Online Pivotal Response Treatment for Autism

(PRT-O Trial)

Overseen By Estefania Millan, MA

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Stanford University

Disqualifiers: Non-English, Severe psychiatric, Unstable medical, others

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

Compensation: Varies

Number of Visits: Unknown

Duration: 12 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how well parents can learn to use Pivotal Response Treatment (PRT) through an online course to assist their children with Autism Spectrum Disorder (ASD). The goal is to determine if parents can effectively apply the techniques learned online to improve their child's communication skills. The trial seeks parents with English-speaking children aged 2 to 5 years with ASD and notable communication challenges, who can commit to a 12-week online learning program. Parents will watch video lessons and practice the techniques at home. Participants should not have extensive previous experience with PRT or be receiving more than 15 hours of in-home therapy per week. As an unphased trial, this study offers parents a unique opportunity to contribute directly to innovative research that could enhance their child's communication skills.

Do I need to stop my current medications for the trial?

No, you don't need to stop your current medications, but they must be stable for at least 1 month before starting the trial and should not change during the study.

What prior data suggests that this online training course is safe for parents of children with Autism Spectrum Disorder?

Research has shown that Pivotal Response Treatment (PRT) is safe and has been widely studied as a method to assist children with autism. Over 20 studies suggest that PRT can enhance communication skills in many children with autism. These studies have reported no major side effects, supporting its safety. Given PRT's effectiveness in various settings, the online version (PRT-O) is also expected to be safe. The online course is designed to teach parents how to use PRT techniques, focusing on learning and applying these skills at home. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Pivotal Response Treatment Online (PRT-O) Course because it offers a new way to support children with autism by empowering parents with an online learning platform. Unlike traditional in-person therapies, PRT-O is delivered entirely online, making it more accessible for families who may have difficulty traveling to sessions. This flexibility allows parents to learn and practice pivotal response techniques at their own pace, integrating these strategies into everyday interactions with their child. By leveraging the convenience of online education, PRT-O could potentially broaden the reach and impact of autism interventions.

What evidence suggests that the PRT-O course is effective for training parents of children with autism?

Research has shown that Pivotal Response Treatment (PRT) improves social communication skills in children with Autism Spectrum Disorder (ASD). Studies have found that children receiving this treatment make significant progress in language and communication. Parents who learn PRT techniques can also use them effectively to support their children. In this trial, participants will either take the Pivotal Response Treatment Online (PRT-O) Course or join a Delayed Treatment Group. An online version of PRT, like the one under study, has demonstrated effectiveness and positive reception. Overall, PRT shows promise in addressing key symptoms of ASD and enhancing communication skills. ^{6 7 8 9 10}

Who Is on the Research Team?

Grace Gengoux, PhD

Principal Investigator

Stanford University

Are You a Good Fit for This Trial?

This trial is for parents of children with Autism Spectrum Disorder (ASD). It aims to teach them how to deliver Pivotal Response Treatment (PRT) through an online course. Specific eligibility criteria are not provided, but typically participants would need reliable internet access and a commitment to complete the training.

Inclusion Criteria

My mental health medication has been stable for at least 1 month.

I am between 2 and 5 years old.

Stable treatment and school placement for at least 1 month prior to baseline measurements with no expected changes

Exclusion Criteria

I am getting over 15 hours of one-on-one ABA therapy at home weekly.

I have completed a pivotal response treatment program successfully.

Children who have a primary language other than English

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants complete 10 online lessons over a 12-week period, practicing PRT at home

12 weeks

Follow-up

Participants are monitored for changes in Parent Fidelity of PRT Implementation and Child Functional Verbal Utterances

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Pivotal Response Treatment Online (PRT-O) Course

Trial Overview The study is testing the effectiveness of an Online Pivotal Response Treatment Training Course (PRT-O) designed for parents. The goal is to see if parents can learn and apply PRT methods effectively with their ASD-diagnosed children after taking this online course.

How Is the Trial Designed?

Group I: Pivotal Response Treatment Online (PRT-O) Course Experimental Treatment 1 Intervention

The PRT-O Online Course (PRT-O) will consist of 10 online lessons completed asynchronously through the Stanford LearnMed Online CANVAS Platform. Parents are expected to view the 10 lessons over the course of a 12-week study period, complete worksheets, and to practice PRT at home.

Group II: Delayed Treatment Group (DTG) Active Control 1 Intervention

No intervention.

Who Is Running the Clinical Trial?

