Pivotal Response Training (PRT)
Description: Pivotal Response Training is an intervention which relies on the principles of applied behavior analysis to enhance communication skills in people with autism spectrum disorder (ASD). The approach focuses on addressing skills which are essential for the development of communicative, social, and behavioral abilities of patients (Lei & Ventola, 2017). The word “pivotal” used in the name of the intervention refers to the exact skills which are considered vital, these include self-initiation, motivation, and self-management.
Pivotal Response Training has been thoroughly studied over the years and is proven to deliver positive results when implemented. The results of the research show that the intervention successfully led to the increase in the number of self-initiated social responses, reduced disruptive conduct, and promoted collateral language acquisition in children with ASD (Lei & Ventola, 2017). Such effects demonstrate that the intervention was capable of causing positive changes in the behavior of the patients, especially in the realms of social motivation and responses.
Intended Population: The intervention in question can be adopted for the treatment of children with issues concerning their social and communication skills, as well as attention. Pivotal Response Training is relevant for children in the age group between 0-14 years old. The intervention is unlikely to be beneficial for individuals older than 15 years old.
How it is used: As mentioned, Pivotal Response Training is an intervention which addresses different key skills; for instance, a program focusing on motivation involves seven key steps. The first step involves establishing the attention of the child, which can be done by tapping them on their shoulder. The second step is the use of shared control interaction, which implies choosing a certain routine and performing it together with the child (Suhrheinrich et al., 2018).
For example, the teacher can put a coat on the child, and the learner will have to zip it. The third step is the learner choice which is an observation on the part of the practitioner of the child’s preferences for activities and items, which then can be used as a reward. The fourth and fifth steps are varying and interspersing of maintenance and acquisition tasks to ensure the child is focused. The sixth and seventh steps involve the use of natural and direct reinforcement of all response attempts of children.
Two resources to find out more: How to use PRT
Lei, J., & Ventola, P. (2017). Pivotal response treatment for autism spectrum disorder: current perspectives. Neuropsychiatric Disease and Treatment, 13, pp. 1613–1626. Web.
Suhrheinrich, J., Chan, J., Melgarejo, M. Reith, S., Stahmer, A., & AFIRM Team. (2018). Pivotal response training. National Professional Development Center on Autism Spectrum Disorders. Web.
Response Interruption/Redirection (RIR)
Description: Response Interruption/Redirection (RIR) is an intervention widely used for the treatment of patients with autistic spectrum disorders (ASD). RIR is particularly popular for using in cases involving vocal stereotypy, a condition which is common among children and teens with autism. RIR implies interrupting every instance of vocal stereotypy and redirecting the patient to pronounce words and phrases in a correct manner. Studies show that RIR was an effective intervention for children with autistic disorders since it reduced the level of vocal stereotypy (Akers et al., 2020). Essentially, RIR can be safely utilized and deliver significant results with a high degree of effectiveness. Moreover, according to research, both matched and unmatched demands were found to have a positive impact on the behavior of the patient (Akers et al., 2020). As a result, RIR can be considered an intervention which can be employed in cases with behavioral, social, and communication issues.
Intended Population: RIR is a universal intervention which can be successfully implemented in many age groups. For instance, studies show that RIR was effective in the reduction of challenging behaviors in people from 3 to 22 years old. Yet, primarily, RIR should be used in children aged between 3 and 15, especially those with vocal stereotypy.
How it is used: As with many other interventions, RIR has several stages which must be performed by the teacher. The first step involves conducting a behavior assessment of the patient and identifying an appropriate intervention. Then, alternative behaviors must be selected to replace the interfering ones, as well as reinforcers for promoting a new type of conduct should be chosen. The second step constitutes using RIR, and it starts with praise for the learner’s independent use of appropriate behaviors (Tomaszewski & AFIRM Team, 2017). The RIR procedures which were identified during the first stage should be implemented during the second one. Such procedures may involve verbal blocking implying prompting the learner to produce a verbal response by asking them a question. Then, an instruction can be given to the learner to perform an alternate behavior which must be reinforced. The third step involves monitoring and choosing the next intervention.
Two resources to find out more: How to use RIR
Akers, J., Davis, T., & Gerow, S. (2020). Self-injurious behavior, rituals, and stereotypies in dual diagnosis. In J. Matson (Ed.), Handbook of dual diagnosis (581–595). Springer.
