Naturalistic developmental behavioral interventions (NDBI)

This family of interventions for youth with autism spectrum disorder (ASD) combines the principles of applied behavior analysis (ABA; this is the science of understanding the foundations of learning) and child development to improve a range of areas in a child’s development: communication, social engagement, challenging behaviors, play behaviors, peer interactions, daily living skills, and academic skills. The overarching approaches and strategies that this type of intervention have in common are (1) providing opportunities for a youth’s skill building in the context of interactive, natural settings (e.g., in the home, at the park) across a range of and during daily routines, social interactions, and play activities; (2) emphasizing the use of natural rewards that are directly related to the activity at hand (e.g., child being able to play with the toy that is used to teach the word); (3) following the children’s play interests to guide activities and learning opportunities to increase motivation and engagement for learning interchanges; and (4) an overarching emphasis on the child’s social engagement and meaningful interactions within the learning context. It typically has a strong component of parent training and family involvement.  

NDBIs target skills and teaching strategies in which learning opportunities are naturally embedded throughout the day in the child and family’s existing daily routines, are geared toward the child’s developmental level, build foundations in core areas needed to reach developmental milestones (e.g., joint attention), and taps into skills that enhance key areas of development (e.g., child engagement, motivation). These treatments have been shown to make positive gains for a wide range of ages starting with children from a young age (toddlers) to older youth. There are numerous research studies demonstrating the effectiveness of NDBI as an evidence-based intervention for ASD. There are several interventions within this behavioral treatment approach, some of which are: Pivotal Response Treatment (PRT), Joint Attention Symbolic Play Engagement and Regulation (JASPER), Incidental Teaching, Early Start Denver Model (ESMD), Enhanced Milieu Teaching, and Social Communication/Emotion Regulation/Transactional Support (SCERTS). Some of these treatments are not yet widely available in the community as they are used in research settings.

Some documented gains with NBDI are: increased generalization (use of skills across settings rather than only in the specific teaching setting), decreased dependence on prompts, reduced avoidance behaviors, and active child engagement and spontaneity of skills. This type of treatment is different from the traditional, highly structured intervention that is characteristic of a discrete trial training (DTT) model. This family of intervention does not include floor-time and relationship development intervention (RDI). Research is being conducted to determine the differences in effects between NDBI and DTT models, who respond best to different approaches of treatment, and the core components that are most effective in these interventions.

Resources:

Autism Speaks website: www.autismspeaks.org

UCLA CAN Clinic: http://www.semel.ucla.edu/autism/clinic

UCLA JASPER: http://www.kasarilab.org/treatments/

UC Santa Barbara Koegel Autism Center: http://education.ucsb.edu/autism/

SCERTS Model: http://www.scerts.com/

Early Start Denver Model (ESDM): http://www.ucdmc.ucdavis.edu/mindinstitute/research/esdm/

Enhanced Milieu Teaching: http://vkc.mc.vanderbilt.edu/kidtalk/projects/