Naturalistic Developmental Behavioral Interventions
Here at Joyscape Therapy, we support children with developmental delays and/or behavioral challenges by teaching communication, socialization, and daily living skills through child-directed therapy. This typically means we use Naturalistic Developmental Behavioral Interventions, or NDBI for short. Are you interested in learning more about what that means? We hope so since you clicked on this blog post.
NDBI is the umbrella term used for naturalistic ABA methodologies. It’s just the term used to describe a few different ways we might target skill acquisition. These methodologies are all evidence-based, involve shared control between the child and therapist, and heavily utilize natural contingencies. By sharing control, we often follow the child’s lead during our sessions. If your child has a particular interest, we’re going to do our best to play at their level, build connections, and incorporate learning. This means we work really hard to look like we’re not working and just playing.
NDBI methods are used to target skills across all developmental domains, including cognition, social, language, play, and motor systems. They are also great for generalization, or the ability to use these taught skills outside of the area they are taught in because of the naturalistic way they are targeted. NDBI uses behavioral strategies such as:
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performing the target behavior for the child to see and copy.
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breaking down a desired behavior into smaller, manageable steps, and gradually modifying the child’s response until we reach the goal.
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breaking down a task into small steps and then teaching each step by itself.
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providing assistance or cues to encourage using a specific skill.
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selectively reinforcing desired behaviors while withholding reinforcement for undesired behaviors.
While the methodologies that fall under the term NDBIs can differ in procedures, they do share a few common evidence-based features. The three-part contingency is one of these and a hallmark of our treatment. This is the ABC or antecedent (what happens before), behavior (how the child responds), and consequence (what happens after their response).
Ex., A. You ask your child to “come here”, B. Your child walks to you, C. You hug and spin your child, which they love, so they always come when you ask them.
Some other common features include individualized treatment goals based on individual assessments, collaboration with families, and ongoing measurement of progress. Continuously evaluating progress helps to identify when modifications are necessary quickly. Once again, child-initiated teaching episodes involve following the child’s lead in play and environmental arrangements. This includes setting up learning opportunities, often by having a favorite toy out of reach to prompt a request for help.
So, what methodologies fall under the umbrella? I am preemptively sorry for all of the acronyms you are about to learn today. Remember, you clicked this blog!
Natural Environment Teaching (NET)
NET is a child-led, unstructured teaching method that utilizes the learners’ motivation and the activities they gravitate to to help teach them skills. If you’ve got a kid who absolutely loves Legos, we will find ways to use Legos to target specific skills. As the name suggests, this method allows kids to learn in their natural environment. At home, in schools, out at the park. Again, this helps with generalizing skills or making sure the skills don’t only happen under particular circumstances. While incorporating NET, we use familiar toys, games, or materials to maximize the kid's motivation to continue the activity. An example of this might be if your child already loves playing with a pretend kitchen set, we might say things like “Ohhh, I am so hungry! I want an apple. Where is the apple? (child identifies where the apple is, gives it to the adult) Oh yay here it is! What color is the apple?” (child answers the question) “Red!” “Yay, this is a red apple!”
Pivotal Response Training (PRT)
Pivotal response training (PRT) is an intervention that integrates principles of child development with those of applied behavior analysis (ABA). The three-part contingency is used throughout a PRT session. Pivotal response training is used effectively to address social, communication, and play outcomes. The core components of PRT include getting the child’s attention, presenting clear learning opportunities, interspersing easy and difficult tasks, using preferred materials, choices, and turn-taking. After observing how the child responds, provide well-timed reinforcers related to the activity's behavior or context. For example, a person may ask, “Where are the red bubbles?” when the child locates the red bubbles, the therapist will then blow them, which naturally serves as the reward for receptively identifying the bubbles.
Early Start Denver Model (ESDM)
The ESDM is an assessment tool and curriculum for children ages 12-48 months. It aims to build positive relationships through joint attending and multisensory learning. Like NET and PRT, the ESDM also used a clear three-term contingency (the ABCs). It is a naturalistic developmental model of treatment that incorporates some teaching elements of ABA and focuses on building strong, positive social relationships with caregivers. ESDM aims to capitalize on high levels of brain plasticity during infancy and toddlerhood. ESDM focuses on positive effects, creating playful and engaging experiences. Joint activities with shared control (play) are the primary vehicles for teaching. ESDM can be intensive teaching with up to one learning opportunity every 10 seconds. It also uses positive behavior approaches to increase replacement behaviors and highly encourages family involvement. An example of ESDM teaching: If a child picks up a crayon and starts to scribble, we may also pick up a crayon and imitate the scribble while also naming the activity (by saying “scribble, scribble…”). The ESDM has empirically solid evidence, focuses on all learning domains, is transportable into the natural environment, and is FUN!
As you can see, these methodologies all share similarities, most notably being child-led and emphasizing a shared experience that leads to learning. We happen to think focusing on these methods is one of the best things about Joyscape Therapy. I know this post was wordy and acronym-filled, but if you made it this far, you are leaving with a bit more technical knowledge to aid you in whichever ways you are currently navigating the field of ABA.
