Saturday, May 11, 2013

Pivotal Behaviors

Individuals with developmental disabilities present a myriad of challenging behaviors. Addressing each one of them separately can be a daunting task for parents, staff and the clients themselves. Successfully addressing multiple behaviors with one intervention is often necessary. PRT (Pivotal Response Training- Koegel, O’Dell and Koegel, 1987) focuses on critical behaviors that are central to many areas of functioning, such as communication and social skills. PRT is built on the premise that improvement in these key pivotal behaviors opens the door to improvement in other areas as well. In other words, teaching pivotal behaviors produces widespread positive effects on other behaviors.  

This is a positive, naturalistic behavior intervention based on Applied Behavior Analysis principles that focus on teaching specific behaviors in the natural settings and is used successfully to help children with ASD and other developmental disabilities. Key pivotal behaviors addressed include motivation and responsivity to multiple cues. 

Motivation: Children with developmental disabilities are frequently viewed as lacking motivation to initiate and respond appropriately to stimuli, to learn new tasks or engage in their social environments. They demonstrate this lack of motivation by engaging in non-compliance, tantrums or other challenging behaviors to escape tasks and social interactions. They may not initiate conversations or ask and answer questions. These children are so difficult to motivate perhaps because since they often fail, they have learned not to try.

Thus, motivation is a key component of a behavior modification program. Lack of motivation constitutes a barrier to teaching appropriate behaviors. A motivated child is interested in learning. Research indicates that increase motivation has a dramatic positive effect on children’s learning (Koegel, O’Dell, & Dunlap).

I like the phrase We can not teach if we cannot motivate” because it summarizes the importance of focusing on motivation.

Responsivity: Children with developmental disabilities are characterized by “stimulus overselectivity”, and attention deficit in which they select or focus on only one part of the environment or an object. A child may focus only on round part of an object such as the wheels on a car. Increasing children’s responsivity to multiple cues is an important pivotal behavior that may help them to learn more from typical educational strategies and naturally occurring situations, which ultimately leads to engage more in desirable and functional social behaviors.

Parents and professional should focus and take advantage of naturalistic child and family-centered situations. Here are some tips:

1. Implement teaching sessions around objects, activities or topics that the child prefers in order to increase motivation. For example, if your child is “crazy” about cars, engage in playing with him the way he plays with cars (start imitating what he does), and slowly include and model social interactions, such as “the red car asks the blue car to play”, or “all the cars are having a playdate” and they take turns while playing games, share toys, collaborate in building with Legos, etc.

2. Take advantage of natural situations to teach. For example, having dinner, taking a bath or doing groceries are great opportunities to model behaviors and increase motivation.  

3. Parent, teacher, make sure that the child is attending to you by getting down to his level, calling his name or asking “Are you ready?”, and then presents the child with a question or instruction that is directly related to the setting, task and material available. In our example, playing with cars.

4. Very Important: All attempts to respond appropriately (even if the response is not perfect) are rewarded. Ample time is allowed so the child can try to respond without stress. Prompt (model, guide) appropriate responses to end always on a positive note, the reward. This allows the child to experience success, which increases motivation.

5. Use rewards directly related to the task and the natural environment. If you are playing cars, the child receives another car, or gets access to his favorite car, for example.  

In sum, teaching pivotal behaviors is a child-centered intervention that can be implemented across settings (school, home and the community) and across caregivers. Once parents learn how to do it, they become the therapists and thus, the intervention is in place 24/7.  

This intervention has been most successful in improving social and communicational behaviors of children with developmental disabilities in the areas of language, play and social interaction.

Another example of an effective way we can help to improve the quality of live of individuals with developmental disabilities and their families.


Daniel Adatto, BCBA