The Autism Society Event and Education Recordings Archive

This presentation will describe the rationale for a novel early intervention model for children with autism. We will outline essential components of Pivotal Response Treatment (PRT, an empirically-supported behavioural intervention), and two aspects of the model of service delivery: (i) training teams of parents and service providers in PRT, and (ii) implementation of the model. The evaluation plan, covering both training and implementation aspects (including monitoring of the fidelity of treatment implementation and assessment of child outcomes), will be presented. Early intensive behavioural intervention programs for children with autism have been widely implemented throughout the U.S. and elsewhere. However, while much has been documented about best practices, very little is known about the effectiveness of transferring evidence-based university treatment models to community-based treatment models, or whether or how they conform to best practices.

Learning Objectives: Following this presentation, learners will gain an appreciation of the important considerations in developing and implementing a community-based model of early intervention for children with ASD. This will be exemplified through a description of a program in which PRT, an empirically supported treatment developed and implemented in California, is being disseminated to and established in Nova Scotia, Canada. Specifically, learners will appreciate: 1. (a) the need for a feasible, sustainable model of service delivery, and (b) the rationale for two aspects of the model of service delivery: (i) training teams of parents and service providers (ii) implementation of model, and will be able to: (3) describe the critical characteristics and intervention procedures of PRT (4) describe the essential training components for transferring an empirically validated treatment from a university-based to community-based model (5) describe the evaluation plan for the (i) training of teams of parents and service providers (ii) implementation of the model (including monitoring of both treatment fidelity and child outcomes).

This presentation will describe a novel, community-based model of early intensive behavioural intervention (EIBI) for young children with autism. We will include a description of (i) the treatment and service delivery models, (ii) training in treatment implementation, and (iii) the evaluation plan. Pivotal Response Treatment (PRT), an evidence-based treatment model (Koegel & Koegel, 2005), is being implemented as a publicly provided service throughout Nova Scotia in both urban and rural communities. Based on best practices, the service delivery model encompasses a coordinated, cross-disciplinary team. The team includes parents and all service providers (interventionists, psychologists, speech and language pathologists and occupational therapists) involved in the care and treatment of each child. We will outline the rationale for adopting PRT, as well as its essential components. In this context, discussion will focus on the importance of optimizing the development of social-communication abilities, and on generalization and self-initiated interactions in children with autism (Lord & McGee, 2001). We will also address the critical issues of parent involvement, team coordination, shared values, and strong leadership, and of how our service delivery model has been designed to optimize the transfer of treatment gains demonstrated in more controlled university-based contexts to community settings.

Our service delivery model includes a major training component with comprehensive follow-up. We will describe two critical aspects of this training: (i) training of parents and service providers in implementing PRT, and (ii) training of trainers in PRT, and the process by which each of these are being achieved. Both aspects of training are aimed at optimizing treatment fidelity and maintenance of gains, as well as feasibility and sustainability of our treatment model. Trained trainers in PRT will provide us with the capacity to train not only new families and EIBI service providers, but also daycare, preschool and school staff involved in the early education of children with autism.

We will also describe the evaluation plan, which covers both the training and implementation aspects of the program. Training of parents and service providers will be evaluated with respect to trainees' understanding of key concepts and fidelity of treatment implementation, as well as social validation measures. Comparable measures will be used to evaluate the training of trainers in PRT. The EIBI program evaluation plan includes monitoring of child outcomes for the cohort of children enrolled in this phased-in provincial program. Critically, the plan for assessment of child outcomes will include not only standardized tests of cognitive, language and adaptive skills, but also qualitative measures of child-parent engagement and affect.

Care has been taken both to incorporate best practices in our treatment and service delivery models and to address critical outstanding research questions. In so doing, the present work promises to advance understanding of how these goals can be accomplished within the context of community-based services aimed at bettering the outcomes of children with autism and their families.

Content Area: Early Intervention