Tomaszewski, B., & AFIRM Team. (2017). Response interruption/redirection. National Professional Development Center on Autism Spectrum Disorders. Web.
Scripting (SC)
Description: Scripting is another intervention for children with autistic spectrum disorders which primarily addresses communication issues. Since such children may experience difficulty during verbal interactions with their peers or other people, scripting implies providing them with ready-made verbal descriptions for situations which may be complex for them (McKenney, 2020). Scripting involves different techniques which are used to ensure that the child is able to demonstrate appropriate conduct in a difficult environment. For instance, scripts presented to the children are rehearsed, assessed, and entail feedback for the learner. The intervention relies on the existing strengths of the learner and offers them models for social and communicative behavior, which will support them in their interactions.
Intended Population: SC was found to be effective as an intervention for different age groups. SC can improve the social and communication skills of people from 0 to 22. Additionally, it can positively affect joint-attention, academic performance, play, and cognitive outcomes of children aged between 0 and 14. Moreover, there is evidence in support of SC’s positive effect on vocational outcomes for children between 6 and 14.
How it is used: SC consists of three stages which include planning, using, and monitoring. During the first step, the teacher must determine the prerequisite skills of the child and the situation with which they have a problem. Next, a script has to be created, the child must be taught additional skills such as specific vocabulary, and the communication partner should receive instructions (Griffin & AFIRM Team, 2017).
The second stage involves teaching the script to the learner and letting them perform it with a partner. During the stage, the learner may receive additional prompts, which can then be removed once they adapt to the situation. Then, the script itself can be gradually faded by first removing certain words from it and then entire sentences. The end goal of the second stage is a generalization and the ability of the learner to repeat their behavior in communication with their peers without the script. The monitoring step implies assessing the effectiveness of the intervention and deciding whether the script needs to be modified.
Two resources to find out more: How to use SC
Griffin, W., & AFIRM Team. (2017). Scripting. National Professional Development Center on Autism Spectrum Disorders. Web.
McKenney, E. (2020). School-based consultation and students with autism spectrum disorder. Routledge.
Social Narratives (SN)
Description: Social narratives are widely utilized by specialists working with children with autistic spectrum disorders to improve their behaviors and communication abilities. SN refers to a practice of providing a description of social situations to children with ASD, which includes explanations of various emotions and thoughts experienced by participants of the interaction (Southern, 2017). It is a common problem for people with ASD to not be able to realize or understand the feelings of their communication partners. SN is used to initiate appropriate behavior in children with ASD by preparing them for different social scenarios, which are often personalized depending on the particular needs of the learner.
Intended Population: The intervention has been extensively studied and was found to be effective in all age groups, therefore SN can be utilized in learners from 3 to 22 years old. SN is also a fairly universal tool and thus can be used for resolving problems concerning behavior, school readiness, communication, social skills, as well as play and adaptive outcomes.
How it is used: SN can be divided into three parts which constitute the main stages of the procedure. First, a targeted social situation should be chosen, which depends on the needs of the learner. Once the situation is identified, a type of SN must be established, which can be Social Stories or Power Cards (“Social narratives (SN),” 2016). Subsequently, the social narrative should be created, and its display has to be designed, which includes fonts, visuals, and other elements. During the second stage, the social narrative is introduced to the learner by explaining its characteristics to them. Then, the learner must read the narrative, and they should be asked questions about it. Next, the learner has to be able to participate in a situation based on the narrative where they have to demonstrate the appropriate behavior. Finally, during the third stage, information should be gathered on the intervention, and the following steps must be identified.
Two resources to find out more: How to use SN
Social narratives (SN). (2016). National Professional Development Center on ASD. Web.
Southern, L. (2017). Social narratives support individuals with autism. Autism Society of North Carolina. Web.
Extinction (EXT)
Description: Extinction is an intervention used by many different professionals who work with children diagnosed with ASD, including therapists, special educators, and teachers. EXT relies on the idea that removal of reinforcements of negative or undesired behavior can contribute to the reduction of the frequency of such behavior (Cosgrave, n.d.). Extinction implies preventing certain conduct from obtaining the standard outcomes. EXT constitutes a behavioral procedure which aims at reducing or completely eliminating a behavior for which the person stops receiving any reinforcement (Cosgrave, n.d.). As a result, EXT is often implemented in combination with other interventions such as Differential Reinforcement of alternative behaviors. Studies show that the utilization of EXT with other procedures increases its effectiveness and also decreases the probability of negative outcomes related to extinction.
