Pivotal Response Intervention II: Preliminary Long-Term Outcome Data

TLDR

Self‑initiations are considered a key component of intervention for children with autism, yet traditional prognostic variables predict good outcomes while actual results vary widely. The study aimed to determine whether self‑initiations predict favorable outcomes and whether teaching them to children lacking spontaneous initiations yields highly favorable post‑intervention results. Phase 1 analyzed archival data from six children, and Phase 2 taught self‑initiations to children with few or no spontaneous initiations to evaluate post‑intervention outcomes. Phase 1 showed that children with favorable outcomes had more spontaneous self‑initiations, and Phase 2 demonstrated that teaching self‑initiations led to extremely favorable outcomes, supporting self‑initiations as prognostic indicators and pivotal targets.

Abstract

The literature and our observations suggest that self-initiations may be an especially important part of intervention for children with autism. Therefore, the purpose of this study was to conduct preliminary assessments as to whether self-initiations might be associated with highly favorable postintervention outcomes. In the first phase of this study, archival data were analyzed for 6 children. At intake, according to traditional variables, they appeared to have especially good prognoses for reducing symptoms of autism, but had extremely different outcomes (either exceptionally good or exceptionally poor) after years of intensive intervention. Results of Phase 1 indicated that the children who had highly favorable outcomes exhibited more spontaneous self-initiations at preintervention. Given these results, Phase 2 of the study assessed whether a series of self-initiations could be taught to children with autism who demonstrated few or no spontaneous self-initiations at preintervention, and whether this intervention would result in highly favorable postintervention outcomes. Results indicated that these children learned a variety of self-initiations and had extremely favorable outcomes. The results of this exploratory study are encouraging in terms of assessment of key pivotal target behaviors that may be identified as prognostic indicators, and that may be important during intervention for children with autism.