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Pivotal Response Training (PRT)

Pivotal Response Training (PRT) is a contemporary naturalistic-behavioral intervention that applies principles of applied behavior analysis (ABA) to build on learner initiative and interests, enhancing the pivotal learning variables: motivation, responding to multiple cues, self-management, and self-initiations of social interactions.

*Now categorized as a Naturalistic Intervention

Evidence Based
Ages: Skip to Evidence

Steps for Implementation

Step 1. Establishing Learner Attention

  1. Establish learners’ attention before providing learning opportunities.
  2. Once the learner is attending, use brief and clear instructions with learners with autism.

Step 2. Using Shared Control

  1. In a shared control interaction, decide which part of the routine an adult will complete for the learner and which parts learners will finish independently.
  2. During teaching episodes, maintain a balance between adult- and learner-selected materials, topics, activities, and toys.

Step 3. Using Learner Choice

  1. Observe learners when they have free access to materials to identify their preferences for items, activities, and toys.
  2. Arrange the environment with learner-preferred, age-appropriate objects and activities.
  3. Allow learners to select materials, topics, and toys during teaching activities.
  4. Follow the learner’s lead during interactions and learning activities.
  5. Incorporate choice-making opportunities into naturally occurring routines and activities throughout the day.
  6. Provide a variety of activities and items for learners to choose from throughout the day to increase their motivation to participate in numerous learning activities.

Step 4. Varying Tasks

  1. Vary tasks, materials, and activities to maintain learner interest and engagement.
  2. Vary instructions and environmental conditions to foster learner response to a range of stimuli.

Step 5. Interspersing Acquisition and Maintenance Tasks

  1. Identify skills that are easy for learners, as well as those that are more difficult.
  2. Provide a mixture of easy and more difficult tasks so that learners can be successful at using a variety of skills.
  3. To facilitate maintenance of previously learned target skills, provide short requests that are easy and within the learner’s repertoire of skills to complete followed by one or two requests that are more difficult for the learner to complete.

Step 6. Reinforcing Response Attempts

  1. Reinforce all verbal attempts at responding that are clear, unambiguous, and goal-directed.
  2. Provide reinforcement immediately after a goal-directed attempt.

Step 7. Using Natural and Direct Reinforcers

  1. Identify materials and activities that can be used to address a learner’s goal during a teaching opportunity.
  2. Implement a learning task that is directly and functionally related to a learner’s goal.

Research and Outcomes

Research Summary

Age Range: 0-14

Skills: Communication, social, joint attention, play

Settings: Home, school, community

Evidence Rating: Evidence Based

The information found in the Research Summary table is updated following a literature review of new research and these ages, skills, and settings reflects information from this review.

Outcomes Matrix

The Outcomes Matrix shows outcome areas by age for which this evidence based practice is effective
Age: 0-5 6-14 15-22
Challenging/Interfering Behavior
Communication Yes Yes
Joint Attention Yes
Mental Health
Play Yes Yes
School Readiness
Social Yes Yes
More about Intervention Outcomes

Pivotal Response Training (PRT) is a contemporary naturalistic-behavioral intervention that applies principles of applied behavior analysis (ABA) to teach learners with autism spectrum disorders (ASD). PRT builds on learner initiative and interests; it is particularly effective for developing communication, language, play, and social behaviors. PRT was developed to create a more efficient and effective intervention by enhancing four pivotal learning variables: motivation, responding to multiple cues, self-management, and self-initiations. According to theory, these skills are pivotal because they are the foundational skills upon which learners with ASD can make widespread and generalized improvements in many other areas.

PRT meets evidence-based criteria with one group design and 7 single-case design studies. According to the evidence-based studies, this intervention has been effective for toddlers (0–2 years) to middle school-age learners (12–14 years) with autism. PRT can be used effectively to address social, communication, joint attention, and play skills.

*Though Pivotal Response Training (PRT; Koegel & Koegel, 2006; Stahmer et al., 2011) has quite an expansive literature base and was categorized as its own EBP in previous literature reviews, it is often described as a Naturalistic Intervention. To provide more conceptual consistency, it has been merged into the category of Naturalistic Intervention in the 2020 literature review completed by the National Clearinghouse on Autism Evidence and Practice (Steinbrenner, et al.,). Despite this change, the TARGET still has a separate article on PRT that includes its own Steps for Implementation.