Intended Population: Extinction is also a universally effective intervention relevant for people of different ages, from pre-schoolers to high-school students. The main outcomes which can be successfully targeted by EXT are school readiness, communication, behavior, and adaptive.
How it is used: In order to utilize EXT, it is first necessary to conduct an assessment of the individual’s behavior and, based on it to determine the replacement behavior. The prompts which will help the person to embrace the new behavior also have to be created, as well as additional interventions must be identified (Morin & AFIRM Team, 2018). Moreover, a crisis plan has to be produced since EXT often causes aggressive reactions in learners. Then, the intervention plan must be explained to the learner, and the process of extinction of reinforces can begin. After removing the previous reinforces, prompts strengthening the desired behavior should be introduced. Gradually, the new prompts should be removed once the learner begins to engage in the appropriate behavior consistently. There is a possibility that the learner will exhibit extinction bursts demonstrating the unwanted behavior more often than usual, yet it is important to avoid reinforcing them. Finally, the learner’s behavior has to be assessed to determine whether the intervention yielded any positive results and decide on future actions.
Two resources to find out more: How to use EXT
Cosgrave, G. (n.d.). Extinction procedures. Educate Autism. Web.
Morin, K. L., & AFIRM Team. (2018). Extinction. National Professional Development Center on Autism Spectrum Disorders. Web.
Structured Play Group (SPG)
Description: Structured Play Group refers to an intervention which involves utilizing group work to improve the skills and abilities of children with ASD. Specifically, SPG implies participating in groups where each member has their own activity which they need to perform (Ennis-Cole, 2019). The main role in the group belongs to an adult who manages the work of other participants and monitors the performance of children with ASD. Groups must meet consistently to achieve better results and may also include children who demonstrate normal development. Studies show that SPG can positively affect the well-being of children with ASD, especially those who experience problems with social play, behavior, school-readiness, academic, and communication outcomes (Ennis-Cole, 2019). SPG is an intervention which can be successfully used by numerous professionals, including special educators, teachers, and therapists.
Intended Population: The intervention was found to be effective in cases involving children in elementary school. In other words, SPG is useful for the age group of learners between 6 and 14 years old.
How it is used: When implementing SPG, it is important to first specify which behavior or skill the intervention will target and in which setting. Moreover, the peers participating in the intervention, the frequency of the meetings, and materials used also must be determined. Each participant has to receive their role and be informed on the rules of the meeting, and the opportunities for the learner’s outcomes should be identified (Sam et al., 2018).
During the implementation stage, the learner should be told the purpose of the group and how it can help them. Next, the play activities should be performed and coordinated if the need arises. Additional interventions can be implemented, such as prompting and visual supports. Gradually, adults must be removed from the group to ensure that that all children are able to engage in play activities on their own. Eventually, the intervention needs to be assessed to discover whether it was successful, and relying on the data next steps have to be determined.
Two resources to find out more: How to use SPG
Ennis-Cole, D. (2019). Seeing autism through parents’ feedback, sketchnotes, technology, and evidence-based practices. Springer.
Sam, A., Kucharczyk, S., Waters, V., & AFIRM Team. (2018). Structured play groups. National Professional Development Center on Autism Spectrum Disorders. Web.
Task Analysis (TA)
Description: Children experiencing ASD often face problems with performing daily routines such as putting on clothes, and TA is used to help them solve such issues. The approach involves breaking one task into several parts, the practice which can significantly facilitate the process of skill acquisition for children diagnosed with ASD (Pratt & Steward, 2020). The concept of chained behaviors is critical for TA, and it refers to skills consisting of multiple steps, for instance, grocery shopping. The learner subject to TA works in a group with teachers or other people supporting them and explores each step in detail. Gradually, they must become independent at performing the target task or skill and will manage to complete it without assistance. The intervention can be utilized for the improvement of various outcomes, including social, communication, motor, adaptive, joint attention, and academic ones.
Intended Population: The intervention is relevant mainly for children with ASD and not teens or people older than 20 years old. Thus, the primary population for TA is children aged between 6 and 14, elementary and middle school students.
