Step 1.1 Develop meaningful objectives

The first step is to develop goal areas and specific objectives. In developing goals and objectives, take into account the toddler’s needs, strengths or interests, and family preferences, values, and context.

a) Identify the toddler's needs through direct observation, interviews, and

assessment

In PRT, the identification of child needs is based on the integration of observational data in everyday environments, interviews and collaboration with parents, and assessments. Generally, goals should address core areas of autism and developmentally meaningful behaviors through improving a toddler’s motivation to acquire and engage in the target behaviors.

There are no prescribed assessments, and it is not necessary to have formal assessments and testing complete in order to start PRT. Assessments might include, but are not limited to:

ADOS

More intensive assessments, such as the Autism Diagnostic Observation Scale (ADOS), could also provide important information on specific target behaviors. Behavioral assessments, such as functional behavior assessments (FBA), provide valuable information regarding the child’s functional communication and challenging behavior. Further, assessments should be strength-based (Cosden, Koegel, Koegel, Greenwell, & Klein, 2006). PRT researchers and clinicians suggest that standardized assessments might reflect performance issues related to motivation, rather than ability levels.

Strength-based Planning for Infants and Toddlers provides some examples of the potential for strength-based, naturalistic assessment for toddlers with autism.

Always directly observe the infant or toddler and collect baseline data within natural, everyday environments and during child interactions with both parents and practitioners.

Semi-structured language and play samples (examples provided below), which collect a variety of information on the child’s communication, language, and behavior during play and daily routines, provide important information necessary to develop the toddler’s PRT program related to communication, socialization, and language. Direct observation and collection of baseline data on meaningful target areas, such as social interaction, joint attention, imitation, play, and interfering behaviors should inform your target goals and objectives.

What target skills might be pivotal or which learning areas will have the widest and most immediate impact on the toddler or infant’s overall development?

In order to establish pre-intervention levels of a toddler’s motivation to learn and engage in developmentally appropriate behavior, initial and ongoing data collection should be collected by the interventionist to evaluate how responsive the toddler is to the social environment, how often the toddler initiates interactions (and the function of the initiations), and the toddler’s overall affect across contexts.

A Likert Scale can be used to monitor the toddler's affect. Included also are examples of possible meaningful goal areas that can be used when developing a PRT program for a toddler or an infant.

pdf iconMonitoring Toddler Affect Using a Likert Scale

pdf iconPossible Meaningful Goal Areas for Infants and Toddlers

b) Develop meaningful communication and language objectives

Language or communication samples can help parents and practitioners assess communication in a toddler. The data gathered from language samples are individualized. This type of data would likely have to be scored from a video, or by another person than the person interacting with the toddler. For each opportunity to communicate or each initiated communicative act (numbered 1, 2,3...):

  • an antecedent is noted (i.e., what happens before the communicative behavior?),
  • what the verbal communication sounded like (and whether it was a new acquisition word, or an easy maintenance word?),
  • what the function or purpose of the communication was, and
  • where and with whom the communicative act occurred?

Nonverbal (prelinguistic) communicative behavior can be assessed in conjunction with verbal behavior, or by itself if that is an appropriate mode of communication for the infant or toddler. It is also important to note the duration of your sample.

pdf iconReview an example oortion of an language sample

Consider the suggested questions to ask about an infant or toddler's social-communicative behaviors. What data can be collected from the language sample?

c) Develop meaningful play, social engagement, imitation, and behavior

objectives

PRT targets social communication and language in the context of play, functional engagement in daily routines, and social activities. The development of social communication within PRT relies on the continued development of other developmentally meaningful areas, including expansion of the toddler’s preferences and play skill repertoire, increased attempts at spontaneous imitation of functional actions, and increased social engagement (including joint attention).

Use questions to guide the development of play, engagement, and functional imitation objectives.

 

While using PRT, you will monitor challenging behaviors, such as stereotypical behavior and tantrums, but may not initially focus intervention here (unless the behaviors are particularly interfering and dangerous). Instead, the effort is placed on improving motivation during learning opportunities and interaction, and increasing functional communication, so that challenging behavior becomes less relevant to the toddler.

As a toddler’s motivation, functional communication, and functional engagement improves during the initial stages of PRT, many challenging behaviors may indirectly decrease. Still, the initial PRT plan should define the challenging behaviors and implement a functional behavior assessment in order to determine the behaviors’ functions, or the purpose they may serve for the toddler.

PRT continuously and proactively teaches communication that is functionally equivalent to challenging behavior, thereby helping to prevent further development of challenging behavior.