University of California, Davis MIND Institute and Department of Psychiatry and Behavioral Sciences, 2825 50thSt., Sacramento, CA, 95817, United States; Child and Adolescent Services Research Center, 3020 Children's Way, MC5033, San Diego, CA 92123, United States.
Child and Adolescent Services Research Center, 3020 Children's Way, MC5033, San Diego, CA 92123, United States; San Diego State University, Special Education Department, United States.
Res Dev Disabil. 2019 Jul;90:101-112. doi: 10.1016/j.ridd.2019.04.003. Epub 2019 Apr 26.
Research in autism spectrum disorders (ASD) has identified a need to understand key components of complex evidence-based practices (EBP). One approach involves examining the relationship between component use and child behavior.
This study provides initial evidence for identifying key components in a specific EBP, Pivotal Response Training (PRT). We examined which components were related to child response and evaluated relationships between provider characteristics, child characteristics and component intensity.
Trained coders reviewed archival videos (n = 278) for PRT fidelity and child behavior. We completed multi-level regression and latent profile analysis to examine relationships between intensity of individual or combinations of PRT components and child behavior, and moderators of component use.
Analyses indicated differential relationships between specific components and child behaviors which may support methods of altering intensity of components to individualize intervention. Profile analysis suggested relatively intensive use of most PRT components, especially antecedent strategies, may maximize child responsivity. Providers with postgraduate education trended toward higher intensity component use. Child characteristics did not moderate use.
Careful examination of key components of ASD interventions may helps clarify the mechanisms of action. Recommendations specific to PRT implementation and use of the methodology for other interventions are discussed.
自闭症谱系障碍（ASD）的研究表明，有必要了解复杂循证实践（EBP）的关键组成部分。一种方法涉及检查组件使用与儿童行为之间的关系。
本研究为确定特定 EBP（关键反应训练（PRT））中的关键组件提供了初步证据。我们检查了哪些组件与儿童反应有关，并评估了提供者特征、儿童特征与组件强度之间的关系。
经过培训的编码员审查了 PRT 保真度和儿童行为的档案视频（n = 278）。我们完成了多层次回归和潜在剖面分析，以检查个别或组合 PRT 组件的强度与儿童行为之间的关系，以及组件使用的调节剂。
分析表明，特定组件与儿童行为之间存在差异关系，这可能支持改变组件强度以实现个体化干预的方法。分析表明，大多数 PRT 组件，尤其是前因策略的使用强度相对较高，可能会最大限度地提高儿童的反应能力。具有研究生学历的提供者更倾向于高强度组件使用。儿童特征没有调节作用。
仔细检查 ASD 干预的关键组成部分可以帮助阐明作用机制。讨论了针对 PRT 实施的具体建议以及针对其他干预措施使用该方法的建议。
