Episode 30 The Magic of Motivation: How PRT and NDBIs Transform Learning for Autistic Children

In this episode of the NDBI Navigator Podcast, Dr. Jamie welcomes Dr. Grace Gengoux, a nationally recognized expert in evidence-based autism intervention, clinical psychologist, BCBA-D, and faculty member at Stanford University. Together, they explore the power of motivation, flexibility, and collaboration in supporting autistic children through Naturalistic Developmental Behavioral Interventions (NDBIs), with a special focus on Pivotal Response Treatment (PRT). Dr. Gengoux shares her journey into the field, the science behind pivotal behaviors, and groundbreaking research on parent coaching, telehealth delivery, and optimizing intervention approaches for diverse learners.

Transcript

SPEAKER_01 0:02

Welcome back, everybody. I'm excited to have Dr. Grace Jonghu with us, who is a nationally recognized expert in evidence-based autism intervention. She's a clinical psychologist, a BCBA at the doctoral level, and clinical professor in the Department of Psychiatry and Behavioral Sciences at Stanford University School of Medicine. And I had the privilege of getting to listen to Grace talk with us last year at the 2025 NDBI Connections Conference. So I'm definitely going to ask her to share some of that research and information with you all on our episode today. Grace, thank you so much for coming on.

SPEAKER_00 0:43

Thank you so much, Jamie. I'm delighted to be here.

SPEAKER_01 0:46

Yes. Can you tell us a little bit more about your background, your journey into NDBI for professionals who are just getting to meet you through this podcast today?

SPEAKER_00 0:58

Absolutely. Thanks so much for giving me the opportunity. I, as you mentioned, I'm a clinical psychologist and a BCBA, and I direct our autism intervention programs here at Stanford. And I see patients and supervise people who are practicing pivotal response treatment, which is a type of NDBI, and I run our PRT training program. And as you know, PRT is one of these techniques that has strong scientific support. It's a type of ABA, but it's different from the structured and adult-directed forms of ABA because it uses play-based and child-directed approaches to motivating autistic children. And, you know, my formal training in NDBI comes from completing graduate work. I studied with doctors Robert and Lynn Cagle, who, along with Laura Schreibman, you know, developed the model that we call Pivotal Response Treatment. And that was really inspiring to me because the Kagels and I also got to know Dr. Schriedman over the years. They're really such creative clinicians, and they really pioneered the idea that motivation really matters. And they just fundamentally believe that all children can make meaningful progress. And that was so inspiring to me as a young clinician and a young scientist. And I think I just learned to be a really astute observer of each individual child and always work on things that matter to the child and family and to try to stay creative and flexible when I'm trying something that's not working. And then I left UCSB when I completed my graduate program and went to the Yale Child Study Center. And I had an opportunity to work on studies of infant siblings there and explore how to adapt treatments for very young children, like before the symptoms of autism were even developing. And how to prevent the worsening of those symptoms in kids who had a high likelihood for developing ASD. And then at Stanford, once I joined the faculty at Stanford, you know, we we have been on a journey. I'll be happy to tell you about studying the different types of ways that PRT can be can be delivered. And I also had a chance to do ESDM at the early start Denver model training as part of a project that we were doing a number of years ago. Um where we're going to be delivering ESDM and PRT to try to understand who who benefits from which treatment and how we can optimally combine developmental and behavioral intervention approaches for a diverse range of children.

SPEAKER_01 3:56

I am so excited about that. I'm so excited that you'll share that with people to get a better understanding and how exciting that is to kind of put them together and to really kind of tease out these different profiles of kiddos and these different characteristics of NDBI models and how we can align the stars to try to get the best fit for those kiddos with the treatment options that are out there to see that optimal, that optimal outcome that's meaningful, like you had mentioned. And I just think that's so critical and needed to have these types of studies. So I am just woo! Happy hands over here, so excited that that is coming and will be out soon. I wanted to highlight something that you said being creative and flexible, and you being able to learn from your mentors and being able to do that. And I think that's something that we do so well in NDBI when we are astute observers of those children's interests, preferences, and motivation. And it just kind of makes me chuckle sometimes when staff are not creative and flexible, but want the children to be who already, you know, have a little bit of extra work to do. So I love that you say that it's important for us to be creative and flexible as well as we support autistic children. So thank you for saying that.

