Implementing Pivotal Response Treatment to Teach Question Asking to High School Students with Autism Spectrum Disorder



For many adolescents with Autism Spectrum Disorder (ASD), navigating the complexities of social communication can be a significant challenge. Initiating conversations, a key social skill often facilitated by asking questions, can be particularly difficult. A recent study published in June 2024 sheds light on a potential solution: Pivotal Response Treatment (PRT) as a tool to improve question-asking abilities in high school students with ASD. Let’s delve deeper into the research, explore the challenges faced by students with ASD, and unpack the potential of PRT as an intervention strategy.


Understanding the Social Communication Gap in ASD


Social interaction is a nuanced interplay of verbal and nonverbal communication. For adolescents with ASD, this intricate dance can be particularly challenging due to core deficits in social communication. These challenges often manifest as difficulties with:

  • Initiating conversations: Starting a conversation can be daunting, especially when formulating appropriate opening lines or greetings. Students with ASD may struggle to overcome this initial hurdle.
  • Maintaining eye contact: Eye contact plays a crucial role in social interaction, conveying interest and attentiveness. However, for some individuals with ASD, maintaining eye contact can feel uncomfortable or overwhelming.
  • Taking turns speaking: Understanding the flow of conversation and waiting for appropriate moments to speak can be difficult. Students with ASD may unintentionally interrupt or speak over others.
  • Recognizing nonverbal cues: Facial expressions, body language, and tone of voice all contribute to understanding the full meaning of communication. Individuals with ASD may struggle to interpret these nonverbal cues, leading to misunderstandings.


Asking questions is a fundamental aspect of initiating conversations and fostering reciprocal communication. Students with ASD may face difficulties formulating appropriate questions or struggle to initiate them seamlessly within social contexts. This can hinder their ability to learn new information, engage with peers, and build meaningful relationships.


Introducing PRT: A Potential Intervention for Enhanced Communication


Pivotal Response Treatment (PRT) is an evidence-based intervention designed to improve core social communication skills in individuals with ASD. Traditionally implemented with younger children, this particular study explored the applicability of PRT in a high school setting. The researchers aimed to answer two key questions:

  1. Educator Training: Can educators be effectively trained to implement PRT with high school students with ASD?
  2. Student Outcomes: Does PRT intervention improve question-asking behavior in high school students with ASD?


Research Design and Promising Findings


The study employed a concurrent multiple baseline design across three dyads (pairs) consisting of a high school student with ASD and their educator. This design allowed researchers to isolate the impact of PRT on question-asking behavior while controlling for external factors.


The findings, while promising, revealed some interesting nuances:

  • Educator Training: All educators showed improvement in their ability to utilize PRT strategies after undergoing training. However, only one educator consistently achieved a high level of fidelity (accuracy) in implementing the program throughout the intervention. This highlights the importance of ongoing support and monitoring to ensure educators effectively deliver the PRT program.
  • Student Outcomes: Two out of the three students with ASD demonstrated significant increases in their frequency of asking targeted questions (who, what, where) following PRT intervention. This suggests that PRT has the potential to be an effective tool for improving question-asking skills in high school students with ASD.


It’s important to note that these results are based on a pilot study with a small sample size. Further research is needed to confirm these findings and explore their generalizability to a wider population.


The Road Ahead: Building on Promising Developments


This pilot study offers valuable insights into the potential of PRT for enhancing social communication skills in adolescents with ASD. However, there’s still room for further exploration:

  • Refining PRT Implementation: Researchers can delve deeper into tailoring PRT methods specifically for the high school setting, considering the unique developmental needs and social dynamics of this age group.
  • Long-Term Sustainability: Investigating whether these improvements in question-asking behavior are sustained over time is crucial for understanding the long-term impact of PRT interventions.
  • Expanding the Scope: Exploring the impact of PRT on other aspects of social communication, such as maintaining conversations and interpreting nonverbal cues, could provide a more comprehensive understanding of its effectiveness.


By building on this research, educators, therapists, and parents can develop more robust interventions to equip high school students with ASD with the social communication skills they need to navigate the complexities of social interaction and thrive in educational and social settings. As research progresses, PRT has the potential to become a valuable tool in empowering adolescents with ASD to become more active participants in social communication.



Leave a Comment

Your email address will not be published. Required fields are marked *

Scroll to Top