-response-treatment-prt/

CEBC » Program › Pivotal Response Treatment Prt Results indicate that the children demonstrated significantly lower levels of disruptive behavior during the PRT condition, as compared to the ABA condition.