Chen, G. M., Yoder, K. J., Ganzel, B. L., Goodwin, M. S., & Belmonte, M. K. (2012). Harnessing repetitive behaviors to engage attention and learning in a novel therapy for autism: An exploratory analysis. Frontiers in Psychology, 3, 1-16.
Reviewed by Kathleen Moran
Caldwell University
Why research this topic?
One of the biggest deficits in children with autism is communication. There is a growing body of research investigating interventions using different modalities to increase communication. In the current study, the investigators evaluated one such intervention, the rapid prompting method (RPM). This intervention, which was developed by a parent of a child with autism, aims to increase the child’s attention to communicative tasks by providing instruction at a pace that matches the child’s rate of repetitive and stereotypic behaviors. In addition, it emphasizes building new communication skills by using sensory prompts such as hand-over-hand guidance and modified instructional materials (e.g., pencils attached to the hand with a rubber band and stencils taped onto a piece of paper to improve the accuracy of written responses). Intervention proceeds from simple to more complex skills (e.g., expanding the array of possible written responses), based on the instructor’s impression of the child’s progress. When the child engages in repetitive behavior, he or she is quickly redirected back to the communicative task.
What did the researcher do?
Nine children who met criteria for autism and had a limited verbal repertoire participated in this study. All children received RPM for four to eight sessions. Sessions were 60 minutes in length and delivered by the developer of the program. Prompts were individualized for each child based on the instructor’s impression of the child’s preferred mode of sensory perception (i.e., auditory, visual, tactile). Data were collected on (1) the therapist’s requests and use of prompts, (2) the child’s frequency of responding appropriately and successfully to requests and the extent to which prompting was required, and (3) the child’s frequency of eye gaze, off-task activity, and repetitive and stereotypic behaviors.
What did the researchers find?
The researchers found that the number of multiple-choice options increased over the course of therapy, but the frequency of correct responding remained stable over time. They also found that repetitive and stereotypic behaviors decreased as therapy progressed and as engaged attention increased. However, prompting from a therapist did not decrease these behaviors, but instead resulted in a slight increase.
What are the strengths and limitations of the study? What do the results mean?
Overall, the study obtained mixed findings on the efficacy of RPM. Moreover, the study had many major limitations including a small sample size, absence of a control group or comparison to other interventions, lack of objective criteria for decisions to increase complexity of tasks, and unsystematic selection of prompts. Generalization of skills was not assessed. Because of these limitations, the study does not support conclusions about whether or not RPM is efficacious.
Citation for this article:
Moran, K. (2015). Harnessing repetitive behaviors to engage attention and learning in a novel therapy for autism: An exploratory analysis. Science in Autism Treatment, 12(1), 15-17.
