Naturalistic Developmental Behavioral Interventions Research Articles

Naturalistic teaching approach to develop spontaneous vocalizations and augmented communication in children with autism spectrum disorder

Naturalistic developmental behavioral interventions (NDBI) have been shown to facilitate the development of spontaneous language in individuals with speech and language impairment. Several meta-analyses have reported a small number of studies that utilized naturalistic teaching approaches combined with augmentative and alternative communication (AAC) interventions to develop requesting skills in individuals with autism spectrum disorder (ASD). Therefore, the main purpose of this study was to determine whether a natural language paradigm (NLP) and time delay is effective in expanding vocal and augmented requesting skills in three children with ASD between the ages of 4 and 6 years. A concurrent multiple baseline design across participants was used to evaluate the effectiveness of the intervention. The results of the study demonstrated that the participants were successful in emitting vocal requests when both modalities were available and NLP combined with time delay was effective in increasing spontaneous vocal requests in all participants.

Meta-analysis supports naturalistic developmental behavioral interventions as a promising approach for improving a range of outcomes for children with autism spectrum disorder

Q Are Naturalistic Developmental Behavioral Interventions (NDBIs) an effective intervention approach for improving a range of outcomes for children with autism spectrum disorder? Design: Meta-analy...

Identifying and measuring the common elements of naturalistic developmental behavioral interventions for autism spectrum disorder: Development of the NDBI-Fi.

Naturalistic developmental behavioral interventions for young children with autism spectrum disorder share key elements. However, the extent of similarity between programs within this class of evidence-based interventions is unknown. There is also currently no tool that can be used to measure the implementation of their common elements. This article presents a multi-stage process which began with defining all intervention elements of naturalistic developmental behavioral interventions. Next, intervention experts identified the common elements of naturalistic developmental behavioral interventions using a survey. An observational rating scheme of those common elements, the eight-item NDBI-Fi, was developed. We evaluated the quality of the NDBI-Fi using videos from completed trials of caregiver-implemented naturalistic developmental behavioral interventions. Results showed that the NDBI-Fi measure has promise; it was sensitive to change, related to other similar measures, and demonstrated adequate agreement between raters. This unique measure has the potential to advance intervention science in autism spectrum disorder by providing a tool to measure the implementation of common elements across naturalistic developmental behavioral intervention models. Given that naturalistic developmental behavioral interventions have numerous shared strategies, this may ease clinicians' uncertainty about choosing the "right" intervention package. It also suggests that there may not be a need for extensive training in more than one naturalistic developmental behavioral intervention. Future research should determine whether these common elements are part of other treatment approaches to better understand the quality of services children and families receive as part of usual care.

Early Interventionists' Appraisals of Intervention Strategies for Toddlers with Autism Spectrum Disorder and Their Peers in Inclusive Childcare Classrooms.

Mounting evidence supports several naturalistic developmental behavioral interventions (NDBI) for toddlers and preschoolers within inclusive childcare centers and preschools. However, these interventions pose many barriers to community implementation. As part of a larger project to create an adapted NDBI for early educators in childcare centers, we surveyed 101 early interventionists who had worked with a toddler with autism within the last 12months. Early interventionists rated 22-of-31 NDBI strategies to be significantly more effective for All Toddlers versus Toddlers with Autism. However, when comparing the top 10 rated strategies between groups, there was a large degree of overlap. Moreover, many of these highly rated NDBI strategies are consistent with best practice accreditation and early education standards within the United States.

PRESS-Play: Musical Engagement as a Motivating Platform for Social Interaction and Social Play in Young Children with ASD.

