Naturalistic Developmental Behavioral Interventions (NDBI)

History

Historically, the applied behavior analysis (ABA) approach has been used extensively in the management of individuals with ASD. Progressively, in concert with the development of ABA-focused programs (e.g., the Lovaas program), numerous models of child development emerged. This leads clinicians and researchers working with individuals with ASD to introduce aspects of these developmental theories to the care of children with ASD. For example, it has been thought to use interventions based on the principle of ABA interventions but in more naturalistic and developmentally sensitive contexts, using rewards linked to the activity performed by the child instead of rewards independent of the activity, or using materials that the child appreciates. Moreover, professionals have began to focus on certain key skills and knowledge that will enable the emergence of other skills or knowledge later in the development (e.g., a focus can be made in improving joint attention to facilitate the future emergence of language). As these interventions have evolved, they have increasingly begun to blend developmental theories and interventions with ABA, and thus, the NDBI approaches were bor With the development of these new, more naturalistic approaches, Schreibman and colleagues (2015) have created the term 'Naturalistic Developmental Behavioral Interventions' (NDBI) to regroup certain interventions integrating the knowledge provided by the developmental theories in ABA-focused interventions.

Description

Schreibman et al. (2015) described 13 core principles of NDBIs

• Teaching incorporates the three-part contingency of antecedent, behaviour, consequence.
• The use of a manual to guide implementation.
• Fidelity checks to ensure the intervention is implemented accurately.
• Individualised intervention goals.
• Ongoing measurement of progress.
• Child-initiated teaching episodes.
• Arranging the environment to promote children’s interaction and learning.
• A focus on intrinsic reinforcement and natural contingencies, over external reinforcement.
• Use of prompting and prompt fading to teach skills, leading to children’s independent use.
• Helping children to learn to take turns in social and play routines.
• Adults modelling the skills children are being supported to learn.
• Adults imitating children’s actions and attempts to communicate to motivate further communication attempts.
• Systematic attempts to broaden children’s repertoires of skills and interests

In the database

In this database, all meta-analyses exploring the efficacy of NDBI in individuals with ASD focused on clinical trials conducted among very young children with important cognitive difficulties. The interventions are dispensed at moderate intensity (mostly between 5 and 19 hours per week) and both professionals and parents are used to dispense the intervention.

Several meta-analyses focused on a specific NDBI intervention, such as Pivotal Response Training (PRT) or Early Start Denver Model (ESDM).

Additional resources

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