SPEAKER_00 5:15

It's it's so true. I mean, flexibility is a challenge for all of us, but if we can uh focus on what really matters and you know stay true to those things, but a lot of times the you know, how we teach or the materials we use or the timing of the teaching actually doesn't matter. Or it does matter, but but we don't have to go according to plan. If we adjust our timing or our materials or our approach, we can get kids to respond much more easily. And that's part of the magic is being flexible to to match the child's level of interest.

SPEAKER_01 5:56

I want to put magic of motivation because that is like something we should be trademarking. Magic motivation, magic, the book, right? Go. It's so true. And I just love the natural reinforcers and teaching within the natural environment and all the other things that PRT does so well in terms of really looking and capturing and contriving those sources of motivation, but also going back to being creative. If that is how a particular child wants to play in this particular way, like we can lean into that and try to build some learning around it, as opposed to redirecting to a different, more quote unquote appropriate way to play with a toy, which might not be motivating for a child, which loses all of the meaning and your learning opportunities. So being an astute observer, as you shared, I think is such a really humbling thing to do because it's hard.

SPEAKER_00 6:50

So true. But you know, you asked about kind of what inspired my my journey, and some of what you're talking about is totally what got me captivated at first. I was I had an opportunity to inter to volunteer for an autism center as an undergraduate student. Actually, it was a autism center that Laura Schryman founded many, many, many years ago. And and Margie Sharlop was um leading that at the time. And I was just completely captivated by the way that scientific knowledge and databased decision making could be applied to helping families with real life challenges that they were facing using that flexibility that you were talking about. And they were using some of the earliest forms of NDBI, the techniques we we called in those days the natural language paradigm. And I saw how well they were working, motivating kids who had really significant developmental challenges to try things that were hard for them and enjoy the process. And I just loved connecting with those parents. They were so dedicated, so inspiring, so grateful to be learning strategies that they could really use in their everyday lives right away. And that's honestly what made me want to go to grad school.

SPEAKER_01 8:11

I, you know, it just the magic of the motivation.

SPEAKER_00 8:14

That's right. That's right. It was so it was so inspiring.

SPEAKER_01 8:18

It is. I think it's inspiring, and I would add on, empowering. I would feel so empowered as a therapist to be able to make that meaningful difference and then have a parent also be able to make that in those real life scenarios and everyday activities, and just being able to kind of help move that needle that they could also do this and support their child. As a parent myself, that is so empowering to feel like I can do something to support my child, that I am the expert in my child, but I might not know the strategies for how to help them best. So being able to work with clinicians that have that mindset is so incredibly valuable.

SPEAKER_00 8:57

Yeah. I mean, I couldn't agree more. That parent training is just such an important key part of it, of course, N DBIs. And it's because parents just love their kids so much. And so if we as clinicians can help parents to channel that incredible love that they feel to help their child grow in a positive way, it's just it's priceless. And um, you know, the parents are really the true experts, but if we can really partner with them and you know be a team, um we can bring the science and the you know clinical art that that we train in and and help families with things they really care about.

SPEAKER_01 9:42

Yes, I always talk about the art and the heart of what we do.

SPEAKER_00 9:46

Oh, I'm gonna take that. That's a good one.

SPEAKER_01 9:48

I know, and I always think about this um this uh container I saw. It was something about SLPs, like a speech therapy session is one marble represents 30 minutes of that child's day. But if we coach and support families and caregivers, then we're adding more marbles, which equates to more minutes and more time, and then that child's glass bottle is full of other ways to support parents, to engage and support social communication, interaction, play. And that was something I found decades ago, and it just stuck with me, like the aha moment of oh my gosh, if we just support the children and don't help with that carryover generalization or empower parents, then they don't know what to do. And instead of 15 hours a week, it could be all of the waking hours that the children are getting opportunities for learning and engagement within those daily routines in a naturalistic way where we push in as opposed to asking a parent to pull out and then try and find more time in an already busy life, right? So it was just such a visual and just stuck there. Yeah. Yeah. So you are Yale and the parent support that you guys have. Is that some of the telehealth research that you guys have been doing? Yeah.

