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Naturalistic Developmental Behavioral Interventions (NDBI) is a set of highly effective early intervention programs for children with autism. Let’s take a closer look at what this term means and how NDBIs can support your child’s development.
What are Naturalistic Developmental Behavioral Interventions for Children with Autism?
The term Naturalistic Developmental Behavioral Intervention (NDBI) was coined in 2015 by Laura Schreibman, director of the Autism Intervention Research Program at the University of California at San Diego, in an attempt to unify recognized autism interventions under an umbrella.
NDBI combines effective treatment methods known to enhance motivation, engagement, and learning in children with autism, such as:
- 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
- Joint Attention, Symbolic Play, Engagement and Regulation (JASPER)
All of the techniques listed above are based on the principles of developmental psychology and applied behavior analysis (ABA).
How are NDBIs implemented?
NDBIs rely on a range of behavioral strategies, such as modeling, shaping, and differential reinforcement. These methods are based on teaching simple skills and building in complexity over time. Additionally, skills are taught in a developmental sequence, where early skills are considered to be prerequisites for the development of more complex behaviors.
To illustrate, an NDBI may focus on teaching a nonverbal child with autism to initiate joint attention with others by using nonverbal communication, pointing, gesturing, imitating sounds, and making eye contact, which may eventually allow the child to learn spoken language.
In contrast to traditional interventions that tend to prioritize the acquisition of isolated skills in a structured setting and subsequently work on their generalization in daily life, the core assumption of NDBIs is that therapy requires exposing the child to natural social interactions. This is why these interventions are implemented in natural settings, such as the child’s home, as part of daily routines and play.
Elements of NDBIs
NDBIs rely on the following elements to support the development of communication and other skills in children with autism:
- Face-to-face interactions that occur on the child’s level
- Following the child’s lead to guide activities and increase motivation and engagement
- Taking into account the child’s interests when selecting teaching materials and activities
- Using positive affect and animation, where the therapist smiles, uses expressive gestures, and varies the tone and pitch of their voice to convey positive emotions and engage with the child in an enthusiastic and lively manner
- Modeling appropriate language, for example describing and commenting on the child’s actions or using open-ended questions to encourage communication
- Responding to communicative attempts in a positive and supportive way
- Using communicative temptations, that is, creating situations that encourage communication and interaction with others
- Providing direct teaching episodes, such as modeling, feedback, and reinforcement, to support learning
- Taking into account the child’s age, abilities, and individual needs when planning activities
- Following the child’s lead to create a more engaging and naturalistic learning environment
- Creating frequent opportunities for teaching in the natural environment, for example, the child’s home or classroom
- Delivering interventions in a way that is natural and integrated into the child’s everyday interactions with adults
- Providing reinforcers that are directly related to the activity being performed, for example, offering a sticker to a child who completes their work on time
- Placing a strong emphasis on the child’s social and interpersonal development, in addition to improving academic learning and other skills
- Emphasis on teaching functional skills that help improve the child’s quality of life and encourage independence
- Coaching parents on the techniques they can use to promote learning, engagement, and connection through daily routines.
How Can NDBIs Support Children’s Development?
The NDBI techniques are used to teach children with autism developmentally appropriate skills, regardless of their age and functioning level. The hope is to create a positive and supportive learning environment that is tailored to the child’s needs and abilities.
Areas of implementations
The NDBI approach can be effective in promoting growth and development in multiple domains. Some of the areas where NDBI models are successfully applied in treating children on the autism spectrum include:
- Early language development
- Nonverbal interactions
- Basic fine and gross motor skills
- Peer interactions
- Play skills
- Social-emotional skills
- Emotional regulation
- Adaptive behavior, including self-help skills and daily living skills
- Improving challenging behaviors
Why are NDBIs so effective?
There are several reasons why naturalistic developmental behavioral interventions are effective in supporting the development of children with autism:
- NDBIs are child-centered. In other words, interventions are tailored to the child’s individual needs, interests, and abilities. This personalized approach can help promote motivation when it comes to learning new skills.
- NDBIs prioritize a naturalistic approach. They are based on the child’s preferences and incorporate everyday routines and activities, which makes learning more relevant and meaningful.
- NDBIs focus on social engagement and interaction, which are critical areas of development for children with autism.
- NDBIs are evidence-based. They are supported by extensive research, which helps ensure that the interventions are effective and appropriate for the needs of each child.
13 Features That Are Common to the Intervention Approaches Classified as NDBIs
In her article entitled “Naturalistic Developmental Behavioral Interventions: Empirically Validated Treatments for Autism Spectrum Disorder” Laura Schreibman defines the features that NDBIs have in common:
- Teaching incorporates the three-part contingency of antecedent, behavior, and consequence
- The use of a manual to guide implementation
- Accuracy assessment of the intervention implementation
- Individualized intervention goals
- Ongoing progress measurement
- Child-initiated teaching
- Setting up the environment in a way that promotes interaction and learning
- Prioritizing natural contingencies over external reinforcement
- Use of prompting and prompt fading to teach communication, social, and other skills
- Helping children to learn to take turns in social and play situations
- Modeling skills that children are being supported to learn
- Imitating children’s actions in order to motivate further communication attempts
- Using methodical approaches to broaden the repertoire of skills and interests.
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