“Naturalistic Developmental Behavioral Intervention” is one of the most supported contemporary models of treatment for children with socio-communication disorders, from late-talkers to young children with autism.
The main characteristic of “Naturalistic Developmental Behavioral Interventions” (NDBI) are the use of natural rewards, the preference for naturalistic contexts, such as play and daily routines, and the attention given to the child’s initiation and spontaneity during the therapeutic process.
NDBIs combine intervention methods derived from both developmental psychology and behavior analysis by using a variety of behavioral strategies to teach developmentally appropriate and prerequisite skills.
On one hand, behavior analysis offers an understanding of the principles of learning, such as the effect of environmental consequence on behavior, discrimination, generalization and shaping, to name just the most important. The application of these principles has proved extremely successful in describing, explaining and predicting learning processes and behaviors that are not language mediated. The acquisition of early language, nonverbal interaction, basic motor skills are just some of the area of development where models derived from behavior analysis have been successfully applied.
On the other hand, developmental psychology has produced a wealth of research on the typical trajectories through which children develop and on the interactive contexts that support their development. Particularly relevant for early interventions is the notion that child’s development is driven by the child’s active, self-directed engagement with others. This research has extended also into the study of the disfunctions that can disrupt normal development.
It is easy to see how both disciplines can contribute to constructing intervention for children with developmental disorders.
The core assumption inherent to NDBIs is that therapy requires, since its beginning, to expose the child to natural social interactions. In contrast, traditional interventions tend to prioritize the acquisition of isolated skills in a structured setting and to work on their generalization in daily life only at a later time. It is common, for example, to see a child ‘drilled’ with flash cards with the aim of expanding the child’s vocabulary. In the majority of cases the target is easily achieved with the child being able to label tens, or even hundreds, of cards. However, the knowledge remains confined to the drill, dependent to those conditions present during the program (the card, the question, the table, the therapist, etc.). It is not uncommon, for children undergoing these programs, to ‘know’ hundreds of words but to continue to be functionally non verbal in their daily life. This failure to generalize has brought on traditional interventions the dissatisfaction of many practitioners and consumers, that in turn has fueled the interest for naturalistic approaches.
| Traditional | Naturalistic | |
|---|---|---|
| Focus | Acquisition of skills | Relational changes that are prerequisite to skill development |
| Teaching situation | Structured (e.g. table, teaching stimuli presented in an arranged field) | Play-based manner (e.g. on floor, during daily routine, child-sized table) |
| Reinforcement | Extrinsic, unrelated to the behavior | Naturally connected to the behavior |
| Generalization | After acquisition | Naturally connected to the behavior |
Table 1. Primary differences between Traditional and Naturalistic Interventions
A growing number of practitioners are coming to recognize that late-talking, language delay and Autism, are not learning disabilities, that can be addressed with mnemonic strategies (repetition, discriminative trials, stimulus fading) but are primarily social disorders, that necessarily require social interventions. The child’s problem is not to learn list of words, numbers or letters, it is to communicate, to attend, to listen and to relate with others. After all, since typical children learn and use words in relational context, it is just sensible for therapists to use their time to help children to establish meaningful relationship.
References:
Clinical Guide to Early Interventions for Children with Autism, (2020). Vivanti, Bottema-Beutel, Turner-Brown
Naturalistic Developmental Behavioral Interventions for Autism Spectrum Disorder, (2020). Bruinsma, Minjarez, Laura Schreibman, Stahmer
Naturalistic Developmental Behavioral Interventions: Empirically Validated Treatments for Autism Spectrum Disorder, (2015). Schreibman, Dawson, Stahmer.
Youtube video: Naturalistic Developmental Behavioral Interventions, (2019), Minjarez.
