Social responsiveness and language use associated with an enhanced PRT approach for young children with ASD: Results from a pilot RCT of the PRISM model

Background: Vulnerabilities in social motivation among children with ASD constrain attention and responsiveness to parents and other social partners. When this limited social responsiveness remains uncorrected, it is hypothesized to restrict the quality and quantity of social learning opportunities and ultimately yield negative long-term effects on development. Early intervention efforts that target social motivation may hold promise for correcting this detrimental chain of events. Method: The current pilot RCT examined changes in participant social responsiveness and language use in a trial of 21 young children with ASD who were randomly assigned to treatment or waitlist control groups. Treatment participants received a mean of 6.81 h/week of an enhanced Pivotal Response Intervention for Social Motivation (PRISM) treatment model for six months. Data on social responsiveness to parent bids and expressive language (number of total words, number of different words, mean length of utterance in words) were obtained from behaviorally coding and analyzing video-recorded parent-child play sessions. Results: Results indicated that young children who participated in the PRISM treatment model demonstrated significant pre-post improvements in social responsiveness and mean length of utterances. Participants in the waitlist condition experienced negligible improvements. Participants who are minimally verbal appear to experience greater gains as a result of the PRISM model. Additionally, initial levels of social responsiveness with parents appear to be predictive of subsequent language use at post-intervention among minimally verbal participants. Conclusion: This study provides preliminary evidence for the importance of using early intervention paradigms that explicitly target social motivation and responsiveness in young children with ASD. Results also suggest that initial social responsiveness to parents may serve as an important predictor of treatment response.