One of the accepted, behaviorally based therapies for people with autism is Pivotal Response Training (PRT). Although many ABA providers, including the one we used during Moe's first year of early intervention, incorporate the concepts of PRT into their programs, few are exclusively implementers of PRT. Moe and I have been lucky to be accepted into a research trial at Stanford, and will be receiving 12 weeks of PRT!
PRT focuses on motivation. Although there are specific ways this is implemented, the general idea is to find your child's motivation and use it to elicit a response. In our case, we want a verbal attempt at saying the word. So if Moe wants his monkey toy, I hold the monkey, and say "monkey?" Then I wait for a response. If he says, or tries to say, monkey, he gets it; otherwise he doesn't. We're building the associations between words and getting what he wants.
This is only our first week, and though the concept is simple, the practice is challenging. It is hard to find something that truly motivates Moe. Though he has toys, activities and foods he likes, when asked to work for one, he'll usually walk away.
It is also tough to determine what is a true vocal attempt. You don't want to accept crying, whining or laughing since you don't want to associate those things with getting a desired result. Moe does a lot of singing and what I think are vocal "stims," or random sounds he likes to make. So I'm finding it tough to determine what is a true verbal attempt.
Finally, because this is a study focused on speech, I can't accept sign language. Although Moe doesn't do a lot of spontaneous signing, he will often sign when prompted or if the sign is modeled. And now that I'm focused on getting him highly motivated, Moe is signing better than ever. Part of me thinks that this is bad; any attempt at communication should be rewarded. But the focus of this study is language, and ultimately we want Moe to speak. (I'll talk more about this in the future.) And he can talk a little when he tries. So, as the researcher told me, for the next 12 weeks, we focus on speech.
As Moe approaches his fourth birthday and still doesn't speak, I'm really hoping this study produces some results for us. I'll update more as we progress through the study.
