What is Pivotal Response Treatment (PRT)?
Pivotal Response Treatment (PRT) is a set of teaching techniques used in children’s everyday environments. It isn’t a therapy in itself. It isn’t a therapy in itself.
PRT is based on the principles of Applied Behaviour Analysis (ABA). It focuses on four key or ‘pivotal’ areas of autistic children’s development, with the aim of helping children develop more complex skills and behaviour, including social and communication skills.
Some autism therapies include PRT techniques as part of their approach, particularly ABA-based programs.
Other common names for PRT include Pivotal Response Intervention and the Natural Language Paradigm.
Who is Pivotal Response Treatment (PRT) for?
Pivotal Response Treatment (PRT) techniques typically target autistic children aged 2-6 years, but they can be used with autistic people of any age.
What is Pivotal Response Treatment (PRT) used for?
Pivotal Response Treatment (PRT) techniques are used to improve autistic children’s social skills, communication skills, play skills and behaviour. The techniques aim to promote independence and reduce the need for ongoing intervention.
Where does Pivotal Response Treatment (PRT) come from?
Pivotal Response Treatment (PRT) was developed in the 1980s, mainly by a team of psychologists in the United States. PRT and other naturalistic teaching techniques grew out of concerns about more traditional behaviour approaches and how well the skills children learned using these approaches could be adapted for different settings.
Naturalistic behavioural interventions like PRT are based on the work done by researchers Hart and Risley in the 1970s. Their studies focused on improving language development in preschool children with language delays.
What is the idea behind Pivotal Response Treatment (PRT)?
The theory behind Pivotal Response Treatment (PRT) is that there are four key areas of child development that are ‘pivotal’ to later development:
- Motivation: this is encouraging learning by giving children choices, varying tasks, combining previously learned tasks with new tasks, prompting, and using rewards.
- Self-initiation: this is encouraging and rewarding children’s curiosity – for example, when they ask questions about something they see.
- Self-management: this is teaching children to be more independent and take responsibility for their learning.
- Responsiveness to multiple cues: this is teaching and encouraging children to respond to various forms of the same prompt or instruction – for example, ‘Get your jumper’, ‘Get your pullover’ or ‘Go and get your jumper now’.
Supporters of PRT believe that improvements in more complex skills (like social skills, communication and play skills, and behaviour) follow if autistic children can first learn and develop in these foundation areas.
What does Pivotal Response Treatment (PRT) involve?
Pivotal Response Treatment (PRT) takes place in autistic children’s natural environments like preschool, home or school. It also uses everyday activities to teach children.
For a person working with an individual child, PRT involves the following steps:
- Set up goals that are specific to the individual child – for example, saying a two-word sentence or phrase.
- Use the child’s interest in something as an opportunity to teach and help the child reach the goal.
- 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.
PRT can take a lot of time. It can involve many hours a day and go on for several years, depending on children’s goals. PRT always takes place in children’s natural environments and can be done by therapists, parents, teachers and even children’s peers.
The cost of Pivotal Response Treatment (PRT) depends on the type of behavioural intervention program in which it’s used and how long children do it for. As a parent, you can reduce the cost by doing the approach yourself, but you might still need to buy training manuals.
Does Pivotal Response Treatment (PRT) work?
High-quality research shows that this approach has positive effects on autistic children’s behaviour.
Who practises Pivotal Response Treatment (PRT)?
Anyone can practise Pivotal Response Treatment (PRT), including professionals, parents, teachers and even peers.
Most official training is available through the Koegel Autism Center in the United States, which provides parent training and support materials.
Parent education, training, support and involvement
If your child is in a program that uses Pivotal Response Treatment (PRT), you’ll be actively involved. You can get training and support materials through the Koegel Autism Center in the United States.
Where can you find a practitioner?
Pivotal Response Treatment (PRT) forms part of some other intervention programs, like the Early Start Denver Model. You might be able to access it through these programs.
There’s no register of trained PRT practitioners, but the Behavior Analyst Certification Board has a list of certified behaviour analysts.
You can find other professionals by going to:
- Speech Pathology Australia – Find a speech pathologist
- Occupational Therapy Australia – Find an occupational therapist
- Australian Psychological Society – Find a psychologist.
If you’re interested in PRT, you could talk about it with your GP or one of the other professionals working with your child. You could also talk about it with your NDIA planner, NDIS early childhood intervention (ECEI) coordinator or NDIS local area coordinator (LAC), if you have one.