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The social vulnerabilities associated with young children with autism are recognized as important intervention targets due to their influence on subsequent development. Current research suggests that interventions that combine motivational and social components can create meaningful changes in social functioning. Simultaneously, it is hypothesized that parent delivery of such strategies can invoke increases in these core social behaviors and parent engagement. This study examined the effects of teaching parents to implement a social engagement intervention with their children. The results indicated that the use of this parent-delivered social intervention led to (a) increases in their children’s use of eye contact, directed positive affect, and verbal initiations, (b) increases in parent positive affect and synchronous engagement, and (c) generalized increases in parent and child behaviors.

Adolescents with ASD face numerous personal and contextual barriers that impede the development of social motivation and core competencies, warranting the need for targeted intervention. A randomized controlled trial was conducted with 40 adolescents to evaluate the merits of a multi-component socialization intervention that places emphasis on experiential learning. This investigation evaluated the impact of the 20-week START program on the social functioning of adolescents with ASD. Significant Group × Time differences between START and waitlist control groups were found across multiple measures. Secondary analyses of the entire program cohort also yielded significant improvement trends across all measures. These findings may be an important step in identifying optimal strategies to target the complex factors limiting optimal social development in ASD.

Early intervention efforts can be transformative for young children with autism, and parent involvement is an increasingly common component of many contemporary treatment models linked to enhanced long-term social communication and developmental outcomes. However, Spanish-speaking families face language barriers that limit opportunities to be trained in these strategies, directly contributing to disparities in their children's developmental outcomes. This study aims to address this barrier by exploring the feasibility, acceptability, and preliminary efficacy of a Spanish-translated and adapted pivotal response treatment (PRT) early intervention model. Using a multiple baseline across participant experimental design, the primary objective of this investigation was to evaluate the impact of ongoing participation in a Spanish PRT workshop on parent fidelity (mastery) of treatment implementation and child verbal responses using behavioral coding and parent-report measures. The study included three children with autism aged 18-60 months and their caregiver(s). Parents completed questionnaires, four PRT instructional lessons, and six in-person coaching sessions. Parent-child interaction videos were recorded at intake and after each in-person session to monitor participant process. All participants met fidelity of implementation criteria (>80%) for the PRT strategies, demonstrating the ability to successfully implement the core intervention components. Parents also reported improvements in their self-perceived (a) comprehension of the PRT principles and (b) confidence in applying them effectively. Lastly, children demonstrated improvements in the frequency of their verbal responses. These results suggest that the Spanish adaptation of PRT can effectively teach parents to understand and implement basic PRT components and facilitate language development in their autistic children.

Proponents of autism intervention and those of the neurodiversity movement often appear at odds, the former advocating for intensive treatments and the latter arguing that autism must be accepted as a form of diversity. The history of behavioral intervention has understandably outraged many in the Autistic community, though many still value supports focused on quality of life. This commentary argues that Naturalistic Developmental Behavioral Interventions (NDBIs) hold promise for bridging the gap between early intervention and the neurodiversity movement. However, we recognize NDBIs have much room to grow and suggest multiple strategies for improvement. We believe these updates are not only feasible for clinicians and researchers to implement but will ultimately lead to improved quality of life for Autistic individuals.

The COVID-19 pandemic has created unprecedented challenges and disruptions for autistic individuals receiving specialized treatment services. This caregiver-report survey study (n = 339) explored predictors of satisfaction with autism services during COVID-19 to improve perceived support for these families. Specifically, we investigated whether service delivery medium (telehealth vs. in person), child’s emotional functioning, and caregiver stress would predict satisfaction with the most highly utilized services. Satisfaction ratings for ABA/behavioral, speech/language, and occupational therapy were lower when delivered via telehealth as compared to in person. Caregivers who reported higher emotional dysregulation in their children were less satisfied with behavioral therapy services. These results provide a critical caregiver-informed perspective on factors influencing satisfaction with specialized autism services during COVID-19.

In the original article there is an error in the Introduction Section (Sentence 2 of the Introduction after the Abstract) and it has been corrected in this erratum.

Young children with autism often experience limited social motivation and responsiveness that restricts establishment of crucial social momentum. These characteristics can lead to decreased opportunities for parental engagement and the social learning associated with these moments. Early social interventions that capitalize on pre-existing interests may be able to re-establish this developmentally critical feedback loop, in which both child and parent social behaviors simultaneously increase and influence one another. This investigation examined the moment-by-moment, micro-transactional relationship between parent and child social behavior gains observed in an early intervention study. Time-window sequential analyses revealed the presence of clinically and statistically significant sequential associations between parent and child social behaviors during an embedded social interaction intervention, but not in a comparable motivational intervention that utilized highly preferred toys and objects. Specifically, the onset of parent eye contact, directed positive affect, or offer of a reinforcing incentive predicted the immediate occurrence of child eye contact and positive affect in the experimental social intervention condition. Additionally, child verbal initiations, positive affect, and eye contact immediately predicted the onset of parent positive affect during this social intervention paradigm. Theoretical implications for the social developmental trajectory of autism are discussed.

Females with autism have unique socialization profiles, but less is known about sex/gender differences in the context of socialization interventions. This study utilized a combination of behavioral and survey measures to examine sex/gender differences in 32 autistic adolescents (10 females, 22 males) before and after participation in the 20-week START socialization program. At intake, males self-reported superior social skills use while parents endorsed that females demonstrated superior social competencies. While males and females both experienced socialization improvements post-trial, females experienced greater increases in self-reported social competency and the proportion of questions they asked during peer conversations. These preliminary findings on differential intervention response may help inform future social skill intervention efforts for the needs of females on the spectrum.

The symptoms of autism spectrum disorder are conceptualized to alter the quality of parent–children interactions, exposure to social learning exchanges, and ultimately the course of child development. There is evidence that modifying the procedures of Pivotal Response Treatment (PRT) to explicitly target social motivation enhances child engagement and parent–child synchrony in moment-by-moment exchanges. However, it is unclear if these within session improvements ultimately yield favorable developmental outcomes over time. The current investigation presents feasibility, utility, and preliminary efficacy data of a pilot randomized clinical trial (RCT) of a Pivotal Response Intervention for Social Motivation (PRISM) model. Data on participant factors, treatment protocol acceptability, and outcome variance and effect size are highly favorable and support the pursuit of a future, large scale RCT.

Children with autism often exhibit low levels of social engagement, decreased levels of eye contact, and low social affect. However, both the literature and our direct clinical observations suggest that some components of intervention procedures may result in improvement in child-initiated social areas. Using an ABAB research design with three children with autism, this study systematically assessed whether embedding social interactions into reinforcers, delivered during language intervention, would lead to increased levels of child-initiated social behaviors. We compared this condition with a language intervention condition that did not embed social interactions into the reinforcers. Results indicated that embedding social interactions into the reinforcers resulted in increases in child-initiated social engagement during communication, improved nonverbal dyadic orienting, and improvements in general child affect. Theoretical and applied implications are discussed.