Musical experiences are ubiquitous in early childhood. Beyond potential benefits of musical activities for young children with typical development, there has long been interest in harnessing music for therapeutic purposes for individuals with autism spectrum disorder (ASD). However, there is debate as to the effectiveness of these approaches and thus a need to identify mechanisms of change (or active ingredients) by which musical experiences may impact social development in young children with ASD. In this review, we introduce the PRESS-Play framework, which conceptualizes musical activities for young children with ASD within an applied behavior analysis framework consistent with the principles of naturalistic developmental behavioral interventions. Specifically, the PRESS-Play framework proposes that musical activities support key elements of evidence-based approaches for social engagement including predictability, reinforcement, emotion regulation, shared attention, and social play context, providing a platform for delivery and receipt of social and behavioral instruction via a transactional, developmental approach. PRESS-Play considers that these factors may impact not only the child with ASD but also their interaction partner, such as a parent or peer, creating contexts conducive for validated social engagement and interaction. These principles point to focused theories of change within a clinical-translational framework in order to experimentally test components of social-musical engagement and conduct rigorous, evidence-based intervention studies.

Practitioner-Implemented Naturalistic Developmental Behavioral Interventions: Systematic Review of Social Validity Practices

Naturalistic Developmental Behavioral Interventions (NDBIs) are evidence-based interventions implemented by the adults in a child’s natural environment (e.g., by practitioners in classrooms). The social validity of this body of research may have an impact on the maintenance of practitioner implementation of NDBIs. We conducted a systematic review to evaluate the components (i.e., goals, procedures, and outcomes) and features of social validation assessment practices within studies where researchers trained practitioners to implement an NDBI with young children with disabilities in early childhood classroom contexts. Results of the systematic review indicated that social validity assessment within practitioner-implemented NDBI studies is lacking. Of the 23 studies identified, only 12 studies reported social validity assessment(s). Findings also highlight a lack of comprehensive social validity assessment and frequent use of biased respondents. An in-depth analysis of social validity assessment methods and features, as well as recommendations for the field, is provided.

Meta-analysis of naturalistic developmental behavioral interventions for young children with autism spectrum disorder.

Naturalistic developmental behavioral intervention is an emerging class of interventions for young children with autism spectrum disorder. The present article is a meta-analysis of outcomes of group-design studies (n = 27) testing interventions using naturalistic developmental behavioral intervention strategies. Small, significant positive effects of naturalistic developmental behavioral intervention were found for expressive language (g = 0.32), reduction in symptoms of autism spectrum disorder (g = -0.38), and play skills (g = 0.23). Larger effects were found for social engagement (g = 0.65) and overall cognitive development (g = 0.48). A marginal effect was found for joint attention (g = 0.14) and receptive language (g = 0.28). For joint attention, improvement was moderated by hours of professional involvement. Evidence of publication and reporting bias was present for language outcomes. This meta-analysis grows the evidence base for naturalistic developmental behavioral interventions, particularly in the key areas of social engagement and cognition.

Case-control study of the low intensive autism-specific early behavioral intervention A-FFIP: Outcome after one year.

Abstracts: Objective: In current international research, early intervention in children with autism-spectrum disorder (ASD) focuses on naturalistic developmental behavioral interventions (NDBI). The manualized Frankfurt Early Intervention Program for preschool-aged children with ASD (A-FFIP) implements NDBI principles within a low-intensity approach of 2 h intervention/week. The present case-control study established effect sizes of change in autistic symptoms, comorbid behavioral problems as well as IQ after one year. Methodology: An intervention group (N = 20; age: 3.4-7.9 years) and a treatment-as-usual control group (N = 20; age: 3.2-7.3 years) of children with ASD were matched for developmental and chronological age. The outcome measures used were the ADOS severity score, the Child Behavior Checklist, and cognitive development. Results: After one year, the A-FFIP group showed a trend towards greater improvement in autistic symptoms (η2 = .087 [95 %-CI: .000-.159]) and significantly greater improvements in cognitive development (η2 = .206 [CI: .012-.252]) and global psychopathology (η2 = .144 [CI: .001-.205]) compared to the control group. Conclusion: The efficacy of A-FFIP should be established in a larger, sufficiently powered, randomized controlled study.

