"Classroom Pivotal Response Teaching, or CPRT, was developed to help meet the educational needs of young children with autism. CPRT (originally called Pivotal Response Training or Treatment) is a form of naturalistic behavioral intervention, based on theprinciples of applied behavior analysis (ABA), and is soundly supported in the scientific literature. This manual will describe the components of CPRT and how to implement the approach in your classroom. Although this manual is geared primarily toward preschool through grade 3 teachers, CPRT strategies can be used by a variety of professionals. Speech and language pathologists, occupational therapists, behavior specialists, psychologists and other teaching professionals may all find CPRT a valuable strategy. Additionally, the techniques in this manual may be useful with typically developing children and those with a variety of special needs. Most children can benefit from this structured, systematic approach that utilizes naturally occurring teaching opportunities. One of the strengths of this approach is that it is adaptable to a wide range of teaching goals and service settings. All who teach are encouraged to integrate CPRT into their existing strategies as often as possible"--Provided by publisher.
The primary purpose of this current investigation was to determine if a variation of Pivotal Response Training (PRT) can be effectively implemented by a preschool autism teacher in a classroom setting. The secondary purpose was to measure changes in spontaneous, prompted, and echoic expressive language (i.e., words and phrases) in children with autism spectrum disorders (ASD). This study included three preschool children with an educational diagnosis of autism and one classroom teacher. A multiple baseline design across participants was utilized in which the three children engaged in baseline, teacher training, PRT treatment, and generalization phases. During the baseline phase, the children engaged in teacher lesson activities, teacher play activities, and peer play activities to measure teacher and child behaviors in their existing state. During the teacher training phase, the teacher learned to utilize PRT through a collaborative consultation model. More specifically, the teacher read PRT strategy manuals, discussed PRT strategies with the primary investigator, and the primary investigator modeled and role played with the teacher in order to effectively implement the PRT strategies. During the treatment phase, the teacher independently implemented PRT strategies during the teacher lesson activities. In the generalization phase, children engaged in teacher play and peer play activities (presented in the same manner as found in the baseline phase) to determine if behavior changes (teacher and child) generalized into nontargeted activities. Throughout the course of this investigation, two child measures and one teacher measure were obtained during the investigation. The first child measure reflected spontaneous, prompted, and echoic expressive language to determine language improvement as a result of teacher implemented PRT. The second child measure reflected the child's play behaviors to determine behavior improvement in nontargeted activities (peer play, teacher play) as a result of teacher implemented PRT. The one teacher measure reflected if the classroom teacher effectively implemented PRT during the teacher lesson and teacher play. Findings from this investigation revealed several improvements relative to teacher and child behaviors. Relative to the teacher behavior, the classroom teacher effectively learned how to appropriately implement all PRT strategies during the teacher lesson activities for all three children. By engaging the teacher in a collaborative consultation model, the teacher's behavior systematically improved. Additionally, results documented that the teacher generalized some, but not all, of the PRT strategies to the teacher play activities (nontargeted activities). More specifically, the teacher significantly improved implementation of the following PRT strategies into teacher play activities: Child attending (Child 3), providing clear opportunities (Child 1, 2, 3), providing contingent reinforcement (Child 1, 2, 3), providing contingent reinforcement for attempts (Child 1, 2, 3), providing social reinforcement (child 2), maintenance tasks (approaching statistical significance for Child 3), following the child's lead (Child 1 and 2), turn taking (Child 2, 3), and child's choice (Child 2). These results are promising in that the teacher effectively implemented PRT in a new setting where no direct instruction of how to utilize PRT was provided. Findings related to the child's behaviors indicated that expressive language improvements were evidenced for all three children. More specifically, improvements in spontaneous words (Child 1, 2, 3), prompted words (Child 1, 2, 3), and echoic words (Child 1, 2) were noted during the teacher lesson activities. Additionally, improvements in spontaneous phrases (Child 1, 2), prompted phrases (Child 1), and echoic phrases (Child 1, 2) were evidenced during the teacher lesson activities. Findings indicate that language improvements in all three children were a direct result of teacher implemented PRT during the teacher lesson. In addition to documented language improvements during teacher lesson activities, expressive language improvements were noted for Child 3 in the areas of prompted words and spontaneous phrases during teacher play activities. Generalization of expressive language skills (i.e., prompted words, spontaneous phrases) from the teacher lesson activities to the teacher play activities suggest that improvements may be due to the fact that some of the PRT strategies were incorporated into the teacher play activities, thus eliciting more communication from Child 3. Improvements in child play behaviors during peer and teacher play activities also evidenced. During peer play activities, it was found that Child 2 and 3 demonstrated significant improvements for appropriate play and functional play. During teacher play activities, Child 1 exhibited significant improvements for symbolic play, whereas Child 3 demonstrated significant improvements in the areas of joint attention, eye contact appropriate play, and functional play and decreases in inappropriate play. Improved play skills may be a result of utilization of educational materials and toys by the teacher that were of interest to the children as well as improved manipulation of play materials by the children, which generalized into play activities. These improvements suggest that the children developed play scripts and used toys more appropriately. Furthermore, these increases may have motivated the children to interact and share toys with other individuals as a result of teacher implemented PRT during the teacher lesson activities.