How it is used: TA begins by determining the initial skills of the learner and identifying the main components of the target skill or activity. Then, each step of the task has to be analyzed to ensure that the learner can perform them, and an appropriate method of teaching should be chosen (“Task analysis (TA),” 2016). During the implementation stage, the target skill can be taught starting from the final step using backward chaining or beginning from the first step utilizing forward chaining. When the former is chosen, the learner must receive assistance during the initial steps and be encouraged to perform the last one themselves. In the case of the latter, the teacher must prompt the learner to perform the first step, and then they should receive assistance during the following ones. Once the intervention is finished, the teacher must collect data and assess the results and determine the next activity.
Two resources to find out more: How to use
Pratt, C., & Steward, L. (2020). Applied behavior analysis: the role of task analysis and chaining. Indiana University Bloomington. Web.
Task analysis (TA). (2016). National Professional Development Center on ASD. Web.
Video Modeling (VM)
Description: Video Modeling is one of a few interventions for children diagnosed with ASD which relies on technology. Specifically, VM implies utilizing display equipment and video recording to produce a visual representation or a model of a certain skill or behavior (Alhuzimi, 2020). VM is a flexible intervention which also can be introduced in combination with other procedures, including prompting and reinforcement, in order to secure better outcomes for the learner. VM involves showing the targeted activity to the child and thus letting them gain information about the behavior which they need to repeat. The intervention was found to be effective in addressing different types of problems concerning ASD and related to communication, joint attention, social, school readiness, behavior, and play outcomes.
Intended Population: VM is another intervention which is relevant for individuals of different ages, from infants to high-school students. Basically, VM can be successfully implemented in cases with people aged between 0 to 22 experiencing ASD symptoms.
How it is used: First, the targeted skill or behavior must be identified, as well as the type of video which will be recorded and demonstrated as part of the intervention. The teacher also needs to choose the reinforcers which will be used to encourage the learner to embrace the new behavior (Cox & AFIRM Team, 2018). Then, the video itself should be recorded, and viewing equipment must be presented to the child if needed. During the implementation stage, the teacher has to show the video to the learner and prompt them to repeat the activity which they observed. Reinforcers can be used to encourage the learner, and all errors have to be corrected. Once the learner gets better at performing the skill or behavior, the video should be gradually removed. After finishing the intervention, the data must be assessed and the next steps determined.
Two resources to find out more: How to use VM
Alhuzimi, T. (2020). Efficacy of video modelling (VM) in developing social skills in children with autism spectrum disorder (ASD) at school in Saudi Arabia. International Journal of Disability, Development and Education, 1, 1–15. Web.
Cox, A., & AFIRM Team. (2018). Video modeling. National Professional Development Center on Autism Spectrum Disorders. Web.
Functional Behavior Assessment (FBA)
Description: Functional Behavior Assessment is a method of analyzing the conduct of a child with ASD symptoms. FBA is utilized in cases when children are experiencing considerable problems with their behavior which can eventually lead to safety concerns or significantly impact their health and development (Turner, 2018). FBA is usually a prerequisite for every other intervention utilized for reducing the symptoms of ASD. Therefore, the specialists who conduct FBA work closely with experts who wish to determine the purpose or function of a particular behavior. As with any other assessment tool, FBA heavily relies on data collection, which is critical for its successful implementation.
Intended Population: FBA is a universal intervention which can be used to analyze individuals of different age groups. FBA is effectively used in cases involving both children and teens, starting from 0 to 22 years old.
How it is used: FBA is a serious matter, therefore, in order to conduct it, a multidisciplinary team has to be established. Then, the team has to determine which of the behaviors of the patient constitutes the most problematic one, usually, these are those raising safety concerns. During the first stage, the records of the learner also should be studied, and assessment procedures will be identified in order to gain additional information (“Functional behavior assessment (FBA),” 2016). The active phase of the intervention involves a collection of data such as frequency and severity of the behavior with the help of the assessment procedures. After the data collection, an analysis must be performed, and a hypothesis should be produced and tested. Then, the team must choose the appropriate interventions and develop a plan of implementation of these procedures. Finally, the team has to continue monitoring the behavior and determine the next steps depending on the situation.
Two resources to find out more: How to use FBA
Functional behavior assessment (FBA). (2016). National Professional Development Center on ASD. Web.
Turner, K. (2018). Functional behavior assessment: Case studies and practice. Cognella Academic Publishing.
