Pivotal Response Training (PRT): A Closer Look

The behavioral treatment has shown to be most effective for individuals with autism. There are various types of behavioral treatments like Applied Behavior Analysis (ABA), Relationship Development Intervention (RDI), Sensory Integration Therapy, Communication Interventions, and Treatment and Education of Autistic and Related Communication Handicapped Children (TEEACH). Of these, Pivotal Response Treatment (PRT) for autism spectrum disorders is derived from the principles of Applied Behavioral Analysis Therapy (ABA Therapy). 

What is Pivotal Response Treatment?

Pivotal Response Treatment was previously called the Natural Language Paradigm (NLP) and has been used since the 1970s. The techniques typically target autistic children aged 2-6 years, but they can be used with autistic people of any age. It is play-based and initiated by the child i.e., the child makes choices that direct the therapy. In this treatment, the therapist does not target specific behavior exhibited by the child. Use of PRT and Applied behaviour analysis in autism treatment help to teach language, decrease disruptive/self-stimulatory behaviors, and increase social, communication and language skills, and academic skills. 

What are Pivotal Areas?

The focus of the treatment is on ‘pivotal’ areas of a child’s development which in turn produces improvements across other areas of social skills, communication, behavior and learning. The four Pivotal Areas that are focused on are 

  • Motivation – where the therapist works to increase children’s desire to learn and perform skills associated using positive reinforcement
  • Response to multiple cues – this is teaching and encouraging children to respond to various forms of the same prompt or instruction
  • Self-management – which teaches children to self-evaluate and discriminate their behaviors for greater independence.
  • Initiation of social interactions where the therapist encourages the child to initiate social interaction by asking questions or obtaining attention. 

What does Pivotal Response Treatment (PRT) involve?

Pivotal Response Treatment (PRT) is a child initiated therapy and is conducted in the child’s natural environments like preschool, home or school. It also uses everyday activities to teach children. Pivotal Response Treatment training should be undertaken by parents, teachers and even children’s peers as well as therapists because the treatment requires active involvement from all those who interact with the child regularly. It can be a time consuming treatment.  It can involve many hours a day and go on for several years, depending on children’s goals. and can be done by therapists, parents, teachers and even children’s peers.

The following are the basic steps followed in PRT

  1. Set up goals that are specific to the individual child – for example, saying a two-word sentence or phrase.
  2. Use the child’s interest in something as an opportunity to teach and help the child reach the goal.
  3. Praise and/or reward every time the child makes an effort to reach the goal. It doesn’t matter whether the attempt is successful. Rewards are based on what the child likes.

Is PRT practiced at Jewel Autism Centre?

Jewel Autism Centre has an applied behavior center for autism that provides pivotal response treatment training for parents based on a focused pivotal response training manual. Applied Behavioral Analysis programs emphasise the role of parents as primary intervention agents. All the people involved in the child’s life are encouraged to use PRT methods consistently in every part of his or her life.