Stanford University

Lead Sponsor

Trials

2,527

Recruited

17,430,000+

Published Research Related to This Trial

The six-week parent training program for Pivotal Response Treatment (PRT) effectively taught four parents to implement the intervention with high fidelity, enhancing their interactions with their children with autism spectrum disorder (ASD).

Parents reported high satisfaction with the program, indicating that PRT parent training is a promising, efficient, and cost-effective treatment model for improving parent-child interactions in ASD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of a Parent-Implemented Pivotal Response Treatment for Children with Autism Spectrum Disorder. Bozkus-Genc, G., Yucesoy-Ozkan, S.[2023]

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]

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]

A pilot study tested a developmental adaptation of Pivotal Response Treatment (PRT) with three infants at-risk for autism, showing promising results in enhancing their functional communication skills.

The introduction of PRT also improved parents' ability to implement the treatment effectively, suggesting that this approach could be a feasible intervention for very young children at-risk for autism.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pivotal response treatment for infants at-risk for autism spectrum disorders: a pilot study. Steiner, AM., Gengoux, GW., Klin, A., et al.[2021]

The pilot study involving seven teachers and students with autism spectrum disorder (ASD) found that training in classroom pivotal response teaching (CPRT) did not significantly improve teachers' implementation fidelity or students' communication skills and maladaptive behaviors.

Despite the lack of measurable improvements in student outcomes, teachers expressed high satisfaction with the CPRT training, suggesting that while the training may not have led to immediate changes, it could still be valuable for educators.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Training Teachers to Implement Classroom Pivotal Response Teaching during Small-group Instruction: A Pilot Study. Verschuur, R., Huskens, B., Didden, R.[2021]

A randomized controlled trial involving 53 children with autism showed that parents trained in Pivotal Response Treatment (PRT) significantly improved their children's language skills compared to those in a psychoeducation group, with a notable increase in the frequency of child utterances.

The study demonstrated that 84% of parents in the PRT group effectively learned and implemented the techniques, leading to enhanced adaptive communication skills in their children, highlighting the efficacy of PRT as a parent training model for addressing language deficits in young children with autism.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized controlled trial of Pivotal Response Treatment Group for parents of children with autism. Hardan, AY., Gengoux, GW., Berquist, KL., et al.[2022]

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]

Citations

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

Pivotal response treatment for autism spectrum disorder Pivotal response treatment (PRT) is a behavioral intervention aimed to improve social communication skills in individuals with ASD,10,11,16,17 which has ...

2. frontiersin.org frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.766150/full

Examining Effectiveness and Predictors of Treatment ... Statistically significant effects of PRT were identified across a majority of identified RCTs for a range of language and communication skills.

3. med.stanford.edu med.stanford.edu/content/dam/sm/sasnl/documents/8_peds_20190178.pdf

A Pivotal Response Treatment Package for Children With ... PRT-P was effective for improving child social communication skills and for teaching parents to implement PRT. Additional research will be needed to understand ...

4. pediatrics.jmir.org pediatrics.jmir.org/2022/3/e32520/

Feasibility and Acceptability of Delivering Pivotal Response ... The aim of this study was to assess the feasibility, acceptability, and clinical effects of an online model of PRT delivered via MindNest Health.

5. nature.com nature.com/articles/s41598-022-10604-2

Pivotal Response Treatment (PRT) parent group training ... This body of research adds evidence on the efficacy of PRT to improve the core symptoms of ASD as well as on its potential to facilitate other ...

6. med.stanford.edu med.stanford.edu/autismcenter/prt/workshops.html

PRT Online Course | Stanford Autism Center The program is intended for individuals who want to learn how to apply Pivotal Response Treatment (PRT) to improve a young child's verbal communication skills ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8791680/

Pivotal Response Treatment (PRT) - Parent Group Training ... This qualitative study examined the perspectives of parents of young children with ASD who participated in a 14-week PRT with parent group training (PRT-PG).

8. autisminternetmodules.org autisminternetmodules.org/m/1202/resources

Pivotal Response Treatment (PRT) - Updated This resource can support your learning while completing the module or be saved for future reference. Sign in to download the module PDF.

9. clinicaltrials.gov clinicaltrials.gov/study/NCT03778827

A Center Based Study of Pivotal Response Treatment for ... The purpose of this study is to examine the effectiveness of pivotal response training (PRT) in an intensive center-based preschool environment to treat social ...

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

Pivotal Response Treatment (PRT) PRT is one of the best studied and validated behavioral treatments for autism. More than 20 studies suggest that PRT improves communication skills in many ( ...