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Randomized Controlled Trial
. 2020 Aug;24(6):1566-1571.
doi: 10.1177/1362361320903138. Epub 2020 Feb 14.

Effects of pivotal response treatment on reciprocal vocal contingency in a randomized controlled trial of children with autism spectrum disorder

Jena McDaniel  1 , Paul Yoder  2 , Madison Crandall  2 , Maria Estefania Millan  3 , Christina Mich Ardel  3 , Grace W Gengoux  3 , Antonio Y Hardan  3
Affiliations
Randomized Controlled Trial

Effects of pivotal response treatment on reciprocal vocal contingency in a randomized controlled trial of children with autism spectrum disorder

Jena McDaniel et al. Autism. 2020 Aug.

Abstract

A recent randomized controlled trial found that children with autism spectrum disorder who received a pivotal response treatment package showed improved language and social communication skills following the intervention. The pivotal response treatment package includes clinician-delivered and parent-implemented strategies. Reciprocal vocal contingency is an automated measure of vocal reciprocity derived from daylong audio samples from the child's natural environment. It may provide stronger and complementary evidence of the effects of the pivotal response treatment package because it is at lower risk for detection bias than parent report and brief parent-child interaction measures. The current study compared reciprocal vocal contingency for 24 children with autism spectrum disorder in the pivotal response treatment package group and 24 children with autism spectrum disorder in the control group. The pivotal response treatment package group received 24 weeks of the pivotal response treatment package intervention. The control group received their usual intervention services during that time. The groups did not differ in reciprocal vocal contingency when the intervention started or after 12 weeks of intervention. However, after 24 weeks the pivotal response treatment package group had higher ranked reciprocal vocal contingency scores than the control group. These findings are consistent with results from parent report and parent-child interaction measures obtained during the trial. The participants in the pivotal response treatment package exhibited greater vocal responsiveness to adult vocal responses to their vocalizations than the control group. Findings support the effectiveness of the pivotal response treatment package on vocal reciprocity of children with autism spectrum disorder, which may be a pivotal skill for language development.

Keywords: autism spectrum disorder; communication and language; interventions–psychosocial/behavioral; pre-school children.

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Conflict of interest statement

The authors have no conflicts of interest to disclose. JM participated in the study design, analyzed the data, and drafted the manuscript; PY conceived the study, participated in the study design, helped interpret the data, and helped draft the manuscript; MC participated in the study design and analyzed the data; MEM collected the data and helped interpret the data; CMA collected the data and helped interpret the data; GWG and AYH conceived the study, participated in the study design, supervised data collection, and helped interpret the data. All authors read and approved the final manuscript.

Figures

Figure 1.
Figure 1.
Control = delayed treatment control group. PRT-P = pivotal response treatment package with parent training and clinician-delivered intervention. Each open circle represents one participant’s reciprocal vocal contingency value (RVC) at Time 3 (immediately after 24 weeks of intervention). The filled diamonds represent the median RVC for each group. The filled circles represent the limits of the 95% confidence interval around the median values.
See this image and copyright information in PMC

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