What is Pivotal Response Training (PRT)?

Applied Behavior Analysis (ABA) offers an abundance of treatment options based on the principles of behavior including formal, structured teaching and more naturalistic approaches. Pivotal Response Training (PRT) is just one of these options. Through a variety of assessments, professionals must determine which treatment option meets the needs of their clients.

ABA teaching methods occur in a variety of treatment settings falling along a continuum between natural and highly analog environments. Pivotal Response Training is a teaching methodology from the more natural end of this continuum. It focuses on improving skills in 4 pivotal areas that, once learned, help the child acquire other skills more rapidly.

Continuum of methodology within ABA-Pivotal Response Training

For more information about the various teaching methodology available within ABA, read these posts: Should I Use Natural Environment Teaching (NET) or Discrete Trial Training (DTT)? and How Teaching Strategies Impact Generalization for Children with Autism.

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4 Pivotal Areas

Pivotal Response Training is based on the assumption that there are key skills that have significant impact on other areas of development. PRT seeks to target these skills as a method of improving efficiency of intervention. Essentially, by focusing on these key skills, interventionists expect collateral impacts on other skill areas outside of those receiving immediate intervention.

Koegel, Koegel, Harrower and Carter (1999) published Pivotal Response Intervention I: Overview of Approach where they describe three pivotal areas (motivation to initiate, response to multiple cues, and self-management). More recently (2013), one of the authors, Dr. Lynn Koegel expanded on this when she specified 4 pivotal areas:

  • Motivation
  • Initiation
  • Multiple cues
  • Self-management

She explains more in this video:

Motivation

Dictionary.com defines motivation as “having a strong reason to act or accomplish something.” Pivotal Response Training seeks to improve the motivation of learners. As motivation increases, the learner becomes more driven to complete tasks. PRT targets motivation through the following interventions:

  • Child choice
  • Task variation
  • Natural reinforcement
  • Interspersal of easy and hard tasks
  • Reinforcing attempts
  • Motivational package

Child Choice

Offering choice has been long identified as connected to motivation in a variety of contexts. Studies in psychology have linked choice with intrinsic motivation (Iyengar & Lepper, 1999) and the field of ABA refers to offering choice as shared control. During PRT, learners control much of the teaching session. The learner communicates their choice, thereby strengthening language (Koegel, 1988).

Task Variation

A study by Stahmer (1995) demonstrated much lower rates of maladaptive and self-stimulatory behavior when programming included variety in tasks. Variety builds motivation and as motivation for task participation increases, the child’s motivation to engage in maladaptive and self-stimulation decreases.

Natural Reinforcement

During PRT, emphasis is placed on reinforcement occurring immediately after a correct response to ensure the correct behavior is reinforced. The relationship between the child’s response and the reinforcement must be clear. PRT focuses on using reinforcement that is the natural result of the behavior. There should be a direct relationship between the behavior and the reinforcer provided. If the learner mands for a ball, the reinforcer is access to the ball, not some arbitrary reinforcer. With this natural reinforcement, the learner understands the relationship between his behavior and access to those items and activities he values.

Initially, every response made by the learner receives reinforcement. Only once the behavior is well established does the interventionist begin to fade the schedule of reinforcement.

Interspersal of Easy and Hard Tasks

Motivation is highest when learners experience success. When easy tasks are interspersed with hard tasks, the learner build momentum with correct responding and then is more likely to attempt hard tasks. The ratio of easy:hard tasks will vary depending on the learner. Some learners quickly become bored with too many easy tasks and others become frustrated with too many hard tasks. Watch the motivation of your learner to guide your decision making.

Reinforcing Attempts

Although it’s critical that the interventionist never reinforce an incorrect response, they often reinforce attempts the child makes at a correct response. Any “reasonable attempt” made by the learner to respond correctly, receives reinforcement, especially when introducing new instructional targets. This reduces frustration on the part of the learner and builds the learner’s motivation to respond.

Many studies conducted by Rober and Lynn Koegel look at reinforcing attempts to shape verbal communication. This aligns with research by others in the field of verbal behavior including Mark Sundberg’s work with the VB-MAPP. When reinforcing attempts, it’s important to keep in mind the need to move forward as the various attempts are mastered. For example, “b” cannot forever be reinforced as a mand for ball. Eventually, the next step (i.e. “ba”) must be encouraged and ultimately required to receive reinforcement.

Motivational Package

Often a “package” addresses many of the above interventions to ensure that programming is effective. Not every learner requires every learner requires that programming include every component. Choose just those interventions that are appropriate given your learner’s specific needs.

