Pivotal response treatment (PRT)

PRT is a play-based way of delivering applied behavior analysis (ABA). It aims at a few key skills, such as motivation, starting communication and self-management. Progress there can help with many other skills. Your child helps pick what to play and gets rewarded for good tries as well as correct answers.

The Centers for Disease Control and Prevention (CDC) says the T stands for training, while many researchers say treatment. Both names mean the same approach. A 2019 trial found more functional speech with PRT than in a group still waiting for it, while a 2017 review notes that few such trials exist and one found no difference in spoken language. That 2019 trial included children aged 2 to 5 and paired parent training with in-home sessions.

Your child might pick between two toys while the therapist waits for them to ask. If your child says "car," they get the car to play with rather than a candy. PRT happens in natural settings such as home and play, and parent training is a common part of PRT programs. Because PRT is based on ABA, it can be part of an ABA program rather than its own therapy.

• How PRT fits the plan: Ask your Board Certified Behavior Analyst (BCBA) whether PRT strategies are part of your child's plan, and which key skills they target.
• What counts as a try: Ask how the team decides which attempts to reward, so you can do the same at home.
• Young children: If your child is a toddler or preschooler, ask how play-based teaching would look in ABA for toddlers.