SPEAKER_00 11:04

So um we start when I first started working at Stanford, we um had a program where we were at a research study, we were really interested, and actually Dr. Mendy Manharez developed this program, um, and then we studied it here at Stanford to see if we could do teach parents how to deliver PRT with fidelity in a group model. And um, we published that back in 2015, and it was effective. We were able to get parents in just 12 sessions, these 90-minute group sessions, they were in person back then, we were able to get parents to learn how to deliver PRT with fidelity, and their kids made significant progress, more than children who were doing community-based ABA and speech therapy and other sort of treatments as usual. So that was really inspiring. And then we did another study that was in person to see if by supplementing the parent training with uh in-home clinician delivery of PRT, if we could um, this is another randomized controlled trial that we published in 2019, and to see if we could um get even better effects with a little bit larger dose. And we did see parents still learned how to do PRT, the kids still improved in their language skills, which was the target of the intervention, but also we in that study we saw improvement on the um what's called the BOSC, the brief observation of social communication change, which is a new measure that's designed to try to be sensitive to treatment-related changes, but it measures core autism symptoms. And it was really exciting to us to see that when we teach parents and we have clinicians really focus on functional communication and verbal ability through PRT, that we're getting these collateral effects on core autism symptoms, better joint attention, better social overtures, more you know, social reciprocity, which are things that we do believe improve. That's why there's a pivotal in pivotal response treatment, because that's the idea is that if we can increase motivation, all sorts of untargeted behaviors improve as well. So that's what led us to the telehealth study, um, in addition to the pandemic, which made it important to understand how we can deliver PRT remotely. We we just were just completing another randomized controlled trial of telehealth delivery of PRT, and we're writing up the results right now, so you'll be seeing it soon. And in that study, we um we took families from all over the US and Canada and um showed that we can teach parents to effectively deliver PRT with their children in a this is a 12-week study. So once a week training for 12 weeks, um we're able to get parents to meet Fidelity and their kids also improve in their use of communication skills. And um there's major benefits of telehealth because of course it improves access. Um lots more people can can benefit from that when we're you know when when we're allowing um to dial in and less travel time and all of that. And then most importantly, we're coaching families about how to do the treatment in their real life routines. There's just a major advantage of seeing them in their homes and we can see the real challenges that they're actually facing and just provide really relevant, ecologically valid guidance that's specific to their context.

SPEAKER_01 14:53

Yes, I remember when the the pandemic hit and we were doing PESTM coaching, and ooh, what a challenge that was to be able to coach remotely and in person in vivo. I would jump in and model and slide a toy across the room to help a parent, you know, positional. And from a distance, you have to really kind of hone those coaching skills. And so I really learned a lot from that experience as a professional and how to coach without being more intrusive because I couldn't reach through the camera. But I also kind of piggybacking on what you're saying, like to see the family with the phone is ringing, the baby is crawling across the floor to get something they're not supposed to, and this parent's trying to engage their child, and life just keeps lifing around them. And so when you can coach in that manner, those are pitfalls or barriers that you can try to coach them through and kind of plan that environment for, which is a bit different when they come into a clinical setting and then go home, and we don't get to see that. So, any other benefits that you guys found from that or anything that you found when you shifted to telehealth? Like it was a stretch for me, and I I love it now, but it took some took some practice.

SPEAKER_00 16:06

Yeah. Well, you just made me think about a new study that I want to do, which is the, you know, how we're we're always interested in what are the best ways to train clinicians and training clinicians in parent training. And it does make me really curious how that uh extra challenge of d doing that coaching via telehealth, how that might actually enhance a clinician training. So I'm gonna think more about that for sure.

SPEAKER_01 16:32

Yes. Bug and ear research, using the little bug and ear stuff, uh, or the like the metaglass. Oh, there's so much technology out there now to bring in for that. It's such a difference of not being in the room, observer effect, like being able to coach through that. Um, I love it. Do it so then I can share the link with everyone.

