Pivotal Response Training is a naturalistic treatment approach developed by Robert L. Koegel & Laura Schreibman.
Pivotal Response Training (PRT) is a behavioral intervention based on the principles of applied behavior analysis (ABA). Addressing a pivotal area of deficit can result in gains by the student in areas that were not directly targeted by the intervention. Based on observation and research, several skill areas are defined as potential focal points for intervention. These pivotal areas include responsivity to multiple cues, motivation to initiate and respond appropriately to social and environmental stimuli and self-direction of behavior including self-management and self-initiations of behavior. The Koegel's define these pivotal areas as "areas that are central to wide areas of functioning such that improvements will have widespread effects on other behaviors." Thus PRT is able to increase the generalization of new skills while increasing the motivation of children to perform these behaviors being taught to them. PRT works to increase motivation by including components such as child choice, turn-taking, reinforcing attempts and interspersing maintenance tasks. PRT has been used to target language skills, play skills and social behaviors in children with autism.
People often wonder how Discrete Trial Training (DTT) is different from PRT. While DTT and PRT are both based on the principles of applied behavior analysis (ABA), there are specific components that make them different from one another. Specific components of DTT include breaking a skill into smaller parts, teaching one sub-skill at a time, artificial reinforcement, prompt fading and shaping appropriate behaviors until mastered, mass trialing to achieve mastery, generalization of skills after mastery in training situations, etc. DTT is often seen as a more structured therapist directed treatment. PRT on the other hand is a child directed naturalistic treatment; PRT uses reinforcement directly related to the task; incorporates multiple cues, teaches to generalize right from the very beginning, and increases natural motivation for learning and improves natural reinforcement repertoires.
Basics of PRT
PRT Components:
The question / instruction / opportunity to respond should:
- Be clear, uninterrupted and appropriate to the tasks
- Be interspersed with maintenance tasks
- Include child choice
- Include multiple components when appropriate
Reinforcers should be:
- Contingent upon behavior
- Administer following any reasonable attempt to respond
- Related to the desired behavior in a direct way
Further discussion of key components in PRT
Child Motivation:
"Motivation" is assessed by "observable characteristics of a child's responding". An improvement in motivation is defined as "an increase in responsiveness to social and environmental stimuli". Characteristics which indicate higher motivation include increases in the number of responses a child makes to teaching stimuli, decreases in response latency, and changes in affect such as interest, enthusiasm or happiness. An early study by R. L. Koegel, O'Dell and Koegel (1987) showed that interventions that focused on motivation variables (i.e., child choice, frequent task variation, reinforcing the child's attempts to comply and incorporating turn-taking,) were effective in producing generalized and spontaneous verbal language. In contrast, when language intervention sessions were conducted without the motivational variables, gains in language were considerably reduced. This led to inclusion of proven motivational techniques as the central core of all pivotal response interventions. The key motivational variables utilized in Pivotal Response intervention are child-choice, use of natural reinforcers and reinforcement of attempts.
Child-Choice:
"Child choice" refers to designing interventions around materials or topics for which the child expresses a preference. This can be accomplished by allowing the child to select stimulus materials from a basket of well known preferred toys or by selecting a known preferred object to teach a desired skill (i.e., using candy wrapped in colored wrappers to teach colors rather than color flash cards). Efforts are made to incorporate child-choice into routine activities (i.e., selecting which shirt to wear or which food to eat).
Natural Reinforcers:
In PRT, the planned reinforcer for the student is something that flows naturally from the student's actions or verbalization. This contrasts sharply with artificial reinforcers (i.e., M&Ms), which are used extensively in DTT. Koegel and Williams (1980) found that students rapidly acquired objectives only if the reinforcer was directly related to the task in a logical way. For example if the planned objective is opening a jar, and there was candy inside the jar, the students rapidly acquired the skills needed to open the jar. If the student was asked to open the lid of an empty jar with the contingent reinforcer being a food reinforce following the completion of the task, the student did not comply with the request. The students showed rapid acquisition only when the target behavior was a direct part of the chain leading to the reinforcer. Translated to the naturalistic environment, a child could be asked to say "Root Beer" in order to obtain a soda, or "out" to get out of the car upon arriving at a destination. The reinforcers (Root Beer or getting out of the car) are both direct consequences of the child's verbalization.
Reinforcement of Attempts:
PRT provides reinforcement whenever the student makes any unambiguous attempt to produce the desired behavior (referred to as "loose shaping criteria). Less restrictive reinforcement criteria may decrease the "learned helplessness" response that some researchers believe cause students with ASD to stop trying to respond to requests or prompts.
Child Initiations:
The language characteristics of students with ASD often include low-levels of question-asking skills, low levels of curiosity, and a lack of motivation to initiate conversation. Lynn Kern Koegel (1998) demonstrated that children with autism could be taught to ask a simple question to initiate interaction. The children were able to generalize the question to other appropriate circumstances.