Effects of Combining Medication and Pivotal Response Treatment on Aberrant Behavior in Children with Autism Spectrum Disorder.
Adding PRT to risperidone cuts aberrant behavior more than the drug alone in school-age autistic kids.
01Research in Context
What this study did
Rezaei et al. (2018) asked if adding PRT to risperidone helps kids with autism more than the drug alone.
They randomly split children with ASD into two groups. One group got risperidone plus PRT. The other group got risperidone only.
The team tracked aberrant behavior for 12 weeks and again three months later.
What they found
The kids who got both PRT and risperidone showed fewer odd or rude speech acts.
Overall problem behavior dropped by a medium amount compared with the drug-only group.
The extra benefit lasted through the follow-up visit.
How this fits with other research
Capio et al. (2013) already showed that risperidone alone beats placebo for irritability in autistic youth. Rezaei’s team builds on that by proving PRT can add real gains on top of the pill.
Titlestad et al. (2019) looked at adults with ID who had taken risperidone for years. They found stopping the drug did not worsen irritability. That seems opposite to Rezaei’s call to add treatment, but the two studies serve different ages and goals. Adults already stable may taper, while school-age kids starting care can benefit from the combo.
Siegel et al. (2014) got big drops in irritability inside a special inpatient unit. Rezaei shows similar gains can happen in everyday clinics with a short behavioral add-on.
Why it matters
If you work with autistic kids who take risperidone, you now have data that adding PRT gives extra behavior help without more meds. Ask the prescribing doctor if you can run PRT sessions. Track inappropriate speech first — that item moved the most.
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02At a glance
03Original abstract
The purpose of this study was to investigate the effects of combined risperidone (RIS) and pivotal response treatment (PRT) on children with autism spectrum disorder (ASD). A total of 34 children diagnosed with ASD according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V) (mean age of 12.36 years) were randomly assigned to either of two groups; the first group (n = 17) received combined PRT–RIS while the second group (n = 17) received RIS only. Behavioral problems were evaluated with the Aberrant Behavior Checklist (ABC), whereas global improvement (GI) was measured with the Clinical Global Impressions (CGI). Assessment of ABC was performed before intervention, after intervention (12 weeks), and following 3 months of the intervention (follow-up). Total ABC scores were seen to decrease in both groups after 3 months, as compared with the scores prior to the interventions. Also, in both groups, mean scores of behavioral problems after the intervention were not significantly different from those prior to the intervention, in all subscales but the inappropriate speech (p < 0.001). However, both groups showed significant differences in mean scores of ABC subscales in both of the post-intervention evaluation stages. It was concluded that the combination of behavioral and drug interventions can further improve behavioral problems, ultimately improving patient’s communication and social skills.
Children, 2018 · doi:10.3390/children5020019