Initiation

During PRT, learners are taught to initiate interactions. This improves spontaneous communication and social interactions. A learner who initiates communication quickly learns to access reinforcement more quickly. The learner who has strong initiation skills becomes more independent, relying less on others to get his needs met.

Multiple Cues

Responding to multiple cues refers to the learners ability to respond to SDs with 2 or more components, for example, blue car. The learner demonstrates understanding that this is not the same as the red car or the blue dump truck (Koegel, 1988). Learners who respond to multiple cues to items within their environment show greater generality and become less rigid in their learning styles. They learn to adapt and respond to the wide variety of cues available within the natural environment. Interventionists use multiple cues throughout as many interactions as possible, expanding the number of learning opportunities available to the learner.

Self-Management

Self-management refers to teaching the learner to become aware of his or her own behavior and intervene to either increase or decrease that behavior. When individuals feel a sense of ownership, control and responsibility for their own behavior, the results can be significant.

Teaching a learner to engage in self-management requires 2 distinct steps:

  1. Teaching the learner to discriminate between when the behavior occurs and when it does not occur.
  2. Teaching the learner to access a reinforcer for exhibiting the behavior.

Learners at a variety of developmental levels can be taught to use self-management interventions. If the learner understands how to follow a schedule, that learner can utilize self-management strategies to obtain reinforcement for completing tasks on that schedule. It is often best to begin with clear, distinct behaviors and build to include other behaviors.

Skills Taught Using Pivotal Response Training

While many skills can be taught using PRT, this instructional format lends itself well for targeting these skill areas:

  • Verbal communication
  • Social interaction
  • Academics
  • Play

Benefits of Pivotal Response Training

Significant research supports the use of Pivotal Response Training for a variety of learners. While it’s not necessarily the best alternative for every learner or every skill, PRT offers some advantages over other teaching methodology. Research has found that with the use of PRT, learners:

  • Learn faster
  • Make collateral gains in non-targeted areas
  • Have lower levels of challenging behavior
  • Generalize skills to untrained settings

If Pivotal Response Training is so Great, Why isn’t Everyone Using it?

Many well-known and respected ABA programs and experts use programming that is heavy in Discrete Trial Training (DTT). Dr. Vincent Carbone and many others model the use of highly structured teaching in their work with children with autism. If the research shows the benefits of PRT, why aren’t these experts using a more natural approach?

The answer may lie, in part, in the difference in learners these researchers are working with. In comparing some of the research, it appears that learners with more profound disabilities may learn better in more contrived or analog situations, although this is hard to confirm. Working with children with severe disabilities and behavior challenges in a more natural, less controlled environment can be difficult on the interventionist.

Another reason might be related to the ease of data collection and the desire to demonstrate experimental control. The more contrived the setting, the more control the researcher has over the variables that might influence skill acquisition and behavior. Although better data does not mean a better intervention, the field of ABA prides itself on ensuring the use of interventions that work. Without high quality data, it can be difficult to justify the use of an intervention.

While Discrete Trial Training (DTT) often comes to mind first when planning your ABA programming, you must consider every option to decide what is best for the individual learner. To learn more about DTT, read these articles: 5 Things You Didn’t Know About Discrete Trial Training (DTT) and Should I Use Natural Environment Teaching (NET) or Discrete Trial Training (DTT)?

Rober and Lynn Koegel’s book Pivotal Response Treatment for Autism Spectrum Disorders is THE guide to help you implement PRT.

Go give PRT a try and see how it impacts your learner.

References

Iyengar, S. S., & Lepper, M. R. (1999). Rethinking the value of choice: a cultural perspective on intrinsic motivation. Journal of personality and social psychology76(3), 349.

Koegel, R. L. (1988). How to teach pivotal behaviors to children with autism: A training manual.

Koegel, L. K. & Koegel, R. L. (2019). Pivotal Response Treatment for Autism Spectrum Disorders, Second Edition. Balmore, MD: Paul H Brookes Publishing Co.

Koegel, L. K., Koegel, R. L., Harrower, J. K., & Carter, C. M. (1999). Pivotal response intervention I: Overview of approachJournal of the Association for Persons with Severe Handicaps24(3), 174-185.

Koegel, R. L., & Mentis, M. (1985). Motivation in childhood autism: Can they or won’t they?Journal of Child Psychology and Psychiatry26(2), 185-191.

Koegel, R. L., O’Dell, M., & Dunlap, G. (1988). Producing speech use in nonverbal autistic children by reinforcing attemptsJournal of autism and developmental disorders18(4), 525-538.

Stahmer, A. C. (1995). Teaching symbolic play skills to children with autism using pivotal response training. Journal of autism and developmental disorders25(2), 123-141.

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