Pivotal Response Therapy (PTR), also known as Pivotal Response Training is an evidence-based intervention treatment for children with autism. Autism is a brain disorder that affects a child’s communication, social, behavioral abilities, and academic areas. Its symptoms include self-stimulatory behaviors, such as repeatedly flapping arms, socially inappropriate behavior, being easily distracted, and inability to initiate social interactions. PRT encourages children to improve in the three broad pivotal areas (response to multiple cues, social interaction initiation, motivation, and self-management).

1. Enhance skills across symptom areas

PRT aims to help learners develop skills across many areas in each broad symptom group. For instance, a child learns to ask for a building piece to complete a tower they’re constructing. This develops the child’s communication abilities (he has to formulate the word or use the correct nonverbal cues, depending on where he is on the autism spectrum), social skills (using socially acceptable ways of getting an object he wants instead of just reaching out and grabbing the building piece), and behavior skills (the child must control the impulse to revert to a repetitive, instead he uses “his word”).

2. Maintaining a child-centered approach

Since one of the broad symptom areas of autism is behavior problems, PRT focuses on helping the child improve his own behavior with fun activities that the child enjoys. Each session is individualized. Collaboration meetings take place at regular intervals so parents and professionals can discuss the child’s progress and goals. The PRT program is then changed for the benefit of the child.

3. Encouraging independence and improvement across symptom areas

One of the primary goals of PRT is to help the child self-manage his or her own behavior. This is done by helping the child first become aware of their own actions and consequences of those actions. This type of therapy is based on play that the child current abilities and intervention goals determined by parents, teachers, and professional. The activities are tailored to the individual child’s physical and cognitive abilities and are altered accordingly as the child’s skills become more advanced.

4. Motivation

Professionals who administer PRT (they can be child therapists, psychologists, special education teachers, speech therapists, and any other professional who have PRT training) focus on encouraging future positive behavior. For this reason, positive reinforcement is used and the professional rewards the child for effort even if he or she doesn’t master a certain skill immediately. The goal is to motivate the child so that he or she finds the activities fun and engaging. By doing this, the professional intentionally leaves no down time for kids to revert to problem behaviors and making skill development more likely.

5. Encouraging socially acceptable behavior

Another goal of PRT is helping the child substitute problem behavior for more positive behavior through Positive Behavior Support. Positive Behavior Supports (PBS) is a broad approach to behavior modification that are effective across disabilities, ages, and abilities. Simply, it means teaching individuals to replace socially inappropriate behavior for more socially acceptable behavior. For instance, a child who throws items he dislikes is rewarded (instantly) for asking or signing for a different toy. He is not allowed the new toy until he requests it properly.

Related Resource: Top 20 Best Applied Behavior Analysis Programs

PRT has been and continues to be one of the first methods of natural treatment used to help children with autism improve their skills. Pivotal Response Theapy treatment has also been shown to improve these same abilities in adolescents and adults, thus there is a constant need for professionals in this field.