ABA & PRT
THERAPY
Pivotal Response Treatment, or PRT, is a behavioral treatment for autism. This therapy is play-based and initiated by the child. PRT is based on the principles of Applied Behavior Analysis (ABA). We offer both focused and comprehensive ABA treatments, PRT Treatments and IEP consultation services. Fill out the short form below for more information and to set up an evaluation with a licensed behavioral therapist.
APPLIED BEHAVIOR
ANALYSIS.
Pivotal Response Training for Children With Autism
Combining Behavioral & Developmental Models.
By Lisa Jo Rudy | Medically reviewed by Steven Gans, MD | Updated December 13, 2019
Scholarly Articles
Everything we do here at the Grain of Sand Academy is backed by sound science. Click on the downloadable PDF icon links below to read more.
Pivotal Response Treatment: A study into the relationship between therapist characteristics and fidelity of implementation
Empirical Support for Pivotal Response Treatment: Koegel Support Chart
Effectiveness of Parent Education in Pivotal Response Treatment on Pivotal and Collateral Responses: Original Paper
A Pivotal Response Treatment Package for Children With Autism Spectrum Disorder:
An RCT
What is Applied Behavior Analysis?
As one of the most widely accepted autism therapies, ABA is “based on the idea that people are more likely to repeat behaviors that are rewarded than behaviors that are not recognized or ignored.” Many children with autism and related disorders exhibit unwanted behaviors that inhibit their ability to complete daily tasks. ABA helps correct these behaviors by enabling children with autism to develop skill sets and reduce the likelihood of problematic behaviors. Since the 1960s, researchers have recognized that ABA is the most effective approach to early treatment, and the medical community agrees: 32 out of 50 U.S. states have laws that “require health insurers to cover it.”
How does it work?
In traditional ABA therapy, therapists work one-on-one with children for up to 40 hours a week. Modified ABA therapy, which allows the child time for other therapies like speech and occupational therapy, decreases this one-on-one time to about 15 hours a week. ABA therapy is most effective if it begins when children are under the age of 5, though older children with autism can also benefit.
There are two broad categories of ABA therapy: comprehensive and focused interventions. The main difference between these two types of procedures is the desired outcome. Comprehensive ABA interventions aim to produce changes in specific skills that impact global measures of functioning. This includes IQ, adaptive skills and social function in children with autism. This category of treatment is continued for an extended period and is home- or center-based. Some skills targeted by comprehensive ABA treatments include:
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Attention
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Discrimination
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Language and communication
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Socialization
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Reading
These programs “rely on the use of clear instructions, reinforcement, teaching small units of behavior and repeated trials to maximize learning opportunities,” according to the Kennedy Krieger Institute. When used as therapy for young children, these types of treatments are often referred to as “Early Intensive Behavioral Interventions"(EIBI).
Focused ABA Treatments are more short-term and time-limited than Comprehensive ABA Treatments, because they are designed to “address specific behavior deceleration concerns including aggression, self-injury, disrupted behavior, pica and other challenging behaviors.”
Typically, focused ABA treatments involve changing a child’s environment to minimize problem behavior, establishing and reinforcing adaptive behaviors and “withholding reinforcement for problem behavior.” This category of ABA therapy can also address concerns such as anxiety and skill deficits, though these services are generally needed only when standard teaching and parenting practices are ineffective.
Regardless of the specific category or treatment goals, the Kennedy Krieger Institute identifies the following common features of all ABA therapy approaches:
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The objective measurement of behavior
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Use of procedures based on scientifically established principles of behavior
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Precise control of the environment to allow for the objective evaluation of outcomes
Therefore, only clinical procedure or research that meet these criteria can be classified as an ABA-Based Treatment.
An Evidence-Based Approach
Applied Behavior Analysis is different from all other autism therapies because it is an objective discipline that focuses on reliable measurement and objective evaluation of measurable behaviors. It takes the principles of learning and motivation from behavior analysis and applies them to the solution of “problems of social significance” such as adaptive living and social skills. The Center for Autism and Related Disorders (CARD) reports that, over the past four decades, thousands of published research studies have documented the effectiveness of ABA across a wide range of:
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Populations (children and adults with mental illness, developmental disabilities and learning disorders)
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Interventionists (parents, teachers and staff)
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Settings (schools, homes, institutions, group homes, hospitals and businesses)
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Behaviors (language; social, academic, leisure and functional life skills; aggression, self-injury, oppositional and stereotyped behaviors)
The key to understanding what makes ABA different is reliable measurement. Problem behaviors must be defined objectively, with vague terms like anger, depression and aggression redefined in “observable and quantifiable terms,” so measurable properties can be directly recorded. The methods of analysis used by ABA professionals yield results that are convincing, reproducible and demonstrable. This ensures that specific behavior changes can likely be accomplished using previously successful ABA approaches. Another important component of ABA therapy is that it evaluates behavior within relevant settings: schools, homes and the community.
According to Autism Speaks a number of completed studies demonstrate that ABA techniques produce improvements in communication, social relationships, play, self-care, school and employment. These studies are encouraging because they involve all age groups, from preschoolers to adults. In all age groups, ABA is shown to increase participation in “family and community activities.” When intensive ABA interventions are compared to other types of early intervention, children who receive intensive ABA treatment are shown to “make larger improvements in more skill areas.” Finally, early intervention programs (those implemented before age 4) have the highest rate of effectiveness.
Continue reading here.
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Pivotal Response Treatment.
About PRT
Pivotal Response Treatment is a highly acclaimed research-based intervention for individuals with Autism Spectrum Disorders (ASD). PRT is a naturalistic intervention model derived from Applied Behavior Analysis (ABA).
PRT was created by Drs. Robert and Lynn Koegel. Over the past 30 years, the Koegels, their graduate students, and their colleagues have published over 200 research articles in peer-reviewed journals that support the effectiveness of PRT®, and have written over 30 books and manuals. PRT is listed by the National Research Council as one of the ten model programs for autism, and is one of four scientifically-based practices for autism intervention in the U.S. (Simpson, 2005).
Of the many treatment programs for Autism Spectrum Disorders (ASD), Pivotal Response Treatment is one of the few that is both comprehensive (as listed by the National Research Council of the National Academy of Sciences) and empirically supported (as recognized by the National Professional Development Center on Autism Spectrum Disorders and the National Standards Project). Pivotal Response Treatment is a naturalistic intervention model derived from ABA approaches. Rather than target individual behaviors one at a time, PRT targets pivotal areas of a child's development, such as motivation, responsivity to multiple cues, self-management, and social initiations. By targeting these critical areas, PRT results in widespread, collateral improvements in other social, communicative, and behavioral areas that are not specifically targeted.
The underlying motivational strategies of PRT are incorporated throughout intervention as often as possible. These include child choice, task variation, interspersing maintenance tasks, rewarding attempts, and the use of direct and natural reinforcers. The child plays a crucial role in determining the activities and objects that will be used in the PRT exchange.
Empirical Support for PRT - Extended Version
Summary Chart of Empirical Support for PRT
- View & Download PDF
Would you like to talk to a ABA & PRT Specialist to learn more about these types of therapies and if they are right for your child? If so please click the button below.
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PROGRAMS.
MISSION
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PARTNERS.
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