Behavioral Therapies for Children with Autism Spectrum Disorder
1. Pivotal Response Training (PRT)
A play-based, child-led behavioral approach that targets "pivotal skills" such as motivation, communication, and social initiation.
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Uses natural environments instead of structured drills.
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Encourages spontaneous communication and engagement.
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Considered a behavioral approach but more flexible and child-centered than traditional ABA.
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2. Positive Behavior Support (PBS)
A behavior-support model that focuses on understanding why a behavior occurs and changing the environment to reduce stress.
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Emphasizes prevention and teaching new skills.
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Often used in schools and home settings.
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Highly aligned with neurodiversity-affirming practices.
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3. Functional Communication Training (FCT)
A structured approach that teaches children to replace challenging behaviors with meaningful communication.
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Often used when behaviors are linked to unmet communication needs.
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Can be combined with speech therapy or AAC
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Evidence-based and widely used in schools and clinics.
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4. Cognitive Behavioral Therapy (CBT) - Adapted for Autism
A psychological therapy - not a behavior modification program - used to help autistic children manage anxiety, emotional regulation, and social understanding.
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Uses visual supports, concrete examples, and special interests.
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Effective for anxiety, depression, and emotional regulation challenges.
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5. Social -Relational Approaches
These focus on connection, communication, and shared engagement rather than behavior change.
Examples include:
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DIR/Floortime - builds emotional connection and communication through play.
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Relationship Development Intervention (RDI) - focuses on dynamic thinking, flexibility, and parent-child interaction.
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Social Skills Groups - helps children practice communication, problem-solving, and peer interaction.
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My Recommendation
As a parent of a child with autism, I explored just about every behavioral approach available. I attended countless parenting classes that focused on positive behavior supports, creating social stories to ease transitions and improve communication, the Floortime approach, and the Nurtured Heart approach. Each one offered something helpful in its own way.
What made the biggest difference for my child, however, was the Social Thinking® framework developed by Michelle Garcia Winner. Through that lens, I began to understand that many of my child’s behaviors were rooted in anxiety and frustration—especially when he struggled to interpret social situations or communicate effectively with peers. Once I recognized that his challenges were tied to social understanding rather than “behavior,” everything shifted. It allowed me to support him in a way that honored his experience and helped him feel more confident and understood.
Resources
www.autism.org/treating-behavioral-issues
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The Child with Special Needs by Stanley I. Greenspan, M.D. and Serena Wieder, PH.D. with Robin Simons
The Out-of-Sync Child: Recognizing Coping with Sensory Processing Disorder by Carol Stock Kranowitz, M.A.
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Mind in the Making: The Seven Essential Life Skills Every Child Needs by Ellen Galinsky
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