Examining Variables Moderating the Effectiveness of Pivotal Response Training in Children with Autism Spectrum Disorder: A Meta-Analysis of Single-Subject Studies

The purpose of this research was to explore which variables might moderate the effectiveness of PRT in children diagnosed with or identified as being at risk for autism spectrum disorder (ASD). Searching was conducted using four databases (Academic Search Ultimate, ERIC, Scopus, and Web of Science). After applying inclusion and exclusion criteria, 24 single-subject design (SSD) studies were included in the meta-analysis. Data were coded according to participant characteristics, intervention setting, and dependent variables. Effect sizes were calculated based on the Percentage of Non-Overlapping Data (PND). The findings showed that PRT is strongly effective across multiple domains, including communication, academic skills, behavior change, and play. Effect sizes were slightly larger for children aged 7–12 compared to younger children, suggesting that school-aged children may benefit at least as much as preschoolers. Regarding setting, interventions conducted across both home and clinic environments produced the strongest effect sizes, while clinic-only interventions showed the lowest. Among dependent variables, play skills yielded relatively lower outcomes, whereas behavior change produced the highest mean effect size, however, this result was based on a small number of studies.