Pivotal Response Training for Autism

Overview
Pivotal response training (PRT), also known as pivotal response teaching or pivotal response therapy, is a comprehensive interventional model for children with autism spectrum disorder (ASD). PRT targets pivotal areas of development such as motivation, self-management and the ability to initiate social interactions. PRT is used to improve behavior, teach language, and foster social, communication and learning skills. PRT was derived from the principles of applied behavioral analysis.

PRT is known as a naturalistic approach because it is largely child-led and does not target individual behaviors, but areas of development. One important tenet of PRT is the use of direct, natural reinforcers. For instance, if a child makes a meaningful effort to communicate desire for a certain toy, they receive that toy as positive reinforcement for their effort.

What does it involve?
PRT may be utilized by child psychologists, special education teachers, speech therapists, or various types of therapy providers. There are six levels of PRT certification. Ask your child’s therapy provider for details about their training and certification in the use of PRT.

PRT programs usually involve at least 25 hours per week of therapy. In addition, parents and other caregivers are trained in PRT and encouraged to incorporate it into every aspect of the child’s daily life. Some people have described PRT as a lifestyle due to the immersive nature of the therapy.

PRT is play-based. In PRT, the child plays a leading role in choosing activities and objects utilized in exchanges. The therapist frequently shares control with the child. For example, the therapist may perform the first few steps in a task, but turn it over to the child to complete. Activities are varied and regularly interspersed with maintenance tasks. The therapist rewards all meaningful attempts that show the child’s intent to achieve the target behavior.

Intended Outcomes
The goal of pivotal response training is to improve motivation and behavior and increase skills in children with autism.

Results
A 2007 synthesis of existing research on pivotal response training concluded that PRT is an effective, evidence-based intervention for improving the social, emotional and communication behavior of small children with ASD.

Constraints
You may have to switch therapy providers in order to find one trained or certified in PRT.

If you pay privately for therapy, it can become expensive.

Depending on where you live, it may be difficult