The PRT Pocket Guide

Pivotal Response Treatment for Autism Spectrum Disorders

by Robert L. Koegel, Ph.D. and Lynn Kern Koegel, Ph.D. Koegel Autism Center University of California, Santa Barbara with invited contributor

Contents

About the Authors

Robert L. Koegel, Ph.D.

has focused his career in the area of autism, specializing in language intervention, family support, and school inclusion. Dr. Robert L. Koegel is Director of the Koegel Autism Center at the University of California, Santa Barbara. He has published more than 200 articles and papers relating to the treatment of autism, has published six books on the treatment of autism and positive behavioral support, and is Editor of the *Journal of Positive Behavior Interventions. Models of his procedures have been used in public schools and in parent education programs throughout the United States and in other countries. He has trained many health care and special education leaders in the United States and abroad.

Lynn Kern Koegel, Ph.D.

is Director of Clinical Services at the Koegel Autism Center and Director of the Eli and Edythe L. Broad Center for Asperger’s Research. She has been active in the development of programs to improve communication in children with autism, including the development of first words, grammatical structures, pragmatics, and social conversation. In addition to her published books and articles in the area of communication and language development, Dr. Lynn Kern Koegel has developed and published procedures and field manuals in the area of self-management and functional analysis that are used in school districts and by parents throughout the United States and have been translated into other major languages. Dr. Lynn Kern Koegel is the author of Overcoming Autism: Finding the Answers, Strategies, and Hope that Can Transform a Child’s Life (Viking/Penguin, 2004) and Growing Up on the Spectrum (Viking/Penguin, 2009) with Claire LaZebnik. The Koegels are the developers of Pivotal Response Treatment, which focuses on motivation. They were the recipients of the first annual Children’s Television Workshop Sesame Street Award for brightening the lives of children and the first annual Autism Speaks award for science and research.

Introduction

Pivotal Response Treatment (PRT) is one of the few evidence-based approaches for the treatment of autism. That is, the approach is supported by research that meets the standards set by many professional agencies and organizations, such as the American Psychological Association. That’s important because supporting children and families affected by autism is a race against time. Families can’t afford to repeatedly go up blind alleys with treatment procedures that sound good but have no evidence to support their effectiveness in helping children with autism. Each day more children are diagnosed with autism, and they need instruction and intervention in many different areas. Furthermore, early intervention is effective—partly because it keeps bad habits from getting started (habits that would be hard to break), but also because without intervention kids on the autism spectrum get worse, whereas with intervention they get better. Although it’s never too late, the earlier any communication delays and social challenges are addressed, the sooner parents, teachers, and therapists can start helping the kids learn what they’ll need to survive and thrive.

PRT focuses on core underlying areas that are critical for children with autism. Functionally, the major core area—which affects all other areas—is motivation to engage in social communication. That core area is linked both to underlying neurological bases and to thousands of individual behaviors that are affected by the motivational problem as the children develop.

It's also important to understand that the PRT procedures were developed over many, many years and that there are now hundreds of studies showing their effectiveness. PRT is based on behavioral intervention, a method developed in earlier work in the field of applied behavior analysis that is also supported by plenty of research that documents its effectiveness as an approach for autism.

This book presents scientifically based and practical intervention procedures that can be implemented in everyday settings; are easy and fun to implement; and produce valuable treatment gains for children with autism, as well as benefits for the entire family’s lifestyle. PRT has been used effectively for more than 25 years with hundreds of thousands of families. By focusing on several foundational areas of development in children, PRT results in life-changing improvements for children with an autism diagnosis. The following chapters will highlight each of the pivotal areas and provide details on effective implementation and expected outcomes.

Summarized empirical support for Pivotal Response Treatment (PRT)