It’s natural for a child to ask questions when he encounters something or someone new. This is known as initiation, and it’s one of the “pivotal” behaviors children naturally engage in. But for kids with autism, these pivotal behaviors most often need to be taught.
That’s why the team at Blossom Behavioral Wellness Center in Novi works with children to develop pivotal behaviors through Pivotal Response Training (PRT). Autism experts and husband-wife duo Drs. Robert and Lynn Koegel developed PRT, which is a motivation- and play-based application of ABA therapy, developed in the 1970s.
“The Koegels have been passionate about helping kiddos with autism, which is why it broke their hearts when they saw kids they worked with become upset and breakdown throughout therapy,” says Elizabeth Webster, Blossom’s licensed professional counselor and a registered art therapist. “They didn’t understand why sometimes it took so long to get small essential things accomplished through traditional ABA therapy.”
“Traditional ABA therapy, when done properly, can be very rewarding and fun. However, when ABA utilizes the methods spelled out in PRT, we find that the sessions are more naturally fun and engaging for the child,” notes Kelly Ray, Blossom’s Qualified Behavior Health Professional. Knowing that ABA can be tough for children, the Koegels’ developed a way for children to learn behaviors in a naturalistic environment, which has proven to be a successful form of therapy. In fact, according to Koegel Autism Consultants, 85 to 90 percent of children with autism who begin PRT interventions before age 5 develop verbal communication as their primary form of communication.
Motivation factors for success
Through PRT, instead of working on one behavior at a time, the therapy targets different “pivotal areas,” which include motivation, initiation, response to multiple cues, and self-management.
“When it comes to behaviors that we’re targeting, it’s more so that we are trying to target the motivation of a child that we are working with,” Webster says. “For instance, questions we ask ourselves to identify motivational factors would be: What brings them happiness? What is interesting for the child? What increases enthusiasm?”
For some children, that motivating factor might be swinging on a swing. If that’s the case, the Blossom team can use the swing as a learning tool for the child. For example, a therapist might push the child on the swing and then pause for them to say, “swing” if they are working on communication.
From here, the team can build on behaviors and help the child thrive in a variety of ways.
Finding motivational factors and addressing behaviors in children encourages them to learn the skills that help with academics, social skills, language, communication, self-management and regulation, according to Koegel Autism Consultants.
Child and family success
Parents play an integral role in a child’s success during therapy.
“We get them for therapy for a limited amount of hours per week, but the parents are with them all the time,” Ray says. “We are huge on parent training! We have the parents get in there and try it while we are with them.”
One way families get in on the therapy has to do with focusing on improving attention, Webster says, which includes sharing an interest in an event or object, and creating dialogue that goes back and forth between participants.
“A common trademark with autism is what may seem as a “lack of interest” in social activities, such as; initiating dialogue, conversation or even play with another person,” Webster adds. “A lot of parents may feel upset or discouraged when they feel a lack of interest from their children, so our interventions may focus on creating ‘joint’ attention. This way we can involve parents in therapy, as active participants to address social skills and attention, while teaching parents the skills to use outside of the therapy and into the world.”
In other words, moms and dads can sit in on and are encouraged to participate PRT sessions and learn some skills to implement at home.
“That’s the beautiful thing about PRT, too: Because it’s so naturalistic and it’s in the child’s environment, it can be done virtually anywhere – you don’t need a set of materials,” Webster says. “Once learned, families are able to implement the principles of PRT anywhere – which allows an increase in new opportunities and in return new skills being learned.”
For more information on Blossom Behavioral Wellness Center, visit blossombehavioral.org.