Pivotal Response Treatment: Empirically Supported Strategies to Target Social Competencies and Motivation in Individuals with ASD

Abstract

Pivotal response treatment (PRT) is a comprehensive intervention package for treating the core social communication vulnerabilities associated with autism spectrum disorder (ASD). PRT is recognized as an empirically validated treatment. These treatment strategies target a number of pivotal developmental areas—key domains that, when targeted, also yield improvements in a broad array of skills. PRT was originally conceptualized as the Natural Language Paradigm, as the origin of many of its component parts was rooted in research aimed at facilitating communicative speech. Using motivational principles, researchers determined that the use of specific therapeutic strategies had a profound effect on behavioral learning paradigms. The communication impairments present in ASD are often perceived to be the most challenging and are generally prioritized by intervention programs. Tremendous strides have been made in the areas of early detection and early language intervention, bringing the state of the science to a place in which the majority of children who are diagnosed with ASD are expected to develop some level of communicative phrase speech. This change represents a paradigm shift in the understanding of the disorder—children with ASD are no longer perceived as uneducable, and expectations for long-term outcomes have increased significantly. As shifts in expectations occurred, so have priorities for intervention efforts. Now that effective intervention strategies exist that enable most children to acquire spoken language, efforts have begun to address other seemingly insurmountable targets—the acquisition of social motivation, play skills, social skills, and interpersonal competence to function effectively within natural environments and contexts.