autism, evidence-based treatment, pivotal response treatment, pivotal skills, PRT, social interaction
Behavioral intervention can impact brain function! Does your BCBA, school, or home behavior team use PRT?
Have you heard?
Many of our community partners recently shared the new article on how behavioral intervention for children with autism can impact brain function. But what kind of behavioral intervention was actually studied? This was NOT 20-40 hours of discrete trial therapy per week. No, the children benefiting from behavior intervention received 8-10 hours weekly PRT, or Pivotal Response Treatment. Does your BCBA, school, or home behavior team use PRT?
What is PRT? PRT stands for “Pivotal Response Treatment” or “Pivotal Response Therapy”.
PRT is making news again because of growing evidence that while effecting change in the lives of children, it may also correspond to changes in their brains. But it’s not a new treatment and has been used for decades to support learners with autism. PRT uses the child’s own interests as motivation for learning more. Using PRT, students can learn how to learn from their environments and find social interaction more meaningful. PRT involves using naturalistic, family-friendly, strategies to strengthen skills that are “pivotal” for the child’s development. For example, a therapist or parent may strengthen skills that are critically important in many contexts, such as responding to multiple cues, initiating activities, and making social initiations. Outcomes of targeting pivotal skills include widespread improvement in additional areas of development, including social interaction, communication, and behavior. Ultimately, PRT is a well-studied component of behavior analytic treatment that can be used in natural settings and implemented by family members, and therapists can easily assist families to integrate PRT into their daily activities.
Learn more about PRT
An earlier version of PRT was known as the “Natural Language Paradigm”. Developers of PRT, Dr. Robert L. Koegel and Dr. Lynn Kern Koegel, have consistently produced research showing the effectiveness of strengthening pivotal responses important to social interaction and motivation. To find out more, please see their website (http://www.koegelautism.com/) for information, articles, resources, books, materials, and educational opportunities.
So how are the brains of children with autism changed by PRT? And does PRT take years to show effectiveness?
Avery C. Voos, one of the lead authors involved in the study, stated: “The cool thing that we found was that these kids showed increased activation in regions of the brain utilized by typically developing kids.” This is consistent with reports of parents of children involved in PRT, who often notice improvements right away as they learn to incorporate the strategies in their daily lives. Corresponding changes in children’s brains likely occur that support the lasting changes in their behavior, but only recently has research directly supported this notion. Voos noted that “[a]fter four months of treatment, they’re starting to use brain regions that typically developing kids are using to process social stimuli.” The study collected information before and after children received 8 to 10 hours per week of pivotal response treatment. Although the study had many limitations, it contributes to a growing body of pioneering research exploring how and why behavioral intervention can have long term beneficial impact. To us at Cusp Emergence, one of the best reasons to use PRT is its social validity and acceptability to the parents and children with whom we’ve consulted.
Family members are easily trained in the paradigm by trained professionals or a combination of using manuals and coaching. Workshops in this technique are offered worldwide, but your local behavior analyst is often familiar with these techniques. Know a school, behavior analyst, team or family who could benefit from additional training or consulting to develop their PRT skills or apply them for a particular learner?