OBJECTIVES: Our aim was to conduct a randomized controlled trial to evaluate a pivotal response treatment package (PRT-P) consisting of parent training and clinician-delivered in-home intervention on the communication skills of children with autism spectrum disorder. METHODS: Forty-eight children with autism spectrum disorder and significant language delay between 2 and 5 years old were randomly assigned to PRT-P (n = 24) or the delayed treatment group (n = 24) for 24 weeks. The effect of treatment on child communication skills was assessed via behavioral coding of parent-child interactions, standardized parent-report measures, and blinded clinician ratings. RESULTS: Analysis of child utterances during the structured laboratory observation revealed that, compared with the delayed treatment group, children in PRT-P demonstrated greater improvement in frequency of functional utterances (F1,41 = 6.07; P = .026; d = 0.61). The majority of parents in the PRT-P group (91%) were able to implement pivotal response treatment (PRT) with fidelity within 24 weeks. Children receiving PRT-P also demonstrated greater improvement on the Brief Observation of Social Communication Change, on the Clinical Global Impressions Improvement subscale, and in number of words used on a parent-report questionnaire. CONCLUSIONS: This is the first 24-week randomized controlled trial in which community treatment is compared with the combination of parent training and clinician-delivered PRT. PRT-P was effective for improving child social communication skills and for teaching parents to implement PRT. Additional research will be needed to understand the optimal combination of treatment settings, intensity, and duration, and to identify child and parent characteristics associated with treatment response.

Autism spectrum disorder (ASD) is more prevalent in males than females. Previous research indicates females camouflage ASD symptoms more than males, potentially contributing to the difference in prevalence. This study investigated sex/gender differences in behavioral phenotypes in 17 males and 11 females with ASD, as well camouflaging in ASD, in an attempt to partially replicate findings from Lai et al. (Autism 21(6):690–702, 2017). Overall ASD symptoms were measured by the autism spectrum quotient (AQ). Mean AQ in females with ASD was higher than males with ASD, with the difference approaching statistical significance. Camouflaging was found to be more common in females with ASD, and not associated to social phobia. Furthermore, camouflaging correlated negatively with emotional expressivity in females, but not males, with ASD. These findings strengthen previous findings regarding camouflaging being more common in females and add to the literature on how camouflaging may be different in females versus males.

From preschool age to adulthood, most humans prefer to help someone who has treated others well over helping someone who has treated others badly. Researchers have recently made opposing predictions about whether such observation-based preferential helping is present when children begin to help in the second year of life. In the present study, 84 toddlers (16-27 months) observed 1 experimenter (antisocial) take a ball from, and 1 experimenter (prosocial) return a ball to, a neutral experimenter. In subsequent tests, children could help either the antisocial or the prosocial experimenter. Only the oldest children showed a significant preference for helping the prosocial agent first. Most children in all age groups were willing to help both experimenters when given multiple opportunities to help. Across age groups, children who looked longer at the continuation of the antisocial interaction were more likely to help the prosocial agent. These findings suggest that social evaluations do affect toddlers' helping behavior but that interactions between human agents may be difficult to evaluate for very young children.

Proponents of autism intervention and those of the neurodiversity movement often appear at odds, the former advocating for intensive treatments and the latter arguing that autism must be accepted as a form of diversity. The history of behavioral intervention has understandably outraged many in the Autistic community, though many still value supports focused on quality of life. This commentary argues that Naturalistic Developmental Behavioral Interventions (NDBIs) hold promise for bridging the gap between early intervention and the neurodiversity movement. However, we recognize NDBIs have much room to grow and suggest multiple strategies for improvement. We believe these updates are not only feasible for clinicians and researchers to implement but will ultimately lead to improved quality of life for Autistic individuals.

While the COVID-19 pandemic radically changed all aspects of everyone’s life, the closure of schools was one of the most impactful, significantly altering daily life for school personnel, students, and families. The shift to Emergency Remote Teaching (ERT) presented particular challenges to special educators of students with significant support needs who often benefit from strong interpersonal connections, modeling, and the use of physical manipulatives. This paper details the experiences of two elementary special education teachers as they navigated the transition to ERT. The teachers reported three distinct stages of ERT: making contact, establishing routines, and transitioning to academics. They also discussed the challenges they faced during this period, such as the inequity in resources amongst their students, needing to rely on at-home support in order to meaningfully teach students, and changes in what it meant to be a teacher while having to teach online. While clearly not in favor of online learning, the teachers do present glimmers of hope, for example, with regards to increased communication between teachers and parents. The challenges and strategies used to overcome these challenges will be of use to educators in the coming months, with implications for distance learning in this population.