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MODULE: Pivotal Response Training (PRT)
The aim of PRT is to change learners’ behaviors to allow for a more typical trajectory of development in both home environments and the most inclusive educational settings appropriate. In the sections that follow, specific procedures are provided to address each key pivotal behavior—motivation, responses to multiple cues, self-management, and self-initiation. Ideally, these procedures should be incorporated into a broader intervention plan and general curricula instead of creating a separate program for learners with ASD (R. L. Koegel & Koegel, 2006).
Strategies to increase motivation can be incorporated into a home setting or general education classroom quite easily and can have positive benefits for typically developing siblings and peers as well as learners with ASD. Several procedures have been identified to increase motivation. These include (a) establishing learner attention, (b) using shared control, (c) using learner choice, (d) varying tasks, (e) interspersing acquisition and maintenance tasks, (f) reinforcing response attempts, and (g) using reinforcers that are directly linked to the learner’s goals (R. L. Koegel et al., 2001).
Responsivity to Multiple Cues
The goal of self-management is to increase the independence of learners while decreasing their dependence on team members. An increase in autonomy also provides learners with more opportunities to engage in activities independently or with others in a more age-appropriate, typical manner (L. K. Koegel et al., 1999).
To promote self-management, learners are taught to discriminate their target behaviors and then to record or monitor the occurrence (or absence) of them. Self-management is designed to take place in the absence of team members and provide learners with a set of procedures to promote autonomy and independence. It is an ideal strategy for teaching learners with ASD who have mild to moderate intellectual impairment and a range of social-communicative behaviors. Prior research has shown this technique to be particularly successful for targeting a range of communicative functions, including information-seeking, bids for attention, and conversational initiations (L. K. Koegel, Camarata et al., 1998). In addition, self-managing social-communicative behaviors has resulted in collateral improvements in untreated social skills and generalized improvements in other pragmatic behaviors such as prosody, on-topic comments and questions during conversation (L. K. Koegel, Koegel, & Parks, 1992; R. L. Koegel & Frea, 1993).
The general process for teaching self-management is explained in the sections that follow (L. K. Koegel, Koegel, & Parks, 1992).
Self-management of interfering behavior involves a second important phase after team members have successfully implemented strategies that reduced and managed the interfering behavior. To successfully reduce the interfering behavior over the long term, learners must be involved in the process of developing a comprehensive intervention plan that is durable, generalizable, addresses the different maintaining functions and problem routines learners present; and involves a self-management component (Horner & Carr, 1997). This requires (a) an assessment of the interfering behavior to determine its function and (b) the development of appropriate behavioral intervention strategies that teach learners how to use alternative behaviors that serve the same function as the interfering behaviors in question (i.e., replacement behaviors).
When self-management is being implemented to reduce an interfering behavior, the reinforcer/reward is particularly important, because for most learners it takes some time before the functionally equivalent replacement behavior becomes as successful as (ideally more successful than) the undesirable predecessor (e.g., appropriately requesting attention instead of having a tantrum). Rewarding the period of time without the interfering behavior will help to quickly reduce it while the replacement behavior is being learned (L. K. Koegel, Koegel, Boettcher, Harrower, & Openden 2006).
Several methods have been devised to develop question-asking and conversation initiation in learners with ASD. Peer-mediated and learner-initiated strategies have shown the most promising results.