Pivotal response treatment (previously known as pivotal response training or the natural language paradigm) is a form of teaching in which the teacher concentrates on changing certain 'pivotal' behaviours, such as motivation and self-management.
Pivotal response treatment is based on the idea that certain aspects of a child's development are considered to be 'pivotal', that is crucial for the behaviours which depend on them. The pivotal areas are motivation, self-management, self-initiation, and the ability to respond to multiple cues.
In pivotal response treatment the trainer concentrates on changing these pivotal areas in order to change the behaviours which depend on them, such as speech and language, social behaviour, and challenging behaviour.
There are several multi-component programmes (such as the Early Start Denver Model and the Nova Scotia early intensive behaviour intervention) which include pivotal response treatment as a key element.