Pivotal Response Treatment

Abstract

This chapter will discuss Pivotal Response Treatment (PRT) for intervention for Autism Spectrum Disorder (ASD). PRT is based on the theory of learned helplessness, where individuals have difficulty learning that there is a response-reinforcer contingency. We speculate this is why individuals with ASD often display low motivation to communicate and engage with others, respond to environmental stimuli, or learn new skills and behaviors. PRT was developed to specifically emphasize response-reinforcer contingencies in order to improve motivation, which has been shown to produce widespread and generalized gains in many untargeted areas. This chapter presents instructions for implementing the motivational PRT procedures of child choice, reinforcing attempts, direct and natural reinforcers, interspersing maintenance and acquisition tasks, and incorporating task variation. In addition to the pivotal area of motivation, research suggests that there are other critical areas that when taught can also result in broad improvements. The chapter also discusses the additional pivotal areas of initiations, self-management, and response to multiple cues. Empirical support and research for both the PRT package and each component of the intervention is included. Lastly, future research and implications for families and practitioners are discussed.