Abstract
Purpose
Access to intervention is a barrier for children with autism. As parent-mediated interventions have emerged to address this need, understanding implementation components contributing to child gains is critically important. Existing literature documents relationships between parent treatment adherence and child progress; however, less is understood about components, such as frequency of learning opportunities, which could also affect child outcomes.
Methods
This study is a secondary analysis of data from a randomized controlled trial evaluating Pivotal Response Treatment group parent training (PRTG) compared to psychoeducation. Linear regression and mediational models were employed to identify potential predictors and mediators of outcome.
Results
PRTG produced large increases in adherence and learning opportunities. In general, greater frequency of learning opportunities and adherence predicted better child outcomes. The best-fitting cross-sectional mediational models indicated at least partial mediational effects, whereby increased learning opportunities mediated the relationship between greater adherence and improved child outcomes.
Conclusions
This study provides preliminary evidence of how early gains in adherence may support parents to provide more frequent learning opportunities, which, in turn, yield positive effects on child social communication. Future large-scale research, with greater granularity of measurement, is needed to further understand the temporal relationships between these variables.
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Funding
Dr. Frazier has received funding or research support from, acted as a consultant to, received travel support from, and/or received a speaker’s honorarium from the PTEN Research Foundation, SYNGAP Research Fund, Malan Syndrome Foundation, ADNP Kids Research Foundation, Quadrant Biosciences, Autism Speaks, Impel NeuroPharma, F. Hoffmann-La Roche AG Pharmaceuticals, the Cole Family Research Fund, Simons Foundation, Ingalls Foundation, Forest Laboratories, Ecoeos, IntegraGen, Kugona LLC, Shire Development, Bristol-Myers Squibb, Roche Pharma, MaraBio, Scioto Biosciences, National Institutes of Health, and the Brain and Behavior Research Foundation, has equity options in Quadrant Biosciences/Autism Analytica, MaraBio, and Springtide, and has an investor stake in Autism EYES LLC and iSCAN-R. Dr. Minjarez has received funding or research support from, acted as a consultant to, received travel support from, received royalties from, and/or received a speaker’s honorarium from EarliTec Diagnostics Inc., Marcus Autism Center, Thompson Autism and Neurodevelopmental Center, Actualmente Autism Argentina, Brookes Publishing, Washington State University, National Institutes of Health, Hoffman-LaRoche AG Pharmaceuticals, and Seoul National University. The remaining authors have declared that they have no competing or potential conflicts of interest.
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Minjarez, M.B., Gengoux, G.W., Paszek, K. et al. Adherence and Opportunity Frequency as Predictors of Communication Outcomes from Pivotal Response Parent Training. J Autism Dev Disord (2024). https://doi.org/10.1007/s10803-024-06447-7
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DOI: https://doi.org/10.1007/s10803-024-06447-7