Varied Treatment Response in Young Children with Autism: A Relative Comparison of Structured and Naturalistic Behavioral Approaches
Track first-week learning speed; stick with the style that rises fastest and switch when it stalls.
01Research in Context
What this study did
Jobin (2019) worked with the preschoolers who had autism. Each child got both DTT and PRT in the same week.
The team swapped the two styles every day. They tracked how fast each child learned new words and play steps.
What they found
Both ways taught the skills and the kids still used them one month later. Some kids zoomed ahead with DTT, others with PRT.
The big clue was the first-week learning speed. If a child’s score shot up early, that child kept doing well in that style.
How this fits with other research
Robertson et al. (2013) ran a similar swap study with flash-cards. They also saw that the style that gave the fastest first gains kept winning.
Gabis et al. (2020) showed parent coaching works for the same age group, but they did not test speed as a sign to switch.
Iwata (1988) and Clark et al. (1977) both trimmed extra steps from preschool lessons. Jobin adds the same idea: watch early speed and drop what lags.
Why it matters
You no longer need to pick a team—DTT or PRT. Run both for one week, graph daily progress, and stay with the one that climbs fastest. If the curve flattens, switch styles for that skill. This keeps therapy efficient and avoids months of slow gains.
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02At a glance
03Original abstract
Heterogeneity of treatment response is common for children with autism spectrum disorder (ASD). Thus, many providers vary which intervention is used based on child characteristics and learning domain. Improved understanding of how to match treatments to different children and domain areas may enhance efforts to individualize treatment and improve treatment response. This study evaluated the relative efficacy of discrete trial training (DTT) and pivotal response training (PRT) for teaching young children at risk for ASD receptive and expressive language, play, and imitation skills. Using a single-subject adapted alternating treatments design, children received both treatments for 12 weeks. Data were collected during treatment and at 3-month follow-up. All participants acquired target skills in both treatments and demonstrated some generalization, maintenance, and spontaneous skill use. PRT and DTT were each more effective for some children and domains. The results suggest that that early rates of learning may be predictive of longer-term treatment response and useful in informing treatment decisions.
Autism, 2019 · doi:10.1177/1362361319859726