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| Individual Child Profiles and Best Treatments for Autism: Finding the Right Fit |
| Sunday, May 28, 2006 |
| 9:00 AM–10:20 AM |
| Regency V |
| Area: AUT; Domain: Applied Research |
| Chair: Laura Schreibman (University of California, San Diego) |
| Discussant: Marjorie H. Charlop (Claremont McKenna College) |
| Abstract: Outcome variability is frequently reported in early intervention studies. Current empirical evidence indicates that not all children will respond well to any one type of treatment, therefore, advocating one type of treatment program or approach is generally not recommended. The recognition that there is a need to individualize treatment for each child with autism makes it vital that we further our understanding of how to match children with the most efficacious treatments. The presentations in this symposium discuss research projects that specifically look at identifying potential predictor variables that could predict a child’s responsiveness to specific treatment approaches. The first presentation concerns the identification of participant characteristics associated with either positive or poor outcomes within two popular behaviorally based therapy approaches, pivotal response training and discrete trial training. The second presentation discusses the development of a "clinician friendly" predictive profile for children with autism to identify responders and nonresponders to a naturalistic behavioral treatment, Pivotal Response Training. The final presentation addresses the possibility of predicting language development based on pretreatment behavioral profiles, thus affording clinicians the ability to individualize treatment and tailor language interventions more rapidly and effectively. |
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| Individual Behavioral Profiles and Predictors of Treatment Effectiveness for Children with Autism. |
| LAURA SCHREIBMAN (University of California, San Diego), Aubyn C. Stahmer (Children's Hospital, San Diego), Sarah A. Dufek (University of California, San Diego, Psychology) |
| Abstract: Differential responsiveness to intervention programs suggests the inadequacy of a single treatment approach for all children with autism. One method of reducing outcome variability is to identify participant characteristics associated with different outcomes for a specific intervention. In this paper, results of two studies will be presented. In the first study an analysis of archival data that yielded two distinct behavioral profiles for treatment responders and nonresponders to a widely used behavioral intervention, Pivotal Response Training (PRT). A subsequent prospective study validates the profiles. In the second study, children whose behavioral profiles differed on one of the profile elements were presented with PRT training. Data suggest that as the elements of the profile vary, so does child response to PRT. Also, data suggest that the PRT predictive profile was NOT predictive of child response to another widely used behavioral treatment, discrete trial training, thus suggesting the PRT profile is indeed specific to PRT responsiveness and not of treatment outcome in general. |
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| The Development of Verbal Behavior in Children with Autism: Predicting Language Outcome. |
| DEBRA ANNE RAUSCH (University of California, San Diego, Autism Research Program), Laura Schreibman (University of California, San Diego) |
| Abstract: One of the central features of autism involves the great range of behavioral and cognitive profiles present in children diagnosed with this disorder. This variation makes it increasingly difficult to efficiently tailor language interventions to effectively meet the needs of each child with autism. It would be beneficial to start conceptualizing language in a uniform manner as well as develop standardized procedures that would afford clinicians with the ability to reliably predict a child’s language development. The ability to make such predictions would enable clinicians to target specific area of language development more rapidly thus saving valuable time. Identification of the development of each verbal operant or functional unit of language (e.g. imitation, receptive language, echo, requests, labels, conversation, etc.) throughout a course of behavioral therapy has not previously been researched. Such information will afford clinicians the opportunity to proactively manipulate treatment variables within the behaviorally-based intervention resulting in more rapid and functional language acquisition. The current paper will discuss research that seeks to identify the specific treatment variables/child characteristics that impact the development of each of the verbal operants. More specifically, this study is looking at the relationship between the development of each verbal operant and the child’s behavioral profile. |
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| Developing a Clinician-Friendly Assessment Tool for a Naturalistic Behavioral Intervention. |
| SARAH A. DUFEK (University of California, San Diego), Marie L. Rocha (University of California, San Diego), Laura Schreibman (University of California, San Diego), Aubyn C. Stahmer (Children's Hospital, San Diego) |
| Abstract: The heterogeneity in treatment outcome for children with autism argues strongly for strategies to prescribe treatment based on child characteristics. Previous research in our laboratory has produced a predictive profile for children with autism identifying responders and nonresponders to a naturalistic behavioral treatment, Pivotal Response Training. This PRT profiles is based on six child behaviors found to be relevant to treatment response. The profile behaviors include Toy Contact, Approach, Avoidance, Verbal Self-Stimulation, and Nonverbal Self-Stimulation. Although previous research has shown this profile to be predictive, specific, and useful, the assessment of the profile requires time and coding that make it difficult to implement in applied settings. If evidence-based practices are to be translated into community settings, barriers to implementation, such as difficult assessment procedures must be addressed. The primary goal of the present study is to modify the original assessment designed for laboratory research into a “clinician-friendly” measure that is convenient to use in the natural environment. This clarification of the profile will allow a clinician to make more informed decisions regarding adding PRT to a child’s behavioral intervention program. Issues addressed are the importance of early and effective intervention for children with autism and dissemination of research based practice into applied settings. |
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