# Introduction

Pivotal Response Treatment (PRT) is one of the few evidence-based approaches for the treatment of autism. It is supported by research that meets the standards set by professional agencies and organizations, such as the American Psychological Association. Supporting children and families affected by autism is critical because families cannot afford ineffective treatments. Early intervention is effective as it addresses communication delays and social challenges, which helps children learn survival skills. PRT focuses on motivation to engage in social communication, a core area linked to underlying neurological bases and affected behaviors.

It’s also important to understand that the PRT procedures were developed over many years, with hundreds of studies showing their effectiveness. PRT is based on behavioral intervention, supported by research that documents its effectiveness. This means that independent researchers have also achieved positive results with the PRT "package" and its individual components.

PRT has been shown to lead to significant changes in children's behaviors. Moreover, as PRT evolves, new components are added. It has been refined over the years and originally referred to as the "Natural Language Paradigm" (NLP), emphasizing natural interactions as opposed to traditional drill-type interventions. The approach later adopted the name "Pivotal Response Treatment" to better reflect its broad impact on behaviors associated with autism.

There are four primary reasons why empirical evidence is important when choosing treatment approaches:

1. **Evidence separates effective treatments from ineffective ones**.  Approaches that sound good may not actually work, so it's important to rely on proven methods.  
2. **Professional standards require evidence-based approaches**. Certifying and licensing bodies are increasingly demanding scientifically-backed methods to avoid legal and professional repercussions.  
3. **Insurance companies often refuse coverage for untested treatments**. Effective treatments are necessary not just from a clinical standpoint but also for practical, financial reasons.  
4. **Untested procedures can be risky or dangerous**. Using unsupported methods can waste time and create additional problems.

This book presents scientifically based and practical intervention procedures that are easy to implement and produce gains for children with autism. PRT has been utilized effectively for over 25 years, yielding life-changing improvements for children diagnosed with autism. Subsequent chapters will detail pivotal areas and provide guidance on implementation and expected outcomes.