FAB Strategies John Pagano, Ph.D., OTR/L

PRT: Secret Sauce for Improving Behavior

An extremely effective approach for improving behavior is often unknown to most of the therapists in my workshops. The approach is Pivotal Response Training (PRT) which has been shown to significantly improve behavior, speech and neurological development in children with Autism Spectrum Disorders (Ventola et al., 2014). PRT was developed by an expert in Applied Behavior Analysis “Robert Koegel” who was smart enough to marry a Speech Pathologist “Lynn Koegel”. PRT is a form of ABA that respects the knowledge of occupational, physical, speech and mental health therapists as well as classroom teachers (Stahmer & Suhrheinrich, 2011). PRT uses Applied Behavior Analysis to improve the development of motivation, generalization, social skills, and self-management (Koegel & LaZebnick, 2009).

A great video shows how the development of generalization and motivation are achieved when Dr. Lynn Koegel teaching a young child with Autism to try to verbalize “swing”, then pushing him on the swing Dr. Lynn Koegel developing speech This treatment video demonstrates how PRT uses developmentally appropriate sensory activities that the child enjoys such as swinging and promotes motivation by rewarding the child for trying to say  “swing”. The typical context of the task promotes generalization and self-management, while social skills are improved by embedding adult interactions of being pushed on the swing in the reinforcement. The evidence-based and developmentally appropriate skills embedded in the PRT approach make it a useful component of FAB Functionally Alert Behavior Strategies.

I learned about PRT when I asked the director of the Yale Child Study Center after a presentation what the most effective treatment was for Autism and he suggested PRT. I went out to Santa Barbara, CA and after taking a workshop agreed with his recommendation (full disclosure, a conference in Santa Barbara is not hard to take, it’s literally on the ocean). For fellow Connecticut residents who have a child with Autism and language or behavior problems I suggest participating in Yale’s PRT research studies



Koegel LK, LaZebnick C. Growing up on the spectrum. New York: Penguin Books; 2009.

Stahmer, AC, Suhrheinrich, J  Classroom Pivotal Response Teaching. NY, NY: Guilford Press; 2011.

Ventola P, Yang DY, Friedman HE et al. Heterogeneity of neural mechanism of response to pivotal response treatment. Vrain Imaging Behavioral. 2014;9(1):74-88.