Pivotal Response Treatment® (PRT®)

Note: The PRT® program was not responsive to the CEBC's inquiry. The following information was obtained from publicly available sources.

About This Program

Target Population: Children diagnosed with an autism spectrum disorder (ASD)

Program Overview

Pivotal Response Treatment® (PRT®) is a naturalistic intervention model derived from Applied Behavior Analysis (ABA) for children diagnosed with an autism spectrum disorder (ASD). PRT® is designed to target pivotal areas of a child's development, such as motivation, responsivity to multiple cues, self-management, and social initiations. These skills are pivotal because they are the foundational behaviors upon which learners with ASD can make widespread and generalized improvements in many other areas. By targeting these critical behaviors, PRT® aims to result in widespread, collateral improvements in communication, social, and behavioral domains.

Specific motivational procedures including child choice, task variation, interspersing maintenance and acquisition tasks, rewarding attempts, and the use of direct natural reinforcers, are incorporated. The goal of PRT® is to move the child with ASD towards a more typical developmental trajectory, through individualized intervention objectives based on the child's needs.

PRT® targets each core area of development and focuses on increasing motivation to engage and learn for children with ASD. PRT® is implemented in the natural environments of the child (e.g., home, community, and school) and emphasizes parent education in an effort to empower family members to become agents of intervention, so that learning can ideally be embedded across daily routines.

Logic Model

The program representative did not provide information about a Logic Model for Pivotal Response Treatment® (PRT®).

Manuals and Training

Publicly available information indicates there is a manual that describes how to deliver this program, and there is some training available for this program.
See contact info below.

Relevant Published, Peer-Reviewed Research

Child Welfare Outcome: Child/Family Well-Being

Koegel, R. L., Bimbela, A., & Schreibman, L. (1996). Collateral effects of parent training on family interactions. Journal of Autism and Developmental Disorders, 26, 347–359. https://doi.org/10.1007/BF02172479

Type of Study: Randomized controlled trial
Number of Participants: 17

Population:

  • Age — Parents: Not specified; Children: 3–9 years
  • Race/Ethnicity — Parents: Not specified; Children: Not specified
  • Gender — Parents: Not specified; Children: 10 Males and 7 Females
  • Status — Participants were children with autism and their families.

Location/Institution: Not specified

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of this study was to assess collateral effects of two parent training paradigms, teaching individual target behaviors (ITB) serially and Pivotal Response Training (PRT). Families were randomly assigned to either ITB or PRT. Measures utilized included the Vineland Social Maturity and Adaptive Behavior Scales. Results indicate that the families in both conditions initially scored in the neutral range, and the ITB training paradigm produced no significant influence on the interactions from pretraining to posttraining. In contrast, however the PRT parent training paradigm resulted in the families showing positive interactions on all four scales, with the parent-child interactions rated as happier, the parents more interested in the interaction, the interaction less stressful, and the communication style as more positive. Limitations include small sample size and lack of follow-up.

Length of postintervention follow-up: None.

Stahmer, A. C., & Gist, K. (2001). The effects of an accelerated parent education program on technique mastery and child outcome. Journal of Positive Behavior Interventions, 3(2), 75–82. https://doi.org/10.1177/109830070100300203

Type of Study: Pretest-posttest study with a nonequivalent control group (Quasi-experimental)
Number of Participants: 22 families

Population:

  • Age — Parents: Not specified; Children: 19–50 months (Mean= 35–35.6 months)
  • Race/Ethnicity — Parents: Not specified; Children: Not specified
  • Gender — Parents: Not specified; Children: Not specified
  • Status — Participants were families with a child with a diagnosis of autistic disorder or pervasive developmental disorder–not otherwise specified (PDD-NOS).

Location/Institution: Children’s Hospital and Health Center, San Diego, California

Summary: (To include basic study design, measures, results, and notable limitations)
The current study provides a large-scale preliminary assessment of (a) the effectiveness of a community-based parent education Pivotal Response Training (PRT) intervention and (b) whether specific child variables are associated with outcomes. Measures utilized included the Vineland Adaptive Behavior Scales. Results indicate that all of the children showed significant improvements in adaptive functioning on the Vineland Adaptive Behavior Scales. However, younger children (3 years old or younger) showed the least impairment at intake and the most improvement postintervention. Limitations include no random assignment and no use of control groups lack of control group, parents’ mastery of the PRT techniques and whether parents applied what they learned in their home are unknown, parents could be biased reporters of their child’s functioning, and lack of follow-up.

