Pivotal Response Treatment

PRT is intended to eventually become a part of the toddler family’s lifestyle. When this occurs, provide opportunities quite naturally, with minimal formal preparation. This is also the case in home and community settings. At first, you may benefit from some explicit planning and preparation. Even as PRT becomes a more natural occurrence throughout the day, continue to engage in some level of planning and preparation, particularly as new objectives and activities are introduced.

a) Create an inventory of motivators through various reinforcer and preference

assessments

This inventory help you provide more motivating items and activities during intervention and throughout the day. Make sure to follow the toddler’s lead and provide choices between these preferences in the moment. Although you may expect the toddler to engage in the most preferred activity, in the moment they may choose a different activity. You may be surprised at how many items and activities a toddler enjoys!

b) Continue to have toddler’s learning strengths and emerging skills in mind as

your prepare the materials

If the toddler is great at reciting the ABC’s, then this might indicate a strength and learning preference. If you are going to introduce some puzzles during play, ABC puzzles might be a great place to start. It might mean that the toddler learns well from repeated patterns and/or songs. If you initially select to teach functional, spontaneous verbal communication to a toddler, you might start by using carrier phrases within the alphabet or within a song. It is important to consider the toddler’s developmental level when selecting motivating activities and materials.

A practitioner might start singing, “A, B, C, ___” and then wait a few seconds for the toddler to say “D” before singing and pointing to the letter D. The practitioner could then plan to use other carrier phrases, such as “ready, set, __” and “one, two, three, __.”

c) List out the daily routines

These routines might differ by weekdays versus weekends, winter days versus summer days, etc. Remember to include the mundane!

Parents and practitioners often find that the best learning opportunities occur among the basic day-to-day events or items a toddler desires. These might include opening the door to go outside and play, buckling a seat belt to drive to the park, turning on the bath tub water before a bath, and turning a light on and off upon entering and exiting a room. Daily routines may provide excellent times to present motivating learning opportunities, as long as the toddler indicates that he or she wants these things to occur in the moment.

d) Decide what parts of the routine can be used to target the toddler’s meaningful

objectives and how the toddler’s interests and preferences can be incorporated.

After listing the various daily routines and activities, form an activity matrix of what objectives can be targeted during the different times of the day. Consider whether a particular time of the day should be dedicated to more intense intervention sessions with more frequent opportunities provided.

Prepare materials.

Once you have identified what types of interests and preferences the toddler has, and have planned where opportunities can be provided, the next step is to prepare any materials.

Consider the environmental arrangement.

Can the materials be arranged to gain shared control and establish motivation? For instance, a parent might prepare by putting the different colored ducks up on a shelf, in sight but out of reach in the shower, or put the ducks in a “locked” Tupperware container. Preparing materials is also about preparing to manage the materials.

If you are working on accurately requesting colors and the toddler enjoys playing with ducks in the bath, then prepare multiple colored ducks to have out during bath time. A toddler can even help paint them or select them at the store! In summary, you should use an activity matrix to help you plan when opportunities will occur and then prepare your materials and activities.