Behavioral Services Methodologies

Pivotal Response Treatment

Pivotal Response Treatment (PRT) is a naturalistic and developmental intervention derived from the principles of Applied Behavior Analysis (ABA), and developed by Robert Koegel, Lynn Koegel, and Laura Schreibman, along with a number of other instrumental researchers. PRT focuses on teaching the child within the natural environment, most often in the context of play, and helping the child to be more responsive to learning and social opportunities through more naturally occurring contingencies. Rather than targeting individual behaviors one at a time, PRT targets pivotal areas of a child’s development, such as motivation, responding to multiple cues, self- initiations (question asking to seek information), and self-management of behavior. By targeting these pivotal areas, research has demonstrated that PRT can result in widespread improvements in other social, communication, and behavioral areas that are not specifically targeted. PRT is implemented through both direct intervention and a parent education model, as parents are considered primary intervention agents for their child’s learning and development.

Star of CA Behavior Services Methodologies

The Motivational Components of PRT:

Gaining Attention	The behavior technician or parent gains the child’s attention prior to providing an instruction and ensures that the instruction is clear and appropriate to the child’s communication level.
Child Choice	The child chooses items or activities for play or within natural daily routines. The behavior technician or parent presents the items or activities to create learning opportunities. This shared control increases motivation.
Intersperse Maintenance and Acquisition Tasks	The behavior technician or parent balances easy tasks that the child has already learned with newer or more difficult tasks to maintain motivation.
Reinforcing Attempts	The behavior technician or parent reinforces the child’s attempts toward the correct response. It is important to reward attempts in order to build motivation and to help the child make the connection between his or her attempt and the desired outcome.
Natural Reinforcers	Reinforcement is functional and directly related to the behavior. For example, if the child says or makes an attempt to say “ball”, he is given a ball to play with.
Immediate and Contingent Reinforcement	Reinforcement is provided immediately following the child’s response, and is contingent upon a response.

Discrete Trial Teaching

Discrete Trial Training (DTT) is a highly systematic and structured treatment approach within Applied Behavior Analysis, which came to be widely recognized following the influential work of O. Ivar Lovaas and colleagues. DTT takes a complex task or process that a child needs to learn and breaks it down into small discrete steps which can be taught in a graduated way through repetition. DTT typically occurs one-on-one with the behavior technician, who prompts the child to do a specific action and rewards success with positive reinforcement. DTT procedures are highly structured, with the choice of stimuli, the criteria for the target response, and the type of reinforcement all clearly defined before each trial begins. Only the child’s correct responses are reinforced, whereas incorrect behaviors are corrected and off-task behaviors are ignored. Discrete trials can be used to develop skills across a variety of developmental domains, including communication, social-interaction, and self-help skills, as well as to reduce challenging behavior. Each discrete trial follows a three-term contingency, also known as the “ABC Model”

ABC MODEL OF A DISCRETE TRIAL

A	The Antecedent is an instruction or request for the child to perform an action.	Behavior Technician says “touch blue”
B	The Behavior is the response from the child.	Child touches the blue car
C	The Consequence is the response by the behavior technician to the child based on the child’s behavior. This can be the behavior technician providing the child with reinforcement in the form of a toy or food item for a correct response, or a correction for an incorrect response.	Behavior Technician gives the child a light up toy and praises the correct response

Positive Behavioral Support

Positive Behavioral Supports begin with a functional behavioral assessment to help better understand the nature of the individual’s challenging behavior. This information is used to develop a comprehensive behavioral support plan. Once implemented, this plan helps to reduce the likelihood that challenging behavior will occur, teaches desirable alternative behaviors that give the individual a more adaptive way to get their needs met, and often makes challenging behaviors irrelevant and ineffective. PBS services are most effective when they include family members and others who support the individual across their day (e.g., teachers, friends, other caregivers), so that the strategies can produce their intended benefit in every environment. Outcomes of PBS services include enhanced quality of life, effective communication of basic wants and needs, and increased opportunities to engage in meaningful activities with others.

Verbal Behavior

The Verbal Behavior (VB) approach encourages very basic to very complex communication skills. Verbal Behavior is a method of teaching language that focuses on the idea that the meaning of a word is found in their functions. More specifically, to teach a child with language delays a meaning of a word, one must first teach its function. VB breaks down language into its basic function, such as repeating, labeling, commenting and responding.

SUMMARY OF VERBAL OPERANTS

The following table summarizes the new verbal operants in the analysis of Verbal Behavior.

Verbal Operant	Consequence	Example
Mand	Directly Effective	A boy is being bathed by his father, and says: "more bubbles". The father pours more bubble mixture into the bath and turns on the tap.
Tact	Social	A child looks up at the sky and says: "Look, an airplane!" The parent says, "oh, it is!"
Intraverbal	Social	A mother asks her son, "How was school today?" The son replies, "It was fun, we had an assembly" The mother says: "Oh, what was the assembly for?"
Echoic	Social	A therapist says apple while holding an apple. The child repeats "apple". The therapist says "great"

One must keep in mind, however, that almost all verbal behavior does not consist of these ‘pure’ operants, but of a mixture of them.

Natural Environment Teaching

The natural environment refers to your child’s day-to-day surroundings. It may include places like school, home, grandma’s house, church, day care, extracurricular activities, etc. This is the environment where your child’s learning and communication skills should be “put to work.” The ultimate goal is for your child to have the ability to interact independently with others in their environment. Training in the natural environment should be consistent and ongoing. Since these surroundings don’t always provide multiple opportunities for your child to use their skills, we often “set up” the environment to create learning opportunities. However, just because these are contrived situations, it does not make the environment “unnatural.” Training in these surroundings simply provides a context for your child to use their skills they have been taught.