SPEAKER_00 16:50

You know, the other thing that was surprising to us, we had to see kids online for direct therapy online as well during the really acute part of the pandemic. And I didn't think that that would be very effective, but we didn't have much of a choice, so we wanted to try it anyway. And actually, um, I was surprised. We had quite a number of kids who really benefited from that model, and it wasn't only the kids that you would expect who were like already doing pretty well. We had some kids who were really struggling with their in-person sessions and ended up doing pretty well with the telehealth delivery. Now, many times it was thanks to the parents for jumping in and being the deliverer of much of the support the child needed. But also uh you can do some really interesting things with motivation and shared control and uh contingent natural reinforcement online. I'm not saying that it could probably ever replace an in-person interaction, but we had therapists who were so creative. Like I'm remembering a kid who was really interested in airports, and of course you couldn't go to the airport at all at that time. And so uh she had all these virtual backgrounds that she had prepared for him, and they were having nice practice of like early conversation skills with her like standing, you know, pretend standing in the security line, and then pretend checking in at the gate, you know, with a picture of the gate behind her, and then sitting in her seat on the airplane with a picture of the seats on the airplane behind her. And you know, you you can set it up so that if we think about the importance of child choice and child interests, the internet is like an infinite source of opportunity and content for things that children are interested in. So if I only have like a half a dozen dinosaurs in my office, but a kid is interested in dinosaurs, if I'm online, I can produce an infinite number of dinosaurs. And and an airport is a good example of, you know, in my office or even in the child's home, if he's really interested in airports, our ability to follow that interest is a little bit more limited. But uh for kids who enjoy images and you know, conversation about things that are a little bit more abstract, like that, we we had a lot of fun. Um it's so creative. Helping kids learn in that in that context.

SPEAKER_01 19:34

Yeah, and earlier I mentioned enjoying the process, the children. And I think that's so important when we dial into motivation and child choice and autonomy, you just naturally it's gonna be enjoyable. So they're gonna keep coming back for more. And it gives me these if you give a mouse a cookie vibes, like if I do this, I'm more likely that they might also want this. And then we just keep building and putting these kind of behavioral chains in place to keep that learning going. But I would love if you could expand a little bit more on the pivotal behaviors. These are like for me, behavioral cusps, like they just open the door for more incredible learning, just in case anybody's listening who might not be quite familiar with the pivotal part of PRT. Um, I think you mentioned social referencing, joy attention.

