A new Stanford study in children with autism showed the value of teaching parents how to use everyday interactions to motivate their children to speak.
The study, which appears in Pediatrics, is the largest ever controlled trial of an autism therapy called pivotal response treatment delivered by a combination of professional therapists and parents. The children in the study had autism and speech delays.
The therapy works by tapping into kids' own motivations, said pediatric psychologist and autism expert Grace Gengoux, PhD, who led the study.
Most children learn to talk without much conscious effort on their parents' part. Kids soak up language, and moms and dads follow their instincts about how to respond to their children's early babble. It's usually a very social process: A toddler might make eye contact with her dad, then point at her sippy cup and say "da" when she wants a drink of water. When she's a bit older, she'll switch to saying "wada," followed eventually by short phrases and full sentences.
But children with autism often don't make spontaneous social connections, which makes it harder for them to learn to speak. So PRT teaches parents a concrete technique that takes advantage of their children's interests -- for instance, in a specific toy -- to get them speaking.
Our press release describes how Palo Alto mom Heidi Pim, a participant in the study, learned to use PRT with her son, James. At the start of the trial, James, then 3, couldn't point at or ask for things. From our press release:
If James wanted a toy car, Pim ... learned to pick up the car, hold it where he could see it and encourage him to say "car." When he tried to say the word, he was rewarded with the toy.
Gradually, PRT helped James progress to speaking multiple words and phrases, asking for things he needed, and understanding that he could use language to express his emotions. He's now a happy 8-year-old who engages verbally with his family and other people. His mom still uses PRT techniques to get him talking about his favorite subjects, such as elevators.
As a whole, children in the study's PRT group improved their communication skills more than kids in a control group. The treatment also improved children's broader social abilities, supporting the theory that targeting the "pivotal" area of language for autism treatment can lead to broader gains.
"This provides a lot of hope," Gengoux said.
Gengoux's team is currently recruiting families in the Stanford area for research on how the brain changes in PRT. Interested parents can call (650) 736-1235 or e-mail autismdd@stanford.edu for more information. Stanford is also hosting a one-day conference in September for parents and teachers who want to learn PRT techniques. More information about the conference is available at http://med.stanford.edu/autismcenter.html.
Photo by Sandy Millar
