Table 4 Content and Procedures of Peer-Mediated Pivotal Response Training

PM-PRT Procedures	Verbal Explanation	Researcher Modeling	Role-play	Feedback
Attending to the Participant with ASD and Staying Near	Explain how to observe where the participant is and what they are doing, and how to approach them closely.	Model approaching naturally after observing the participant’s play.	Practice approaching while the researcher plays the role of the participant with ASD.	Feedback on whether the peer successfully approached the target participant.
Providing Multiple Cues	Explain moving to a play area where preferred toys are located with the participant with ASD.	Model moving toward the toy shelf while holding hands.	Practice moving to the play area while holding hands.	Feedback on whether movement cues (e.g., holding hands, pointing) were clear.
Choice-making	Explain how to provide questions that offer a choice of play materials.	Model questions such as, “Which one should we play with, the train tracks or the Legos?”	Practice presenting choice- making questions.	Feedback on clear choice questions and waiting for a response (Time Delay).
Playing with Preferred Toys	Explain starting play with the selected toy when the participant with ASD shows a social response (e.g., pointing, nodding, answering).	Model starting play with the selected toy upon a social response.	Practice starting play when the participant shows various social responses.	Feedback on whether play was initiated immediately upon a response.
Turn-taking and Sharing Play Materials	Explain turn-taking with toys and sharing behaviors (e.g., handing over materials, dividing roles).	Model turn-taking and sharing by handing over materials during activities like building train tracks.	Practice initiation and response behaviors such as “Can I have the track?” or “Here you go”.	Feedback on whether clear verbal and non-verbal modeling was provided during turn-taking or sharing.
Interspersing Maintenance and Acquisition Tasks	Explain how to suggest new play methods that the peer is familiar with during play.	Model proposing new play ideas, such as “Let’s build a tunnel after connecting the tracks”.	Practice suggesting new play ideas to the participant.	Feedback on whether new play ideas were successfully proposed.
Consequent Reinforcement and Reinforcing Attempts	Explain providing social reinforcement (praise) for both correct and approximate responses.	Model providing social praise such as “Thank you,” “I like it,” or “Great job”	Practice providing praise for various types of responses.	Feedback on whether praise was provided in appropriate situations.