Functional Communication Training (FCT)
Description: Functional Communication Training is an intervention which is used to deal with maladaptive and even aggressive behaviors. The core idea of FCT is that every inappropriate behavior constitutes a form of communication and has a certain purpose (“Functional communication training (FCT),” n.d.). FCT serves to, first of all, identify the real need of the learner by assessing their non-productive conduct. Additionally, FCT is used to discover a replacement behavior which will have the same purpose but will not entail any aggression. In other words, FCT involves teaching a child to attain their goals in a socially acceptable manner and prevents them from engaging in disruptive behaviors.
Intended Population: The intervention can be effectively used in the majority of age groups from pre-schoolers to high-school students. Thus, teachers can employ FCT when working with individuals aged between 3 and 22.
How it is used: FCT starts by identifying the problematic behavior of the individual and determining its core function, and the person tries to achieve with it. Then, the teacher must find a behavior which will replace the previous one yet will serve the same purpose (AFIRM Team, 2017). During the implementation phase, the teacher has to provide the learner with training for the replacement behavior using prompts which, as the child improves their conduct, should be gradually removed. The new behavior then must be reinforced by giving the learner a response which leads to the outcome they desire. At the same time, reinforcement for the unwanted behavior must not be provided to the learner. The teacher also should promote the generalization of the new behavior by the learner and engage in correcting the new conduct if needed. Finally, the data on the intervention must be collected and used to determine the next activities.
Two resources to find out more: How to use FCT
AFIRM Team. (2017). Functional communication training. National Professional Development Center on Autism Spectrum Disorders. Web.
Functional communication training (FCT). (n.d.). Association for Science in Autism Treatment. Web.
References
AFIRM Team. (2017). Functional communication training. National Professional Development Center on Autism Spectrum Disorders. Web.
Akers, J., Davis, T., & Gerow, S. (2020). Self-injurious behavior, rituals, and stereotypies in dual diagnosis. In J. Matson (Ed.), Handbook of dual diagnosis (581–595). Springer.
Alhuzimi, T. (2020). Efficacy of video modelling (VM) in developing social skills in children with autism spectrum disorder (ASD) at school in Saudi Arabia. International Journal of Disability, Development and Education, 1, 1–15. Web.
Cosgrave, G. (n.d.). Extinction procedures. Educate Autism. Web.
Cox, A., & AFIRM Team. (2018). Video modeling. National Professional Development Center on Autism Spectrum Disorders. Web.
Ennis-Cole, D. (2019). Seeing autism through parents’ feedback, sketchnotes, technology, and evidence-based practices. Springer.
Functional behavior assessment (FBA). (2016). National Professional Development Center on ASD. Web.
Functional communication training (FCT). (n.d.). Association for Science in Autism Treatment. Web.
Griffin, W., & AFIRM Team. (2017). Scripting. National Professional Development Center on Autism Spectrum Disorders. Web.
Lei, J., & Ventola, P. (2017). Pivotal response treatment for autism spectrum disorder: current perspectives. Neuropsychiatric Disease and Treatment, 13, pp. 1613–1626. Web.
McKenney, E. (2020). School-based consultation and students with autism spectrum disorder. Routledge.
Morin, K. L., & AFIRM Team. (2018). Extinction. National Professional Development Center on Autism Spectrum Disorders. Web.
Pratt, C., & Steward, L. (2020). Applied behavior analysis: the role of task analysis and chaining. Indiana University Bloomington. Web.
Sam, A., Kucharczyk, S., Waters, V., & AFIRM Team. (2018). Structured play groups. National Professional Development Center on Autism Spectrum Disorders. Web.
Social narratives (SN). (2016). National Professional Development Center on ASD. Web.
Southern, L. (2017). Social narratives support individuals with autism. Autism Society of North Carolina. Web.
Suhrheinrich, J., Chan, J., Melgarejo, M. Reith, S., Stahmer, A., & AFIRM Team. (2018). Pivotal response training. National Professional Development Center on Autism Spectrum Disorders. Web.
Task analysis (TA). (2016). National Professional Development Center on ASD. Web.
Tomaszewski, B., & AFIRM Team. (2017). Response interruption/redirection. National Professional Development Center on Autism Spectrum Disorders. Web.
Turner, K. (2018). Functional behavior assessment: Case studies and practice. Cognella Academic Publishing.