Pivotal Response Treatment ® (PRT)
(Lynn Koegel and Robert
Koegel)
Pivotal
Response Treatment (PRT) is an evidence-based practice that may be used to
promote functional communication, such as first words, in children with autism. It may be used to promote social interaction,
such as joint attention, play, and initiating interactions. This treatment
approach is pivotal because it
supports the foundational skills that can be generalized to other situations and
environments. PRT was used to promote child’s production of first words and to
expand his functional play.
To
implement PRT, the clinician withheld an object or action that child wanted, and
she only gave him the object or performed the action after he said, or attempted
to say, the target word (i.e., label for that object or action). During the
sessions, the clinician engaged child in play with high-interest items or
activities. She then gained shared control of the item child was
playing with. The clinician held up the motivating item at child's eye level to
get his attention. The activity paused until child said the target word, then the
clinician gave child the item and the activity continued. Giving child a preferred
object or performing a preferred action after he produced the target was a
natural reinforcer. It taught him that objects and actions have labels, and
that he can request that object or action by saying the label. The clinician
used PRT throughout the contact period to encourage child to produce as many
words, or approximations of words, as possible. The clinician also exposed child to a variety of activities to expand his play.