Length of postintervention follow-up: None.

Baker-Ericzén, M. J., Stahmer, A. C., & Burns, A. (2007). Child demographics associated with outcomes in a community-based pivotal response training program. Journal of Positive Behavior Interventions, 9(1), 52–60. https://doi.org/10.1177/10983007070090010601

Type of Study: One-group pretest–posttest study
Number of Participants: 180 families (Children = 158)

Population:

  • Age — Parents: Not specified; Children: 24–113 months (Mean=49.36 months)
  • Race/Ethnicity — Parents: Not specified; Children: 35.4% Hispanic, 27.4% White, 19.5% Asian/Pacific Islander, 4.4% African American, 2.7% Native American, and 10.6% Unknown/Other
  • Gender — Parents: Not specified; Children: 83% Male and 17% Female
  • Status — Participants were families with a child with a diagnosis of autistic disorder or pervasive developmental disorder–not otherwise specified (PDD-NOS).

Location/Institution: Children’s hospital in Southern California

Summary: (To include basic study design, measures, results, and notable limitations)
The current study provides a large-scale preliminary assessment of (a) the effectiveness of a community-based parent education Pivotal Response Training (PRT) intervention and (b) whether specific child variables are associated with outcomes. Measures utilized included the Vineland Adaptive Behavior Scales. Results indicate that all of the children showed significant improvements in adaptive functioning on the Vineland Adaptive Behavior Scales. However, younger children (3 years old or younger) showed the least impairment at intake and the most improvement postintervention. Limitations include no random assignment and no use of control groups lack of control group, parents’ mastery of the PRT techniques and whether parents applied what they learned in their home are unknown, parents could be biased reporters of their child’s functioning, and lack of follow-up.

Length of postintervention follow-up: None.

Nefdt, N., Koegel, R. L., Singer, G., & Gerber, M. (2010). The use of a self-directed learning program to provide introductory training in pivotal response treatment to parent of children with autism. Journal of Positive Behavior Interventions, 12(1), 23–32. https://doi.org/10.1177/1098300709334796

Type of Study: Randomized controlled trial
Number of Participants: 27 families

Population:

  • Age — Parents: Mean=36.21–36.31 years; Children: Mean=38.43–38.92 months
  • Race/Ethnicity — Parents: Not specified; Children: 81% Caucasian
  • Gender — Parents: Not specified; Children: 92.6% Male
  • Status — Participants were primary caretakers and their children with autism.

Location/Institution: Not specified

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of this study was to evaluate, whether the use of a self-directed learning program, Pivotal Response Training (PRT), could result in changes in behavior for parents and their children with autism. Measures utilized included the Parenting Stress Index (PSI). Results indicate significant differences between treatment and control groups at posttest on all of the dependent measures. Furthermore, all of the parents who completed the self-directed learning program reported high ratings of satisfaction. Limitations include generalizability and maintenance of skills as this was not addressed in this study, small sample size and lack of follow-up.

Length of postintervention follow-up: None.

Additional References

Koegel, L. K., Ashbaugh, K., & Koegel, R. L. (2016). Pivotal response treatment. In R. Lang, T. B. Hancock, & N. N. Singh (Eds.). Early intervention for young children with autism spectrum disorder (pp. 85–112). Springer International Publishing. https://doi.org/10.1007/978-3-319-30925-5_4

Koegel, R. L., & Koegel, L. K. (2006). Pivotal response treatments for autism: Communication, social, & academic development. Paul H Brookes Publishing.

Koegel, R. L., & Koegel, L. K. (Eds.). (2012). The PRT pocket guide: Pivotal Response Treatment for autism spectrum disorders. Paul H Brookes Publishing.

Contact Information

Koegel Autism Consultants
Website: www.autismprthelp.com
Email:
Phone: (805) 967-6241

Date Research Evidence Last Reviewed by CEBC: March 2021

Date Program Content Last Reviewed by Program Staff: June 2021

Date Program Originally Loaded onto CEBC: June 2021