"One of the most respected and widely used autism interventions, Pivotal response treatment uses natural learning opportunities to modify key behaviors in children-leading to widespread positive effects on communication, behavior, and social skills. Now the pioneering experts behind PRT have created a comprehensive modern guide to this research-based approach, completely reworked and revised for today's therapists, educators, and parents."--Page 4 de la couverture.
With this proven approach based on of 20 years of research, educators and therapists will use natural learning opportunities to help children with autism enjoy more positive interactions, more effective communication, and higher academic achievement.
Developed by pioneering autism experts Robert and Lynn Koegel, this reader-friendly guide introduces and demystifies PRT--one of a select group of highly effective, evidence-based treatments for autism.
This intervention report presents findings from a systematic review of "pivotal response training" conducted using the What Works Clearinghouse Procedures and Standards Handbook (version 3.0) and the Children and Students with an Autism Spectrum Disorder review protocol (version 3.0). "Pivotal response training" ("PRT") is an intervention designed for children with autism spectrum disorders. This practice focuses on pivotal (core) areas affected by autism, such as communication and responding to environmental stimuli. "PRT" sessions typically begin with a parent or teacher providing clear instructions to a child, having the child help choose a stimulus (such as a toy), and focusing the child's attention. The parent or teacher then encourages the desired behavior (for example, asking for the toy or choosing "toy" from a list of words) by providing rewards if the child implements or attempts to implement the desired behavior. The complexity of the required responses increases as training progresses. Parents, teachers, and peers collaboratively implement the practice at school, at home, and in the community. "PRT" can be used with autistic children aged 2-18. "PRT" is also known as "Pivotal Response Therapy," "Pivotal Response Treatment"ʼ, or "Natural Language Paradigm." "PRT" was found to have no discernible effects on communication/language competencies for children and students with an autism spectrum disorder. The WWC identified three eligible group design studies and 37 eligible single-case design studies that investigated the effects of "PRT" on children and students with an autism spectrum disorder. The WWC reviewed three eligible studies against group design standards. Two of the eligible group design studies are randomized controlled trials that meet WWC group design standards without reservations. They are: (1) Hardan, A. Y., Gengoux, G. W., Berquist, K. L., Libove, R. A., Adrel, C. M., Phillips, J., & Minjarez, M. B. (2015). "A randomized controlled trial of Pivotal Response Treatment Group for parents of children with autism." "Journal of Child Psychology and Psychiatry," 56(8), 884-892. (2) 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(5), 1244-1251. Appended are: (1) Research details for Hardan et al. (2015); (2) Research details for Schreibman and Stahmer (2014); (3) Group design outcome measures for the communication/language competencies domain; (4) Group design findings included in the rating for the communication/language competencies domain; (5) Group design supplemental subscale findings for the communication/language competencies domain; (6) Group design supplemental follow-up test findings in the communication/language competencies domain; and (7) Single-case design studies that meet WWC pilot standards. WWC rating criteria and a glossary are provided.
