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Pivotal Response Training May Improve Brain Responses to Social Cues

Early results from a preliminary study on Pivotal Response Training (PRT) suggest that its use in young children with autism improves their brain responses to social cues. The improved brain activity corresponded with improvements in the children’s social skills

Kevin Pelphrey, Ph.D., and colleagues from the Yale Child Study Center reported their results at the International Meeting for Autism Research (IMFAR).

The researchers followed six children, ages 4 to 6, who completed four months of PRT. Before and after treatment, the children underwent a noninvasive brain scan. Specifically the researchers used functional magnetic resonance imagining (fMRI) to track activity in parts of the brain associated with sociability.

During the scans, the children viewed videos of moving lights. Some of the lights followed random motion patterns. Others traced human-like motions.

The researchers created the human motion patterns by filming someone moving in a dark room with lights on his major joints. (See image on left.) Previous studies have shown that this type of motion activates social parts of the brain in individuals with typical brain development. By contrast, individuals with autism tend to show little difference in their brain responses to human versus random motion patterns.

During an IMFAR press conference, the researchers described their preliminary results with two children. After 4 months of PRT, both children responded to the human light patterns with significantly more activity in brain regions associated with recognizing social cues. Both children also showed remarkable gains in social and communication skills. The researchers measured these skills using widely accepted checklists of behaviors associated with autism.

Pivotal Response Training
PRT is a form of autism therapy based on the techniques of Applied Behavioral Analysis. PRT therapists interact with children in a play environment. During play, they encourage important social behaviors, or “pivotal responses.” A number of studies have shown PRT to be effective in building new social and communication skills. The Yale study was the first to look for changes in the brain activity associated with social interactions following PRT.

Early Intervention and Improved Brain Function
Last year, a larger, randomized and controlled study of the Early Start Denver Model provided the first scientific evidence that early intervention for autism can improve brain function.

“Such research is of interest for two primary reasons,” comments Autism Speaks Chief Science Officer Geri Dawson, Ph.D. “First, it suggests that early intervention may actually change the course of brain development in children with autism. Second, it suggests that brain scans may help predict who will benefit from a given therapy and provide an objective measure of its benefits.”

Research Continues
With the support of an Autism Speaks grant, the PRT study's lead researcher, Avery Voos, has begun a larger study at the University of California, Santa Barbara. Her continuing research is being made possible through an Autism Speaks Dennis Weatherstone Predoctoral Fellowship.

More news from IMFAR 2013 here.