Pivotal Response Treatment (PRT) from Pre-K through Transition

Transcription

1 Pivotal Response Treatment (PRT) from Pre-K through Transition Robert E. Daniels, Ph.D. Licensed Clinical Psychologist Executive Director

2 Goals What is PRT? What are Pivotal Skills? What are the components of PRT? How Effective is PRT?

3 What is PRT? Developed using the principles of Applied Behavior Analysis (ABA) and Typical child development Implemented in the natural environment Improvements in untargeted areas Coordinated effort by all stakeholders

4 Pivotal Skills: Lead to Gains in Untargeted Areas Motivation Responsivity to Multiple Cues Self-initiations Self-management Social Facilitation

5 Why is PRT Effective? Research Variables that increase motivation to respond Stimulus variation (Dunlap & Koegel, 1980) Natural reinforcers (Koegel & Williams, 1980) Child-preferred activities (Koegel, Dyer, & Bell, 1987) Reinforcing attempts (Koegel, O Dell, & Dunlap, 1988) Point 1: Child Attention Point 2: Maintenance Tasks Point 3: Shared Control Point 4: Responsivity to Multiple Cues Point 5: Contingent Reinforcement Point 6: Reinforce Attempts Point 7: Direct and Natural Reinforcers

6 The A-B-C s of PRT Antecedent: Provide an opportunity to respond. Behavior: The child responds. Consequence: Provide a reinforcer contingent upon the child s response

7 Clear Opportunity

8 A B C Opportunity What color do you want? Child responds Yellow Response Reinforced: Child given yellow marker

9 Child Attention

10 Shared Control Adult does not have control of object Adult DOES have control of object/action

11 Responsivity to Multiple Cues

12 Contingent Reinforcement

13 Reinforce Attempts

14 Natural Reinforcers

15 How Quickly It Can Work! Reinforce INTENT and ATTEMPTS FIRST WORDS!!!!

16 Opportunities for Language Definition: Any question/offer/instruction that the parent provides to the child where the child is expected to respond verbally Examples of Opportunities Model-Prompt Open-ended Time-delay

17 Putting It All Together

18 Initiations Independent, spontaneous use of functional communication What? Questions Start with model-prompt Quickly introduce openended & time delay Be sure to reinforce intent and attempts

19 Social Conversation in ASD Limited quantity Limited quality/variety Marked by select, perseverative topics Limited complexity

20 What Needs To Be Taught? 1) On-topic question-asking* 2) On-topic commenting* 3) Transitions 4) Checking-in

21 Self-Management 1. Identify self-management strategy a. Materials b. Length c. Reinforcement 2. Identify skill a. On-topic question-asking b. On-topic commenting 3. Teach what skill is and is not 4. Teach how to self-manage

22 Sample Self-Management Sheet =Reward

23 On-Topic Commenting: Procedure Parent/adult/peer provides leading statement I saw Shrek 2 last night. I got a ticket for speeding. Child with autism or asperger prompted to make ontopic comment I ve seen that before You probably weren t too happy. Fade prompting for independence **

24 12-Month Outcome June 2009 July 2010

25 Motivational Academics PRT Principle Child Choice Task Variation/Maintenance Tasks Examples Order of assignments Writing instrument Color of paper Book to be read Writing topic Intersperse preferred tasks and breaks using First/Then framework Intersperse a learned task (i.e., counting), with new task (i.e., money).

26 Motivational Academics-Continued PRT Principle Reinforce Attempts Natural Reinforcers Examples Provide verbal and written praise for effort vs. outcome Change prompts, pace, and task difficulty to ensure sustained effort and motivation Meaningful activities Tell time relevant to student s schedule Earn money to purchase desired activities Write about personal experiences Read about upcoming events

27 Motivational Academics-Conclusion PRT Principle Multiple Cues Initiations Self-Management Example Furnish multiple writing utensils and surfaces Vary questions Apply concepts to multiple examples Teach question-asking Provide checklists for specific desirable behaviors

28 Analogue PRT STIMULI PROMPTS INTERACTIONS CHILD RESPONSE CONSEQUENCES -Chosen by clinician -Repeated until criterion met say with a manual prompt (clinician touches child s mouth) Clinician holds up item while child sits passively Only correct responses reinforced Edible paired with social -Chosen by child -Varied Clinician labels item Clinician and child are playing together Appropriate attempts reinforced Natural reinforcer & social

29 Koegel, O Dell & Koegel (1987)

30 Koegel, Koegel, & Surratt (1992)

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