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Social Skills: The Benefits of Peers and Pivotal Response Training

Social behavior is complicated, and for individuals with a diagnosis of autism, the social barriers can be daunting.  Also, the lack of motivation to learn and generalize complex social behavior is a common problem that is well known in this population. Pivotal response training (PRT) is a method that has been shown to help the motivation problem while increasing generalization.

Sidenote: Why is generalization so important for children with autism? Many individuals with autism learn a new skill in one setting and cannot demonstrate that same skill in another setting. If a child learns a skill that occurs at other times, in other places, and with other people and without the need to relearn that skill in each new setting and with each new person—generalization has occurred. The other important piece of generalization: if a new skill emerges that was not directly taught and is part of the original skill—generalization has occurred. Here’s an example: a child who is learning to tie her shoes calls out to her mom, “I need help!” Later that week, the child is having shoe-tying problems again and sees that her mom is on the phone. This time, she waves her arm back and forth to signal help from her mom. The child had not been trained to wave her arm back and forth when she was originally taught to ask for help appropriately, but she successfully learned a new skill that served the same function.

While PRT is a well thought out method, it is nevertheless carried out during natural activities that look like typical interactions. These natural techniques have been used to increase language, attention, play, and social skills. Because the training techniques are more natural, typical peers (who have a great potential to produce behavior change in individuals with autism) can implement the technique. PRT can be implemented on the playground, in the classroom, in the lunchroom, and at home. Plus, PRT focuses on different objects and activities in the natural environment that are found to be reinforcing for the child (which helps with the motivation problem) and can be effective for children at all levels of the autism spectrum.

How is it done? Pierce and Schreibman published their research on peer-implemented PRT in the Journal of Applied Behavior Analysis and this is what they found:

One participant in the study was a 10 year old with a diagnosis of autism who had the vocabulary of a 3 year old and isolated himself during free-play sessions. The other participant was a 10 year old, also with a diagnosis of autism, who was described by his teacher and parents as “unresponsive” and engaged in repetitive actions and tantrums. Both participants were in a special education classroom. The peer trainers were both 10 years old and were chosen by the teacher and described as “cooperative and friendly.”

Peer trainers were trained though modeling and performance feedback using some of the following PRT strategies:

  • Making sure that the child was paying attention to the comment or instruction before it was delivered;
  • Giving the child plenty of choices in play activities so that motivation remains high;
  • Verbally reinforcing any attempts with social interaction (e.g., “great throw”);
  • Providing many different examples of appropriate play and social interaction, including verbal statements (e.g., “this game is fun!”);
  • Encouraging conversation by withholding the preferred activity or object until the child produces a verbal response related to the activity (e.g., the child may be required to say “let’s play ball”);
  • Encouraging additional conversation by talking about tangibles in the room (e.g., “I like pizza, do you like to eat pizza or ice cream?); and
  • Describing the play activity that is taking place (e.g., while opening the cabinet, the peer says “I’m going to make some cookies”).

What was the outcome? After several weeks of training, both children began to initiate play and conversation with the peer role models and maintained the initiations after treatment. Finally, both children generalized these skills to different play activities and different settings. The frequency of language also increased for both children. Finally, both children’s ability to engage in joint attention increased (being able to switch from an activity, then to another person or activity or object).

This study demonstrates how easy it can be for peers to learn a comprehensive treatment package in a relatively short period of time, how the treatment can take place in multiple natural settings at a relatively low cost, and how minimal adult supervision is required once the peers are trained. The obvious benefit is that the children benefited from treatment in multiple social skill areas.

Reference:

Pierce, K., & Schreibman, L. (1995). Increasing complex social behaviors in children with autism: Effects of peer-implemented pivotal response training. Journal of Applied Behavior Analysis. 28, 25-295.

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