Abstract
This chapter will discuss Pivotal Response Treatment (PRT) for intervention for Autism Spectrum Disorder (ASD). PRT is based on the theory of learned helplessness, where individuals have difficulty learning that there is a response-reinforcer contingency. We speculate this is why individuals with ASD often display low motivation to communicate and engage with others, respond to environmental stimuli, or learn new skills and behaviors. PRT was developed to specifically emphasize response-reinforcer contingencies in order to improve motivation, which has been shown to produce widespread and generalized gains in many untargeted areas. This chapter presents instructions for implementing the motivational PRT procedures of child choice, reinforcing attempts, direct and natural reinforcers, interspersing maintenance and acquisition tasks, and incorporating task variation. In addition to the pivotal area of motivation, research suggests that there are other critical areas that when taught can also result in broad improvements. The chapter also discusses the additional pivotal areas of initiations, self-management, and response to multiple cues. Empirical support and research for both the PRT package and each component of the intervention is included. Lastly, future research and implications for families and practitioners are discussed.
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Abramson, L. Y., Seligman, M. E., & Teasdale, J. D. (1978). Learned helplessness in humans: Critique and reformulation. Journal of Abnormal Psychology, 87, 49.
Ashbaugh, K. (2014, September). Improving success for adults with ASD in higher education and employment settings. Paper presented at the Seventh Annual Pivotal Response Treatment Conference. University of California, Santa Barbara.
Baker-Ericzen, M. J., Stahmer, A. C., & Burns, A. (2007). Child demographics associated with outcomes in a community-based Pivotal Response Training program. Journal of Positive Behavioral Interventions, 9, 52–60.
Barnhill, G. P., & Myles, B. S. (2001). Attributional style and depression in adolescents with Asperger syndrome. Journal of Positive Behavior Interventions, 3, 175–182.
Bellugi, U. (1965). The development of interrogative structures in children’s speech. In K. Riegel (Ed.), The development of language functions (pp. 103–138). Ann Arbor, MI: University of Michigan Language Development Program.
Bradshaw, J., Steiner, A. M., Gengoux, G., & Koegel, L. K. (2014). Feasibility and effectiveness of very early intervention for infants at-risk for Autism Spectrum Disorder: A systematic review. Journal of Autism and Developmental Disorders, 45, 778–794.
Bruinsma, Y. (2004). Increases in the joint attention behavior of eye gaze alternation to share enjoyment as a collateral effect of Pivotal Response Treatment for three children with autism. Santa Barbara, CA: University of California.
Burke, J. C., & Cerniglia, L. (1990). Stimulus complexity and autistic children’s responsivity: Assessing and training a pivotal behavior. Journal of Autism and Developmental Disorders, 20, 233–253.
Carter, C. M. (2001). Using choice with game play to increase language skills and interactive behaviors in children with autism. Journal of Positive Behavior Interventions, 3, 131–151.
Cimera, R. E., & Burgess, S. (2011). Do adults with autism benefit monetarily from working in their communities? Journal of Vocational Rehabilitation, 34, 173–180.
Cosden, M., Koegel, L. K., Koegel, R. L., Greenwell, A., & Klein, E. (2006). Strength-based assessment for children with autism spectrum disorders. Research and Practice for Persons with Severe Disabilities, 31, 134–143.
Dunlap, G. (1984). The influence of task variation and maintenance tasks on the learning and affect of autistic children. Journal of Experimental Child Psychology, 37, 41–64.
Dunlap, L. K., Dunlap, G., Koegel, L. K., & Koegel, R. L. (1991). Using self-monitoring to increase students’ success and independence. Teaching Exceptional Children, 23, 17–22.
Dunlap, G., & Koegel, R. L. (1980). Motivating autistic children through stimulus variation. Journal of Applied Behavior Analysis, 13, 619–627.
Dyer, K., Dunlap, G., & Winterling, V. (1990). Effects of choice making on the serious problem behaviors of students with severe handicaps. Journal of Applied Behavior Analysis, 23, 515–524.
Fox, L. (1962). Effecting the use of efficient study habits. Journal of Mathematics, 1, 75–86.
Frith, U., & Happé, F. (1994). Autism: Beyond “theory of mind”. Cognition, 50, 115–132.
Garcia-Villamisar, D., Ross, D., & Wehman, P. (2000). Clinical differential analysis of persons with autism in a work setting: A follow-up study. Journal of Vocational Rehabilitation, 14, 183–185.
Goldiamond, I. (1965). Self-control procedures in personal behavior problems: Monograph supplement 3-V17. Psychological Reports, 17, 851–851.
Hedley, D., & Young, R. (2006). Social Comparison Processes in Depressive Symptoms in Children and Adolescents with Asperger Syndrome. Autism, 10(2), 139–153.
