Scaling Evidence-Based Practice in Autism: A Randomized Clinical Trial of a Digital Parent trainer in Pivotal Response Treatment

The accessibility of evidence-based interventions (EBIs) for children with autism spectrum disorder (ASD) remains limited, creating a significant research-practice gap. This study aimed to address this gap by examining the efficacy of a digital parent trainer in delivering Pivotal Response Treatment (PRT), an evidence-based intervention for ASD. The digital trainer utilized e-learning technologies and video feedback to train parents in implementing PRT strategies. A randomized clinical trial was conducted with 10 children with ASD and their parents participating, the primary objective was to evaluate the effectiveness of the digital trainer in advancing the communication skills of children with ASD. Secondary objectives included assessing the trainer's effectiveness in teaching parents to implement PRT and evaluating the usability of the digital App. The study consisted of a 16-week intervention phase, during which parents received training through the application, uploaded videos of themselves implementing the strategies and received feedback in the form of a concise video with feedback embedded on their uploaded video, synchronized to the important interactions. The feedback was given by a person trained to provide video feedback. The clinical trial's control group received parental guidance through telehealth group meetings from a BCBA certified professional. Outcome measures included assessments of children's communication skills, parental fidelity of implementation (FiO) to PRT strategies, and parent-reported data. Blinding was maintained during the video coding process. The results indicate positive outcomes in the areas of children's communicative behaviors, parental FiO to PRT, and parent satisfaction with the digital app. The study highlights the potential of digital tools to scale up the delivery of evidence-based interventions for ASD, improving accessibility and empowering parents as key agents in their children's treatment journey. Further research is needed to validate these findings with a larger study group and explore the long-term effects of digital parent training in ASD interventions.