Author: Mendy Minjarez PhD

Naturalistic Developmental Behavioral Interventions for Children with Autism

With so many different interventions being used in the treatment of ASD, it can be incredibly challenging to understand what they all mean, which ones are effective, what the research tells us about different models, and which one is best for an individual child. Terms like Applied Behavior Analysis, Pivotal Response Treatment, Early Start Denver Model, Project DATA and Incidental Teaching become a blur, especially when parents and caregivers are trying to make sense of what is best for their child. Although developing a new term may seem like it just adds to the confusion, the term Naturalistic Developmental Behavioral Intervention (NDBI) was coined by Laura Schreibman and colleagues in 2015 in an attempt to unify the field around interventions that have a shared set of characteristics. Let’s take a look at what this new term means and why it is helpful.

Many years of research has shown us that interventions based on Applied Behavior Analysis (ABA) are effective for teaching skills to individuals with ASD and reducing challenging behaviors (e.g., tantrums, aggression, rigid behavior patterns). ABA interventions can be delivered in many different ways. Many researchers and clinicians have moved toward developmentally-focused models where ABA interventions are delivered within natural activities (e.g., play) and routines (e.g., family routines). As these interventions have evolved, they have increasingly begun to blend developmental theories and interventions with ABA, and thus, the NDBI approaches were born.

Some of the hallmark features of NDBI include teaching functional skills for increasing quality of life; a focus on enhancing motivation and engagement in treatment; embedding active opportunities for teaching in the natural environment; and following the child’s lead and interests when selecting teaching materials and activities. In a nutshell, NDBI combine effective teaching methods based on the science of ABA with the developmental methods known to enhance motivation, engagement and learning. This blend is then used to embed learning into activities that are appropriate and fun for individuals and families regardless of age or developmental level. While some have referred to it as a “modern ABA”, we just refer to it as good teaching!

Many existing treatment models fall into the NDBI category, including Early Start Denver Model (ESDM); Pivotal Response Treatment (PRT); Classroom Pivotal Response Treatment (cPRT); Enhanced Milieu Teaching (EMT); Incidental Teaching (IT); Project ImPACT (Improving Parents as Communication Partners); Project DATA (Developmentally Appropriate Treatment for Autism in Toddlers); Social ABC’s; and Joint Attention, Symbolic Play, Engagement and Regulation (JASPER). While some of these models are primarily available in university-based research settings (e.g., EMT, JASPER), others are more readily available in the community depending on where you live (e.g., ESDM, PRT, Project DATA).

Since making sense of these interventions and gaining access to them can be very difficult for clinicians and families, a small group has recently collaborated to improve access to this information. A new book, titled, Naturalistic Developmental Behavioral Interventions for Autism Spectrum Disorder (Bruinsma, Minjarez, Stahmer and Schreibman) is due out this fall. Further, an NDBI conference has just been announced for October in Irvine, CA! The book and conference will focus on outlining the core components that are shared among these interventions in an attempt to increase access to the “active ingredients” of treatment regardless of which model you choose. This effort is focused on moving away from rigid adherence to any one model and promoting widespread use of a core set of intervention strategies that are known to be effective in improving the lives of individuals with ASD. The conference will feature speakers who have developed these models (e.g., Laura Schreibman, Sally Rogers), which will be an exciting opportunity to learn about ASD intervention straight from the source! Hope to see you there!

Conference information and registration.

 

DIR®/Floortime™ and Autism

 

 Supporting the Rhythms of Relationships

Relationships are an important component to a healthy life; we experience life through shared experiences. But for children with autism, forming relationships can be challenging. The Developmental, Individual Differences, Relationship-Based Model (DIR®/Floortime™), developed by Stanley Greenspan, MD and Serena Weider, PhD, is a framework used to help children with developmental differences, including autism, work through these challenges. Read full post »

Pivotal Response Training

PRT. Yet Another Acronym. What is Pivotal Response Training and How Does it Differ from Other Behavioral Interventions?

If you have been following our blog recently you know that we are in full swing with our series on autism treatments. We featured two posts that reviewed Applied Behavioral Analysis (ABA) therapy so it only makes sense that we now move on to covering Pivotal Response Training (PRT). PRT is yet another type of ABA therapy. Remember, we learned that ABA therapy is not a synonym for discrete trial training, which is often how people use the term. ABA therapy is the science of altering human behavior through learning principles. And PRT uses those very same principles, but in a different way. So, your next question is logically…then what is PRT? Read full post »

What If The World Ends? When the Media Causes Anxiety in Your Child With Autism

Seattle Children’s recently received a tweet from the parent of a child with autism asking about strategies for support when the news makes their child anxious. This question comes up frequently in our clinic. The following general tips may be helpful. As usual, they should not be viewed as clinical advice and should not replace advice from your mental health or medical provider. Read full post »

Highlights from IMFAR and Current Findings from Controlled Treatment Studies in Autism

The International Meeting for Autism Research (IMFAR) was recently held in San Diego from May 12-14 by the International Society for Autism Research (INSAR). In one of many research symposiums, recent findings from multiple randomized controlled trials of autism treatments were presented. The methodology used in randomized controlled trials requires substantial resources to develop strong study designs that have often not been used in autism research. Therefore, the research presented in this symposium was quite exciting, as it begins to address many of the current gaps in knowledge that have occurred due to the previous use of study designs that are not well controlled.  Read full post »