SPEAKER_00 20:19

Yeah, absolutely. So when we say pivotal, what we mean is that um, you know, as opposed to many, many years ago when we used to think that you had to teach every single behavior one at a time to autistic children. Um, the idea of having pivotal behaviors is like, I wonder if, and it turns out that there are, we've shown through a lot of science, that I wonder if there are certain behaviors that matter more than others in terms of unlocking new untargeted behaviors. So in PRT, we're really looking for focusing on things that are going to have a broad impact across many domains of the child's functioning. So when people talk about pivotal behaviors, they're often talking about motivation because we we think of that as kind of the most important pivotal area, that if the child is motivated, they can learn and do way more than if they're not motivated. So if we focus on motivation, we can unlock lots of other skills. We are also talking about things like initiations, like learning how to ask questions, because when children can initiate to ask questions, then they can learn plenty of new things. You know, if a if a child learns to ask, what's that? they can grow their vocabulary way faster than the people that are teaching them because they can learn lots of new words. Another pivotal behavior or area that we talk about is multiple cues. Like when children are too focused on just one aspect of their environment, we call this stimulus over. Over selectivity, but if they're so focused on just one aspect of their environment, it's really hard to learn. And so if we can help kids to focus on lots of different things at once, understand multiple cues and kind of unlock or release that stimulus over selectivity, then they can learn in more typical learning environments. And lastly, we talk about self-management, teaching kids, you know, the way the way many of us adults do, you know, keeping a calendar and setting timers and doing things, you know, a grocery list and doing things to monitor our own behavior and help our memory. If we can teach autistic individuals to monitor their own behavior, set their own goals, determine positive consequences for achieving those goals, then that helps them with a level of independence that would be, you know, would be impossible without that. And then in the area of motivation, we the research on PRT over the last 30 plus years has really shown that there are some variables that really boost motivation. And these are the things that we're teaching to parents and to clinicians when when we're hoping that they'll deliver PRT. And it's things like we call it child choice or following the child's lead, which means teaching during an activity the child is really interested in, so that so that they're already bought in and motivated when the thing they're learning is hard, at least they love the content the rest of what they're doing. Yeah. And then the other one that we focus on a lot is maintenance tasks. We call this one task variation, and it's all about how important it is to teach and practice a lot of easy tasks. You know, you think when a kid is behind with their learning that they that you need to force them to do things that are hard all the time, and that's kind of our instinct. But the research actually shows that kids, especially autistic kids, learn best when they have a lot of opportunity to demonstrate the things that they know, and you can kind of create that behavioral momentum where they're feeling good and confident about the work that they're doing, and you can kind of sneak in hard tasks when they don't even notice it's hard, and they it's a lot more fun and the learning is a lot faster. And then those are those techniques really are on the antecedent side of the ABC equation, right? Like really clear prompts when the child we have the child's attention, making sure it's always focused on something that they're interested in and it's always easy. That's kind of the antecedent package that we use in PRT. And then on the consequence side, in addition to contingent reinforcement, which is something that all ABA practitioners use, we focus for motivation on making sure that the reinforcer is related to the child's behavior and interest. So it's not MMs and stickers and iPad time for doing good talking or whatever. But it's it's more about like you know, if you want to play with the wood chips, if the reinforcer is wood chips, if you know, want to um jump on the trampoline, like the reinforcer is jumping on the trampoline. If you you know, it could be, it can be a tangible item like a like a toy or uh food if that's the activity the child is doing, but it can also be um you know uh an action that another person does, or it even even some uh repetitive behaviors are extremely reinforcing to children, and um, so engaging in those can can sometimes feel like a natural reinforcer. And then finally, what we do is we reinforce attempts, not perfection. It doesn't have to be perfect. Um, we know that trying is the most important thing for learning, and so we we don't expect perfection. We figure if the child is even putting in a reasonable effort, no matter how good it turns out. Um, if we can reinforce that, they'll try more the next time.

SPEAKER_01 26:24

Yeah, more momentum coming.

SPEAKER_00 26:26

Yeah.

SPEAKER_01 26:27

Yes, child choice is so important with the motivation. Um, I've I always say you need to reach before you teach. And what I mean by that is you need to have attention, motivation, and a well-regulated child before you even think about instruction. And what I love about NDBIs, ESDM, PRT is this child-centered kind of co-constructive, we're doing this together around something that's meaningful that matters, but we're also being creative with how we do that, kind of building a behavioral trap. If the kid likes wood chips, how can I think about how to embed those learning opportunities? And how can I make that meaningful for the child, but also for myself as a play partner here to be able to do that? Um, or thinking about some of the programs, you know, how do we make math worksheets more reinforcing if that's something that they're gonna do in school? Maybe it starts out with Spider Man counting the way, right? And then we build it into those natural now, it's just numbers on a paper if we get kiddos there. And so being really creative with that source of motivation and aligning it to those interests is so important. Like you said, jumping on the trampoline or the wood chips, like meet them where they're at, not where you want them to be. So if that's where they're at and that's what they're interested in, I need to either go into that with the plan or I need to somehow figure out how to back around and get in there and join that play and then have that learning happening. And I find that to be challenging for some people to be present and productive in those types of settings where they give up a lot of the adult control and it's more of the child-centered focus, and I have to kind of work with that. They might be present and can enjoy and play, but the productivity of teaching and data seems to drop. And it's like we kind of have to have both, and that can be tricky if we're not at the table with the binder and the control. Have you found that with any of the staff that you've supported when they kind of make that shift from more traditional to kind of looser, more naturalistic types of teaching?

