Pivotal Response Therapy (PRT) – Exercises for parents of ASD children and ASD professionals

Showing is a pivotal behavior because it opens the door to social attention, praise, commenting, and other intrinsic features that motivate children to want to share things with others. 

First, you show your child things. While you are in front of the child say “Look!” and hold the interesting object in front of your child. This will encourage your child to shift his gaze to the object. As soon as he does, name the object and hand it right over. Do this many times each day with objects your child is interested in. 

Since you and your child are already taking turns with the objects that your child comes into contact with each day, start holding them out to show what it’s called, how it works, or what new actions can be done with it before you give it. 

During toy play, hold up an object and call your child’s name: “Toma, look!”. When he looks, name it “It’s a balloon”, then do something with it (let go the inflated ballon). Pairing the concept of “showing” with a fun and interesting effect also rewards the look and is likely to strengthen your child’s response. 

At meals, while the child is focused on his plate, pick up a container of a highly preferred food and say “Look!” while showing the container. After your child looks,hand over some of the food. 

At bedtime, as you are looking at a book with your child, point to a picture while saying “Look, it’s a [object name]”. When your child shift his gaze to the picture, make an interesting effect (a sound or an action with the book).

If your child doesn’t eat at the table, you can work on this step by step. Try to structure three meals and three snacks a day, all at the table and all involving others, while you decrease/ eliminate eating on the run. 

If the child is sitting down to eat, this gives you the chance to work on many other skills like requesting, imitating, and communication skills. 

1. Begin by requiring the child to seat down wherever he or she is, if sitting at the table is too far. Once seated, you can hand your child food or drink. If the child starts to get up while holding the food, consider taking the food away and encouraging your child to sit down again. If your child isn’t yet full, he will be hungry again soon and you can practice again. 
2. Once your child sits, switch to having the child sit in the kitchen, near the high chair. Try to give your child as much as he or she can eat at one time, and then put off the next snack or meal for an hour or two. 
3. Once the child is sitting in the kitchen for all food and drink, move the eating place to the chair. You will sit right across from your child. 
4. Sit with your child; have your child’s food on the table, offer your child food and name it. Make it a social time!

Give the child multiple opportunities to choose during the day. 

For example, during the dressing routine, in the morning, he can choose between two blouses, the one he likes the most. 

During mealtime, he can choose which chair to sit on and from which plate he wants to eat.  

Give him the opportunity to choose the order in which to do activities (first I do maths, then writing; first I play with the cars, then with the playdoh).