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Combining Pivotal Response Training and pragmatic communication book in communication intervention

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Aim: The aim of this single case study was to promote early communication skills of a child with autism spectrum disorder (ASD). The aim was also to find out if Pivotal Response Training (PRT) can help in transition to the use of an AAC system when the system is needed to enhance the understanding of spoken language.

Method: This case profiles a 4-year-old boy who was diagnosed with a suspected ASD. The data were collected for a period of 18 months when his early communication skills were enhanced using PRT. Language acquisition was evaluated using MCDI and progression in cognitive skills was scaled with Object Play Level Progression. Early communication skills and the transition to visual AAC system was described by clinical notes of the SLP.

Results: During the first 6 months PRT was the primary intervention method used. Parents and pre-school professionals were actively involved and had PRT sessions with the boy every day. The progress in early communication skills was evident. After 4 months, single pictures were taken in use. The use of the pragmatic communication book (CB) started 2 months later. Emergence of vocabulary suggests that the subject needed the CB to enhance his understanding of semantic and pragmatic functions of language.

Conclusion: This case confirmed that early communication skills are needed to implement visual AAC systems. In this case PRT helped the transition to the use of CB but intensive intervention was needed. Individualization of the CB was crucial to enhance the understanding.


Kirsi Katajisto    
University of Helsinki

Kaisa Launonen    
University of Helsinki


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