SPEAKER_00 28:25

Yeah, you know, I wish we had better data on this. Maybe now you've given me another idea for a study I want to do. Um because one of the things that I use to comfort myself with when I face this challenge or when my staff face this challenge is that I really believe that we don't need so many trials for the child to learn if the quality is super high. So, for instance, when you were talking about how hard it is to get kids to do math and you know other um academic activities, it was reminding me of a teacher that I worked with a number of years ago. And she was learning how to do PRT, and she had some of the most creative ideas for getting her kids motivated to do math and and writing. And she um what she would do is she would just make the password to the computer that they wanted to use during their break time was the answer to a math problem that they had to complete. And boy, were those kids motivated to try to get the right answer for these math problems. And I wonder if in that case you really need to do like lots and lots and lots and lots of math problems, or whether if the child is really focused and really motivated and they really put in their effort and the natural reinforcer is super big, um maybe they don't actually need to do 50. Maybe just a couple will have a similar effect. This same teacher, she had a great um modification that she made after we were in there doing PRT training. She used to make the kids write um a sentence before they could go out to recess. And it the, you know, the sentence would be something completely random and unrelated, but when she learned how to do PRT and she learned about natural reinforcers, she started making them write about what they were planning to do for recess, which actually for autistic kids who also benefit from thinking ahead a little bit about who they're gonna play with and what they're gonna do socially, it had a double effect. Um but they, you know, if they had a capital letter and everything was spelled correctly and they had a period at the end and it was a nice sentence, then off to recess you go. And again, those kids were just so much more locked in and interested in getting these sentences written, and you just don't see so much um challenging behavior or like avoidance behavior anymore. So I do, going back to your original question, I mean, I do think this is a real challenge for us as therapists to figure out how to design data collection systems that really work in the natural environment and how to make sure that we are staying motivated and productive when we're working with kids where the um maybe the behaviors they're interested in are pretty repetitive and not related to the things that we consider to be like toys or age-appropriate toys or pre-academic materials that we or their parents maybe wish that they were more interested in. But in the short term, at least, it's often your best payoff in terms of child learning is gonna be from figuring out how to teach within whatever it is that captivates the child. And the way I sleep at night is by believing that the quality just matters so much more than quantity because I've seen it over and over again that if you can get a trial in that's super meaningful to the child because they're paying attention and they care about the outcome and they really are trying, then the learning is just so much quicker.

SPEAKER_01 32:28

Yeah, so it makes me think about dosage of hours again. Like, do some of these children need 30 hours? It's quantity, but what are they doing within those hours as a quality versus if you could have a really focused, meaningful, motivated, child-led, child-centered kind of focus in the session, could you get more done with that than 50 minutes of that session? You were trying to find motivation, or I don't want to say force them or coerce them into playing with the toy a particular way, but really um not obvious into what their interests are. So on that kind of a session where it might be really adult-led and we're missing those cues for communication, potential motivation, might have more challenging, problematic behavior that we're trying to extinguish and put out, right? I feel like it just seems the easier way to go. Like it's just when, like you said, locked in. When we get the kids locked in and we can lock in with them, a lot of that stuff goes away. And I know when I shifted practice and parents would be like, well, how do you, you know, handle challenging behavior? I'm like, I we don't see it that often, right? I really feel like when I moved into NDBIs, environmental arrangements, shared controlled strategies, following their interest. There's really not a lot of things that they're gonna push back against. Um, we have strategies for transitions, ending routines, transitioning to the next one. So all of those potential antecedents that might be a trigger for some children. Like those just they don't happen, and we adjust accordingly to that. I don't know if you also have encountered that, but I just I loved it. I'm like, there's just not those big tantrums and behaviors that I used to see. Um and that makes it more um enjoyable from a from a process of one for the child and also for what I was as a therapist.

SPEAKER_00 34:16

Yeah, and that that therapist perspective is so important as well because it can be, we can waste so much of our available energy um trying to convince kids to do things that they don't want to do. And it's just um it can really contribute to burnout and um you know frustration and um that you know it's it's probably not worth it. We do have better ways.