This book discusses the deficits in the development and presentation of play behavior and social skills that are considered central characteristics of autism spectrum disorder (ASD). The book explains why play provides an important context for social interactions and how its absence can further exacerbate social deficits over time. It highlights the critical roles of social skills in development, and the social, cognitive, communication, and motor components of play. Chapters offer conceptually and empirically sound play and social skills interventions for children with ASD. Play activities using diverse materials and including interactions with peers and parents are designed to promote positive, effective social behaviors and encourage continued development. The book provides unique strategies that can be tailored to fit individual children’s strengths and deficits. Topics featured in this book include: Naturalistic Teaching Strategies (NaTS) for developing play and social skills. Teaching play and social skills with video modeling. Peer-mediated intervention (PMI) strategies that promote positive social interactions between children with ASD and their peers. Visual Activity Schedules and Scripts. Parent-implemented play and social skills intervention. Play and Social Skills for Children with Autism Spectrum Disorder is a must-have resource for researchers, clinicians, and graduate students in clinical child and school psychology, behavioral therapy/rehabilitation, social work, public health, and related psychology, education, and behavioral health fields.
This book examines early intensive behavioral intervention (EIBI) programs for young children with autism spectrum disorder (ASD). It analyzes current research on early intervention (EI) and explains the importance of accurate, timely detection of ASD in facilitating the use of EI. Chapters address five widely researched EIBI approaches: Discrete Trial Training, Pivotal Response Training, the Early Start Denver Model, Prelinguistic Milieu Teaching, and Enhanced Milieu Teaching. This in-depth study of current EIBI approaches offers a rigorous guide to earlier and more intensive interventions for children with ASD, leading to greater autonomy and improved later life outcomes for individuals. Featured topics include: Parent-implemented interventions and related issues. Evaluations of controversial interventions used with children with ASD. Factors contributing to rising ASD prevalence. Obstacles to obtaining accurate ASD diagnosis in young children. Early Intervention for Young Children with Autism Spectrum Disorder is an essential resource for researchers, clinicians, and graduate students in developmental, clinical child, and school psychology, behavioral therapy/rehabilitation, social work, public health, educational policy and politics, and related psychology and behavioral health fields.
Dissemination of evidence-based interventions for autism spectrum disorders (ASD) is a major challenge facing the field. Collaboration between researchers and practitioners aimed towards developing and adapting interventions with strong scientific support may aid in the widespread adoption of evidence-based intervention in community classrooms. The following three studies were motivated by teacher feedback on the use of one evidence based intervention, Pivotal Response Training (PRT), in the classroom. Two intervention components were selected for examination based on teacher report of difficulty with use and subsequent omission and observed difficulty with implementation: response to multiple cues and turn taking. Response to multiple cues was evaluated by administering a discrimination learning assessment to typically developing children to determine the age at which it is developmentally appropriate to incorporate conditional discriminations into instruction (Chapter 1). The discrimination learning assessment was also administered to children with ASD to determine the extent to which today's population of children receiving intervention services has difficulty with overselectivity (Chapter 2). Results demonstrated that typically developing children do not consistently respond to simple conditional discriminations until 36 months of age, indicating that response to multiple cues does not need to be incorporated into PRT until children with ASD reach that developmental level. Additionally, a significantly smaller percentage of children with ASD display difficulty with simple conditional discriminations than in previous studies. The turn taking component of PRT was evaluated through a single subject, alternating treatments design that examined the effects of the elements of modeling and contingency on children's communication and play behavior (Chapter 3). Results demonstrated consistent patterns in children's behavior based on the elements of turn taking in use and the functioning level of the child. Avenues for adaptation of the multiple cues and turn taking components and methods of treatment individualization are discussed. Based on these three studies, adaptations to PRT that may support teachers' use of the strategy in the classroom may be made. This research represents a useful model for the iterative and collaborative process of gathering information from front-line practitioners, conducting basic research based on their feedback, and utilizing that basic research to inform clinical practice.
An important component of Division TEACCH's mandate from the Department of Psychiatry of the University of North Carolina School of Medicine and the North Carolina State Legislature is to conduct research aimed toward improving the understanding of developmental disabilities such as autism and to train the professionals who will be needed to work with this challenging population. An important mechanism to help meet these goals is our annual conference on topics of special importance for the understanding and treatment of autism and related disorders. As with the preceding books in this series entitled Current Issues in Autism, this most recent volume is based on one of these conferences. The books are not, however, simply published proceedings of conference papers. Instead, cer tain conference participants were asked to develop chapters around their pres entations, and other national and intemational experts whose work is beyond the scope of the conference but related to the conference theme were asked to contribute manuscripts as weil. These volumes are intended to provide the most current knowledge and professional practice available to us at this time.