Hiroto, D. S. (1974). Locus of control and learned helplessness. Journal of Experimental Psychology, 102, 187.
Hiroto, D. S., & Seligman, M. E. (1975). Generality of learned helplessness in man. Journal of Personality and Social Psychology, 31, 311.
Horan, J. J., & Johnson, R. G. (1971). Coverant conditioning through a self-management application of the Premack principle: Its effect on weight reduction. Journal of Behavior Therapy and Experimental Psychiatry, 2, 243–249.
Hung, D. W. (1977). Generalization of “curiosity” questioning behavior in autistic children. Journal of Behavior Therapy and Experimental Psychiatry, 8, 237–245.
Kim, S. (2014). Incorporating parent preferred interests into social interventions. Paper presented at the Seventh Annual Pivotal Response Treatment Conference. University of California, Santa Barbara.
Klein, D. C., Fencil-Morse, E., & Seligman, M. E. (1976). Learned helplessness, depression, and the attribution of failure. Journal of Personality and Social Psychology, 33, 508–516.
Koegel, L. K. (2000). Interventions to facilitate communication in autism. Journal of Autism and Developmental Disorders, 30, 383–391.
Koegel, L. K., Ashbaugh, K., Koegel, R. L., Detar, W. J., & Regester, A. (2013). Increasing socialization in adults with Asperger’s syndrome. Psychology in the Schools, 50, 899–909.
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.
Koegel, R. L., Brookman, L., & Koegel, L. K. (2003). Autism: Pivotal response intervention and parent empowerment. The Economics of Neuroscience, 5, 61–69.
Koegel, L. K., Camarata, S. M., Valdez-Menchaca, M. C., & Koegel, R. L. (1998). Teaching children with autism to use self-initiated strategy to learn expressive vocabulary. American Journal of Mental Retardation, 102, 346–357.
Koegel, L. K., Carter, C. M., & Koegel, R. L. (2003). Teaching children with autism self-initiations as a pivotal response. Topics in Language Disorders, 23, 134–145.
Koegel, R. L., Dyer, K., & Bell, L. K. (1987). The influence of child-preferred activities on autistic children’s social behavior. Journal of Applied Behavior Analysis, 20, 243–252.
Koegel, R. L., & Egel, A. L. (1979). Motivating autistic children. Journal of Abnormal Psychology, 88, 418–426.
Koegel, R. L., & Frea, W. D. (1993). Treatment of social behavior in autism through the modification of pivotal social skills. Journal of Applied Behavior Analysis, 26, 369–377.
Koegel, R. L., & Koegel, L. K. (1990). Extended reductions in stereotypic behaviors through self-management in multiple community settings. Journal of Applied Behavior Analysis, 1, 119–127.
Koegel, R. L., & Koegel, L. K. (2006). Pivotal response treatments for autism: Communication, social, and academic development. Baltimore, MD: Brookes.
Koegel, R. L., & Koegel, L. K. (2012). The PRT pocket guide: Pivotal response treatment for Autism Spectrum Disorders. Baltimore, MD: Brookes.
Koegel, L. K., Koegel, R. L., Ashbaugh, K., & Bradshaw, J. (2014). The importance of early identification and intervention for children with or at risk for autism spectrum disorders. International Journal of Speech-Language Pathology, 16, 50–56.
Koegel, L. K., Koegel, R. L., Green-Hopkins, I., & Barnes, C. C. (2010). Brief report: Question-asking and collateral language acquisition in children with autism. Journal of Autism and Developmental Disorders, 40, 509–515.
Koegel, L. K., Koegel, R. L., Hurley, C., & Frea, W. D. (1992). Improving pragmatic skills and disruptive behavior in children with autism through self-management. Journal of Applied Behavior Analysis, 25, 341–353.
Koegel, L. K., Koegel, R. L., Kellegrew, D., & Mullen, K. (1996). Parent education for prevention and reduction of severe problem behaviors. In L. K. Koegel, R. L. Koegel, & G. Dunlap (Eds.), Positive behavioral support (pp. 3–30). Baltimore, MD: Paul H. Brookes.
Koegel, L. K., Koegel, R. L., Shoshan, Y., & McNerney, E. (1999). Pivotal response intervention II: Preliminary long-term outcome data. Research and Practice for Persons with Severe Disabilities, 24, 186–198.
Koegel, L. K., Koegel, R. L., & Ingham, J. C. (1986). Programming rapid generalization of correct articulation through self-monitoring procedures. Journal of Speech and Hearing Disorders, 51, 24–32.