SPEAKER_01 34:45

Yes, and I love the strategies that you're talking about, both from the antecedent and the consequence side, to kind of pick your kind of choose your own adventure. Which one do you think is going to work best and which one is more important for this child right now in this teaching context? But going back again to that motivation of how meaningful it is, and um, outside that lens of just you know a therapist trying to motivate a child, that that bigger perspective of we all do things that we're motivated to do, right? We would prefer to do that from a human to a human perspective of like, do you like to do things that are hard? Do you like to do things that you get feedback on that weren't correct and they delay and deny you access to nobody likes that? Nobody that I know. Yeah, I think it's that bigger picture of kind of thinking about supporting learning just in general, regardless of of who we're supporting. But I wanted to ask you, because you had mentioned that there is um the 2026 PRT conference and um September 26, 26, I believe was the date, correct? Yep. And it's a virtual, so I'm gonna put a link to that when that comes out because that would be something if listeners are interested in learning more about PRT, the research, the practice. This would be an incredible event to attend online. And then you also had shared um a link with me uh for an online, I'm assuming asynchronous PRT course. Can you talk about that a bit more as a resource?

SPEAKER_00 36:15

Yeah, absolutely. So the so the PRT conference you described, we do this once a year in September, and that's a one-day conference with different lectures related to pivotal response treatment, and people can um they can attend live or often we have recordings available for a short time after, but it's a it's a one-day event, um, and it'll be on the 26th of September this coming year in 2026. And then we recently developed an online course for parents, and we have a version available for professionals who are interested in learning the basics of PRT. Many of the techniques that I described today, we go into some more detail about that. So it's video recorded lectures about PRT, and for parents and for professionals, um, those living in the United States, have an opportunity to submit a video and get written feedback about their own PRT implementation. So it is asynchronous, it's self-paced, you can just work through the modules on your own, but you also do have that opportunity to get feedback if you're interested in practicing the PRT with a kid that you work with or your own kid in the case of a parent.

SPEAKER_01 37:33

Yeah, that's fantastic to have that really to support application. So getting the knowledge and then getting it into your practice, and then also getting a little bit of feedback from an expert to guide you and see if that can get some things moving in your practice or at home in your in your family. Any advice that you would give listeners or any recommendations or if they wanted to get started with PRT or or lean into NDBI models anything you would share like to get them in the right direction?

SPEAKER_00 38:09

Absolutely. Um there's a couple things that that come to mind. I mean, I think it's really exciting how many new and good training materials are available now. And so I would say keep reading, keep watching lectures, you know, look for video examples, um, see if you can find other clinicians who are interested in NDBIs. Um I I like to attend autism conferences, and so I, you know, I try to go to the International Society for Autism Research and the many of the other um like American Psychological Association conferences, or um, we have we have ABA conferences that are very helpful. I think the real gem is the NDBI Connections Conference, which you um you know have hosted these last couple of um cycles, and those that's a really great place to um I'm encouraging all my staff and trainees to attend and watch the recorded lectures because it's uh that's so important. Um but I also I you know I think if you're doing this kind of on your own, a few like little tips I would give people.

SPEAKER_01 39:21

Peace.

SPEAKER_00 39:22

I really think that what we talked about about partnering with parents and you know, seeing parents as a real ally and um and you know someone that you can empower to do a lot of this work with you, um, that's a good place to start. I also like to use the the term that I learned from Sally Rogers, follow the smile. I think you know that's a great reminder for all of us about when we're working with a kid, we just have to figure out what lights them up. What is it that makes them smile and gets them excited? And if we can figure that out, we we can figure out how to teach them.

SPEAKER_01 40:02

I love that. I think that's a wonderful place to start, to be an astute observer, to be creative, to be flexible, and to follow the smile.

unknown 40:13

I love it.

SPEAKER_01 40:14

This has been so incredible. Thank you so much, Grace, for coming on and sharing your knowledge and resources about PRT and more information about it so people can continue to learn and then shift their practice, hopefully.

SPEAKER_00 40:28

Thank you so much for the invitation. It's been wonderful to talk with you.

SPEAKER_01 40:32

Thank you.