Time to make a change. Early Start Denver Model for Young Children with ASD

Il est temps de changer. Le modèle de Denver pour jeunes enfants Le nombre d’enfants diagnostiqués avec un trouble du spectre de l’autisme (TSA) est en progression. L’intervention précoce fondée sur les preuves est l’une des clés pour améliorer l’évolution. Cet article présente brièvement l’histoire des Interventions Comportementales et Développementales en milieu naturel (Naturalistic Developmental Behavioral Interventions NDBI) et utilise le Modèle de Denver pour jeunes enfants (ESDM) comme exemple d’une intervention NDBI pour illustrer les données scientifiques actuelles et les orientations futures de ces interventions. Finalement, nous appelons à plus d’efforts pour diffuser ce type d’intervention à travers le monde.

5.15 The Impact of Comprehensive Behavioral Intervention on Mu Rhythm Attenuation in ASD

Naturalistic developmental behavioral interventions use principles of applied behavior analysis and developmental science. One such program, the Early Start Denver Model (ESDM), has been shown to facilitate gains in cognitive, social communication, and adaptive skills in young children with ASD. ESDM also has a specific emphasis on supporting caregiver relationships. The aim of this study was to examine the impact of this comprehensive behavioral intervention on neural functioning in children with ASD, using an established EEG paradigm that indexes neural activity associated with the observation of movement.

Integrating a Parent-Implemented Blend of Developmental and Behavioral Intervention Strategies into Speech-Language Treatment for Toddlers at Risk for Autism Spectrum Disorder.

Naturalistic developmental behavioral interventions include an explicit focus on coaching parents to use therapy techniques in daily routines and are considered best practice for young children with autism. Unfortunately, these approaches are not widely used in community settings, possibly due to the clinical expertise and training required. This article presents the work of the Bond, Regulate, Interact, Develop, Guide, Engage (BRIDGE Collaborative), a multidisciplinary group of service providers (including speech-language pathologists), parents, funding agency representatives, and researchers dedicated to improving the lives of young children with autism spectrum disorder and their families. The group selected and adapted a parent coaching naturalistic developmental behavioral intervention specifically for use with toddlers and their families for community implementation. Lessons learned from the implementation process include the importance of therapist background knowledge, the complexity of working with parents of young children, and needed supports for those working closely with parents, including specific engagement strategies and the incorporation of reflective practice.

Parent perceptions of an adapted evidence-based practice for toddlers with autism in a community setting.

Although data from parent-implemented Naturalistic Developmental Behavioral Interventions have shown positive effects on decreasing core symptoms of autism, there has been limited examination of the effectiveness of Naturalistic Developmental Behavioral Interventions in community settings. In addition, parent perspectives of their involvement in parent-implemented early intervention programs have not been well studied. Using both qualitative and quantitative data to examine parent perspectives and the perceived feasibility of parent training by community providers, 13 families were followed as they received training in the Naturalistic Developmental Behavioral Intervention, Project ImPACT. Data indicate that parent training by community providers is feasible and well received, and parents find value in participating in intervention and perceive benefit for their children. Recommendations for adaptation of program elements and future research are discussed.

Naturalistic Developmental Behavioral Interventions: Empirically Validated Treatments for Autism Spectrum Disorder.

Earlier autism diagnosis, the importance of early intervention, and development of specific interventions for young children have contributed to the emergence of similar, empirically supported, autism interventions that represent the merging of applied behavioral and developmental sciences. “Naturalistic Developmental Behavioral Interventions (NDBI)” are implemented in natural settings, involve shared control between child and therapist, utilize natural contingencies, and use a variety of behavioral strategies to teach developmentally appropriate and prerequisite skills. We describe the development of NDBIs, their theoretical bases, empirical support, requisite characteristics, common features, and suggest future research needs. We wish to bring parsimony to a field that includes interventions with different names but common features thus improving understanding and choice-making among families, service providers and referring agencies.