The results of this preliminary study suggest that the predictive behavioral profile identified by Sherer and Schreibman (2005)
is specific to PRT in that it did not predict responsiveness to another, more highly-structured, behavioral intervention, DTT. This was the case even though the children did not meet all of the behavioral criteria of the original study. Nathan showed a substantial positive response to PRT (especially after his profile changed to a “responder”), yet his response to DTT was very similar to that of Chris, who had almost no response to PRT. Similarly, Kevin took a good deal of time to show any response to DTT even though he had the best response to PRT of the three children with high toy contact.
Children with a high interest in toy contact, as a group, performed better than children who did not have an interest in toys (excluding Nathan). One limitation is that George may have responded differently due to more severe symptoms as evinced by his slightly older chronological age, more severe CARS scores, and lower adaptive behavior scores. However, it does seem clear that PRT may be a helpful component of a child’s program for children interested in objects. The profile is robust in that these children did not do as well as children identified as “responders” in all areas in the original study and might be characterized as minimal responders. These children may take longer to respond to PRT. It may be that object interest is a key characteristic for treatment responders. In contrast, low social avoidance did not appear to help children respond to PRT. This group performed essentially identically to the nonresponders in the original study, suggesting that low avoidance is not a behavior that can compensate for other areas that predict reduced response to PRT. We did have one case, Nathan, who appeared to respond very differently from the other children. Nathan was highly avoidant upon beginning treatment. He had been cared for exclusively in the home and did not have a great deal of exposure to new people or environments. Once he became used to the setting (which took several weeks) he became more interested and interactive. It is possible that his extreme difficulty adjusting to the environment affected the original assessment. Therefore, in practice, it is important to reassess children as their behavior changes.
This investigation is best considered preliminary because of several limitations. First, because of our desire to replicate the original profile prediction for PRT, all participants were exposed to this condition first. Thus we have a possible order effect. We did introduce a return to PRT for three of the participants however the data do not lead to easy interpretation. Second, the short time for the intervention does not allow us to determine effects that may have occurred over a longer period of treatment. Third, we cannot directly compare vocalizations during PRT and DTT since the DTT programs often did not include verbal tasks. Finally, one participant, George, had more severe deficits than other participants. His did not appear to benefit greatly from either treatment method, although he did eventually master several DTT programs. His data provide information regarding treatment response for more severely affected children, but the differences between his pre-treatment skills and those of the other participants should be noted when interpreting the results.
The overall purpose of the present investigation was to provide more detailed understanding of the predictive properties of a particular behavioral profile in the hopes of refining the utility of such a profile. The possibilities for increasing our ability to provide individualized intervention for young children merit such investigation. While we are in the infancy of such research, we are hopeful that continued work in this area will greatly increase the overall effectiveness of our treatments for children with autism.