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.