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Pivotal Response Treatment (PRT)

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Pivotal Response Treatment® (PRT) is a behaviorally-based intervention designed specifically for children on the autism spectrum. It is a form of incidental or naturalistic teaching that is based on the principles of Applied Behavior Analysis (ABA). As with other behaviorally-based interventions, PRT can be applied to help improve a wide range of skills, including requesting, labeling, imitation, joint attention, social interaction, and play skills.

PRT is also known as:

  • Pivotal Response Training®
  • Pivotal Response Teaching®
  • Pivotal Response Therapy
  • Pivotal Response Intervention
  • Pivotal Response Optimization
  • Natural Language Paradigm

What is unique about PRT?

The main goal of PRT is to increase pivotal areas of behavior that produce widespread effects on a child's symptoms. The pivotal areas include motivation, response to multiple cues, self-management, and social initiations. So, for example, instead of teaching an individual skill, such as pointing, a PRT therapist would work to improve the child's overall motivation to communicate. Through this approach, a child will be more likely to communicate in some way, maybe by pointing, or maybe by using a word or word approximation. In this example, motivation is the pivotal response: when a child is highly motivated, he or she is more likely to try something challenging, such as communicating.

PRT is considered a form of incidental or naturalistic teaching because it uses the child's natural environment and interests to improve skills. As in the above example, communication skills are taught by encouraging the child to communicate for something that he or she truly wants, such as a favorite food or activity. PRT therapists carefully arrange a child's environment to try and provide as many natural opportunities for communication (or other specific skills the child is working on) as possible. For example, the therapist may place a favorite toy out of reach from the child, but somewhere where he or she can still see it, so that the child is motivated to request the toy.

PRT is conducted in multiple settings, such as at home, school, or in the community.

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Additional Resources

The Center for Autism Research and The Children's Hospital of Philadelphia do not endorse or recommend any specific person or organization or form of treatment. The information included within the CAR Autism Roadmap™ and CAR Resource Directory™ should not be considered medical advice and should serve only as a guide to resources publicly and privately available. Choosing a treatment, course of action, and/or a resource is a personal decision, which should take into account each individual's and family's particular circumstances.