Koegel, L. K., Matos-Fredeen, R., Lang, R., & Koegel, R. (2012). Interventions for children with autism spectrum disorders in inclusive school settings. Cognitive and Behavioral Practice, 19, 401–412.
Koegel, R. L., & Mentis, M. (1985). Motivation in childhood autism: Can they or won’t they? Journal of Child Psychology and Psychiatry, 26, 185–191.
Koegel, R. L., O’Dell, M., & Dunlap, G. (1988). Producing speech use in nonverbal autistic children by reinforcing attempts. Journal of Autism and Developmental Disorders, 18, 525–538.
Koegel, R. L., O’Dell, M. C., & Koegel, L. K. (1987). A natural language teaching paradigm for nonverbal autistic children. Journal of Autism and Developmental Disorders, 17, 187–200.
Koegel, L. K., Singh, A. K., Koegel, R. L., Hollingsworth, J. R., & Bradshaw, J. (2013). Assessing and improving early social engagement in infants. Journal of Positive Behavior Interventions, 16, 69–80.
Koegel, L. K., Singh, A. K., & Koegel, R. L. (2010). Improving motivation for academics in children with autism. Journal of Autism and Developmental Disorders, 40, 1057–1066.
Koegel, R. L., Symon, J. B., & Koegel, L. K. (2002). Parent education for families of children with autism living in geographically distant areas. Journal of Positive Behavior Interventions, 4, 88–103.
Koegel, R. L., & Wilhelm, H. (1973). Selective responding to the components of multiple visual cues by autistic children. Journal of Experimental Child Psychology, 15, 442–453.
Koegel, R. L., & Williams, J. A. (1980). Direct versus indirect response-reinforcer relationships in teaching autistic children. Journal of Abnormal Child Psychology, 8, 537–547.
Kuriakose, S. (2012). Making data collection easy in PRT. In R. L. Koegel & L. K. Koegel (Eds.), The PRT pocket guide: Pivotal response treatment for Autism Spectrum Disorders. Baltimore, MD: Brookes.
Lang, R., Machalicek, W., Rispoli, M. J., & Regester, A. (2009). Training parents to implement communication interventions for children with autism spectrum disorders: A systematic review of training procedures. Evidenced Based Communication Assessment and Intervention, 3, 174–190.
Lovaas, O. I. (1977). The autistic child: Language development through behavior modification. Oxford: Irvington.
Lovaas, O. I., Schreibman, L., Koegel, R., & Rehm, R. (1971). Selective responding by autistic children to multiple sensory input. Journal of Abnormal Psychology, 77, 211.
Maier, S. F., & Seligman, M. E. (1976). Learned helplessness: Theory and evidence. Journal of Experimental Psychology: General, 105, 3.
Maier, S. F., & Watkins, L. R. (1998). Cytokines for psychologists: Implications of bidirectional immune-to-brain communication for understanding behavior, mood, and cognition. Psychological Review, 105, 83.
Matson, J. L., Benavidez, D. A., Stabinsky Compton, L., Paclawskyj, T., & Baglio, C. (1996). Behavioral treatment of autistic persons: A review of research from 1980 to the present. Research in Developmental Disabilities, 17, 433–465.
Mawhood, L., & Howlin, P. (1999). The outcome of a supported employment scheme for high-functioning adults with autism or Asperger syndrome. Autism, 3, 229–254.
Miller, I. W., & Norman, W. H. (1979). Learned helplessness in humans: A review and attribution-theory model. Psychological Bulletin, 86, 93–119.
Miller, W. R., & Seligman, M. E. (1975). Depression and learned helplessness in man. Journal of Abnormal Psychology, 84, 228–238.
Mitchell, K. R., & White, R. G. (1977). Behavioral self-management: An application to the problem of migraine headaches. Behavior Therapy, 8, 213–221.
Müller, E., Schuler, A., & Yates, G. B. (2008). Social challenges and supports from the perspective of individuals with Asperger syndrome and other autism spectrum disabilities. Autism, 12(2), 173–190.
Mohammadzaheri, F., Koegel, L. K., Rezaee, M., & Rafiee, S. M. (2014). A randomized clinical trial comparison between Pivotal Response Treatment (PRT) and structured Applied Behavior Analysis (ABA) Intervention for Children with Autism. Journal of Autism and Developmental Disorders, 44, 2769–2777.
Overmier, J. B., & Seligman, M. E. (1967). Effects of inescapable shock upon subsequent escape and avoidance responding. Journal of Comparative and Physiological Psychology, 63, 28–33.
Peterson, C., Maier, S. F., & Seligman, M. E. P. (1993). Learned helplessness: A theory for the age of personal control. New York, NY: Oxford University Press.
