Pivotal Response Treatment for Children with Autism Spectrum Disorders: A Systematic Review

Intervention studies evaluating pivotal response treatment (PRT) were systematically identified and analyzed. Forty-three studies were summarized in terms of (a) participant characteristics, (b) dependent variables, (c) intervention procedures, (d) intervention outcomes, and (e) certainty of evidence. The majority of the reviewed studies (56.4 %) had serious methodological limitations. However, the reviewed studies that provided conclusive or preponderant evidence (43.6 %) indicated that PRT results in increases in self-initiations and collateral improvements in communication and language, play skills, affect and reductions in maladaptive behavior for a number of children. Furthermore, the reviewed studies suggested that the majority of caregivers and staff members were able to implement PRT techniques, but evidence for collateral improvements in caregivers' and staff members' behaviors remains sparse. Implications for future research are discussed. © 2013, Springer Science+Business Media New York.