Training Teachers to Implement Classroom Pivotal Response Teaching during Small-group Instruction: A Pilot Study

Figures & data

Table 1. Demographic characteristics of students at baseline

Student	Age	Diagnosis	SRS	Verbal IQ	Performance IQ	Social-communication goal
1	10;9	ASD	69	102	110	Requesting help
2	9;0	ASD	69	73	86	Requesting help
3	9;9	ASD, ADHD, tic disorder, and unspecified obsessive-compulsive disorder	84	104	98	Following instructions and gaining the teacher’s attention in an appropriate manner
4	8;0	ASD	84	90	94	Following instructions and responding to questions
5	8;11	ASD	77	74	98	Requesting help
6	10;2	ASD and Tourette’s disorder	81	90	100	Communicating annoyance in an appropriate manner
7	11;6	ASD, ADHD	80	71	104	Gaining the teacher’s attention in an appropriate manner

Note. ASD: autism spectrum disorder; ADHD: attention deficit hyperactivity disorder; SRS: social responsiveness scale. A score > 60 on the SRS is an indication for ASD.

Table 2. Overview of group sessions

Session	Session content	Homework assignment
1.	Introduction to ABA and ABC pattern of behavior Introduction to PRT and CPRT Instruction in antecedent CPRT components (gaining the student’s attention, presenting clear and appropriate cues, interspersing maintenance and acquisition tasks) Worksheet ‘student attention’ Roleplay to practice antecedent components	Reading: Chapter 2, 3 (pages 33–41), and 4 (pages 57–63) Video: Implement CPRT during small-group instruction
2.	Video feedback on implementation of CPRT Instruction in antecedent CPRT components (sharing control and using multiple cues) Instruction in prompting Roleplay to practice antecedent components	Reading: Chapter 3 (pages 41–47) and 4 (pages 63–66) Video: Implement CPRT during small-group instruction
3.	Video feedback on implementation of CPRT Instruction in setting goals and data collection Worksheet ‘student goals’ Instruction in consequent CPRT components (providing direct and contingent reinforcement and reinforcing attempts) Worksheet ‘reinforcement’ Roleplay to practice consequent components Introduction to assessment of fidelity of implementation	Reading: Chapter 3 (pages 47–54), 4 (pages 66–68) and 5 Video: Implement CPRT during small-group instruction

Table 3. Definitions of behavioral categories for three-term contingency learning trials

Behavioral category	Operational definition
Gaining the student’s attention	The teacher had the student’s attention if the student (a) was looking toward the teacher or teaching materials, (b) had oriented his or her body toward the teacher or materials, or (c) was reaching for teaching materials. If the student is engaged with other materials, he or she is not attending.
Presenting a clear and appropriate cue	The teacher presented a clear and appropriate cue if (a) the cue was uninterrupted, and (b) only one cue was presented at the same time. Six different cues (increasing in difficulty) were recorded: Instruction: giving a direct instruction telling the student exactly what to do, for example ‘Get your math book’ Multiple cues: giving a direct instruction that requires the student to attend to multiple cues, for example ‘Give me a small blue block and a big red block’ Question: asking a closed or open-ended question, for example ‘What’s your book about?’ Comment: making a statement, without giving details, for example ‘We’re going to do something fun’. Waiting: waiting while looking expectantly to the student, for example when the student needs help or when the teacher is expected to act. Environmental arrangement: setting up activities or situations to elicit communication, for example by sharing control, keeping teaching materials in sight out of reach, or keeping materials out sight out of reach.
Student response or reasonable attempt	The student responded correctly if his or her response was (a) appropriate, and (b) related to the teacher’s cue. A reasonable attempt was recorded if the student’s response was less accurate or complex than expected based on the student’s level of (social) communication skills, but appropriate and related to the teacher’s cue.
Prompting the student to respond	If the student did not initiate within 3 seconds after the teacher presented a cue, the teacher offered help by prompting. Five types of prompts were recorded: Time delay prompt: giving the student an expectant look to stimulate him or her to respond. Visual prompt: showing a picture or using gesture to stimulate the student to respond. Open-ended question prompt: asking an open-ended question to stimulate the student to respond, for example ‘What could you ask me now?’ (Verbal) model prompt: modeling the verbal or nonverbal response excepted from the student. Physical prompt: physically guiding the student to respond. The teacher continued prompting until the student responded or until three prompts were given. The order of prompts was not predetermined.
Reinforcing the student’s response directly and contingently	The teacher provided direct and contingent reinforcement if (a) he or she responded to the student within two seconds, (b) this response was the teacher’s first behavior after the student’s response, and (c) this response was directly or naturally related to the student’s response. Reinforcement was also recorded if the teacher withheld reinforcement if the student did not respond after being prompted at least once.

Table 4. Interobserver agreement (PABAK) for fidelity of CPRT implementation and communication skills

		PABAK
Category		M	SD	Range
Fidelity of CPRT implementation	Total fidelity	0.63	0.26	0.20–1.00
	Maximizing student motivation	0.86	0.20	0.00–1.00
	Implementing three-term contingency learning trials	0.55	0.27	0.00–1.00
	Interspersing maintenance and acquisition trials	0.46	0.41	−0.56–1.00
Communication skills	Spontaneous initiations	0.80	0.13	0.53–1.00
	Spontaneous responses	0.66	0.16	0.33–1.00

Note. CPRT: classroom pivotal response teaching; PABAK: prevalence-adjusted bias-adjusted kappa; M: mean; SD: standard deviation.

Table 5. Median percentages of fidelity of CPRT implementation and values of Tau

Teacher	Median percentage of fidelity of CPRT implementation				Tau
	Baseline	Intervention	Post-intervention	Follow-up	B-I contrast	I-PI contrast	PI-FU contrast
1	5.00%	20.00%	15.00%	5.00%	0.50	0.00	−0.13
2	5.00%	15.56%	45.00%	40.00%	0.52	0.58	−0.04
3	0.00%	30.00%	25.00%	25.00%	0.58*	−0.17	0.04
4	10.00%	20.00%	40.00%	-	0.63*	0.08	-
5	30.00%	40.00%	55.00%	60.00%	0.15	0.52	−0.17
6	20.00%	20.00%	25.00%	50.00%	−0.09	0.20	0.51
7	5.00%	25.00%	35.00%	25.00%	0.74*	0.10	−0.13

Note. CPRT: classroom pivotal response teaching; B: baseline; I: intervention; PI: post-intervention; FU: follow-up; ^a Tau-U; * significant at α = 0.05.

Figure 1. Percentage of CPRT fidelity during small-group instruction as rated by observers (squares) and trainers (crosses). Note. During intervention, data were collected from the third group session

Table 6. Median percentages of CPRT fidelity components across teachers

Category	Median percentages of fidelity of CPRT implementation
	Baseline	Intervention	Post-intervention	Follow-up
Maximizing student motivation	80.00%	90.00%	90.00%	90.00%
Implementing three-term contingency learning trials	30.00%	50.00%	60.00%	50.00%
Interspersing maintenance and acquisition trials	33.33%	55.56%	55.56%	66.67%

Note. CPRT: classroom pivotal response teaching.

Figure 2. Percentage of child initiations (squares) and responses (circles) during small-group instruction

Figure 3. Percentage of maladaptive behavior as experienced by teachers between circle and recess time

Availability Of Data

The data that support the findings of this study are available from the corresponding author upon reasonable request.