Pierce, K. L., & Schreibman, L. (1994). Teaching daily living skills to children with autism in unsupervised settings through pictorial self‐management. Journal of Applied Behavior Analysis, 27, 471–481.
Pituch, K. A., Green, V. A., Didden, R., Lang, R., O’Reilly, M. F., Lancioni, G. E., & Sigafoos, J. (2011). Parent reported treatment priorities for children with autism spectrum disorders. Research in Autism Spectrum Disorders, 5, 135–143.
Prizant, B. M. (1983). Language acquisition and communicative behavior in autism toward an understanding of the whole of it. Journal of Speech and Hearing Disorders, 48, 296–307.
Raulston, T. Carnett, A., Lang, R. Tostanoski, A., Lee, A., Machalicek, W., … Didden, R. (2013). Teaching individuals with autism spectrum disorder to ask questions: A systematic review. Research in Autism Spectrum Disorders, 7, 866–878.
Roberts, J. W. (1969). Termination factor for RNA synthesis. Nature, 224, 1168–1174.
Rogers, S. J., Vismara, L., Wagner, A. L., McCormick, C., Young, G., & Ozonoff, S. (2014). Autism treatment in the first year of life: A pilot study of infant start, a parent-implemented intervention for symptomatic infants. Journal of Autism and Developmental Disorders, 44, 2981–2995.
Rowland, C. F., Pine, J. M., Lieven, E. V., & Theakston, A. L. (2003). Determinants of acquisition order in wh-questions: Re-evaluating the role of caregiver speech. Journal of Child Language, 30, 609–636.
Santarelli, G., Koegel, R. L., Casas, J. M., & Koegel, L. K. (2001). Culturally diverse families participating in behavior therapy parent education programs for children with developmental disabilities. Journal of Positive Behavior Interventions, 3, 120–123.
Schreibman, L., Kaneko, W. M., & Koegel, R. L. (1991). Positive affect of parents of autistic children: A comparison across two teaching techniques. Behavior Therapy, 22, 479–490.
Schreibman, L., & Lovaas, O. I. (1973). Overselective response to social stimuli by autistic children. Journal of Abnormal Child Psychology, 1, 152–168.
Schreibman, L., & Stahmer, A. C. (2014). A randomized trial comparison of the effects of verbal and pictorial naturalistic communication strategies on spoken language for young children with autism. Journal of Autism and Developmental Disorders, 44, 1244–1251.
Seligman, M. E. P. (1967). The disruptive effects of unpredictable shock. Doctoral Dissertation. University of Pennsylvania, Philadelphia, Pennsylvania.
Seligman, M. E., & Maier, S. F. (1967). Failure to escape traumatic shock. Journal of Experimental Psychology, 74, 1–9.
Seligman, M. E. P. (1975). Helplessness: On depression, development, and death. W H Freeman/Times Books/ Henry Holt & Co, New York, New York.
Simpson, R. L. (2005). Evidence-based practices and students with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 20, 140–149.
Steiner, A. M. (2011). A strength-based approach to parent education for children with autism. Journal of Positive Behavior Interventions, 13, 178–190.
Steiner, A. M., Gengoux, G. W., Klin, A., & Chawarska, K. (2013). Pivotal response treatment for infants at-risk for autism spectrum disorders: A pilot study. Journal of Autism and Developmental Disorders, 43, 91–102.
Taylor, B. A., & Harris, S. L. (1995). Teaching children with autism to seek information‐acquisition of novel information and generalization of responding. Journal of Applied Behavior Analysis, 28, 3–14.
Vismara, L. A., & Lyons, G. L. (2007). Using perseverative interests to elicit joint attention behaviors in young children with autism theoretical and clinical implications for understanding motivation. Journal of Positive Behavior Interventions, 9, 214–228.
Voos, A. C., Pelphrey, K. A., Tirrell, J., Bolling, D. Z., Vander Wyk, B., Kaiser, M. D., … Ventola, P. (2012). Neural mechanisms of improvements in social motivation after pivotal response treatment: Two case studies. Journal Autism Developmental Disorders, 43, 1–10.
Watkins, L., O’Reilly, M., Kuhn, M., Gevarter, C., Lancioni, G., Sigafoos, J., & Lang, R. (2015). A review of peer-mediated social interaction interventions for students with autism in inclusive settings. Journal of Autism and Developmental Disorders, 45, 1070–1083.
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Koegel, L.K., Ashbaugh, K., Koegel, R.L. (2016). Pivotal Response Treatment. In: Lang, R., Hancock, T., Singh, N. (eds) Early Intervention for Young Children with Autism Spectrum Disorder. Evidence-Based Practices in Behavioral Health. Springer, Cham. https://doi.org/10.1007/978-3-319-30925-5_4
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