Overview of Naturalistic Intervention
After reviewing this overview section, you should be able to answer the following questions about this practice:
What is Naturalistic Intervention?
Why use Naturalistic Intervention?
Where Can You Use Naturalistic Intervention?
What is the Evidence-base for Naturalistic Intervention?
What is Naturalistic Intervention?
Naturalistic Intervention is a collection of practices including environmental arrangement, interaction techniques, and strategies based on applied behavior analysis (ABA) principles, such as modeling and time delay. These practices are designed to help toddlers develop skills in the areas of communication (both prelinguistic and linguistic) and social development by responding to the toddler in ways that are naturally reinforcing, appropriate to the interaction, and build up to more elaborate behaviors. By definition, naturalistic intervention is used across settings and within routines and activities that occur throughout the day by anyone trained in the intervention processes.
Interventionists may be:
- teachers
- educational assistants
- therapists
- child care providers
- parents
- other family (e.g., grandparents, older siblings)
- community members (e.g., librarians)
Embedding the intervention into a toddler’s natural environment and daily activities encourages generalization of skills and allows the adult to use their insights about a toddler’s interests and expand upon them to reach target behaviors. Naturalistic intervention has demonstrated effectiveness with toddlers with ASD and is appropriate for toddlers of any cognitive level.
A naturalistic intervention is guided by assessment information as well as the daily routines and activities in which the toddler participates. The assessment may include toddler activities that occur at home (e.g., dressing, eating, bathing and bedtime), at a family child care provider’s home (e.g., play time, snack, nap), or at a child care center (e.g., art project, movement time). These activities provide baseline data on the toddler’s behaviors and skills. This module will provide examples of assessment tools and strategies for identifying family routines and activities, including toddlers’ interests. Conversations and structured interviews with families and other team members will help the intervention team identify appropriate activities and routines into which naturalistic intervention can be embedded. Naturalistic interventions also rely upon understanding and building upon a toddler’s interests, which will need to be assessed.
Next, assessment information is used to set target behaviors and identify the environments and interactional contexts in which the target behavior may be elicited. The first approach is to set up the environment with high interest activities to naturally engage the child in social and communication interactions. Data analysis may indicate that ABA strategies are needed to add more structure to the naturalistic context of daily routines and activities. In this instance, the intervention team modifies their naturalistic intervention to include one of these ABA strategies: modeling, mand-model, time delay and incidental teaching.
Data are collected and used on an ongoing basis to determine the success of the naturalistic intervention and/or to modify the intervention. This may include increasing the complexity of the target behavior when it has been successfully met or more intentionally using ABA strategies to strengthen the naturalistic intervention.
Why Use Naturalistic Intervention?
Motivating a toddler with ASD to initiate communication and engage in social interactions can be very challenging. Identifying and building upon a toddler’s interests and working within daily routines and activities offer opportunities to increase meaningful engagement. Naturalistic intervention provides a way for just about anyone in a toddler’s life to learn strategies for interacting with the toddler in any setting where the child spends time. The intervention starts with the toddler’s interests, is planned around baseline data, and provides strategies to meet targeted behaviors.
Naturalistic interventions also provide guidance in structuring environments to elicit targeted behaviors.
Where Can a Naturalistic Intervention System be Used and By Whom?
Naturalistic intervention can be implemented in any setting where a toddler spends time, by parents and a variety of other appropriately trained adults, to support the acquisition of target behaviors in the areas of communication (prelinguisitic and linguistic) and social development. Parents, other family members (such as siblings, grandparents), early interventionists (such as teachers and therapists), child care providers, and community members (e.g. clergy, librarians) who have received training in the toddler’s naturalistic intervention may all be appropriate team members.
It is important to have a designated lead that will include all of the identified adults in planning and provide training in the specifics of a toddler’s naturalistic intervention. All participants will require some training in how to elicit the target behavior and collect data; some may need frequent training and ongoing coaching. At times, it may be appropriate to include siblings or other children in a naturalistic intervention. When that is the case, clear adult guidance and support is needed.
How are some ways naturalistic intervention can enhance communication and social skills that occur within everyday toddler activities and routines?
-
Initiating communication with a sibling during play time at home.
-
Engaging in two way communication during play time in a center-based program.
-
Using words to request “more” during snack or meal times.
-
Making a choice for a preferred bedtime story.
By using naturalistic interventions for target behaviors within specific routines such as those described above, responses can be strategically elicited and expanded upon to generalize skills to other routines and activities.
EXAMPLE
If a child is successful in learning to use the word, “more” to request more snack, the toddler is encouraged with similar strategies to use “more” to request more food in a restaurant or to request “more” of a preferred activity.
What is the Evidence-Base for Naturalistic Intervention?
The National Professional Development Center on Autism Spectrum Disorder (NPDC) reviewed and updated the literature on evidence-based, focused intervention practices previously conducted by NPDC.
- A total of 27 EBPs are identified in the current review.
- A total of 10 of these practices meet the criteria and have been shown effective with infants and toddlers with ASD.
The practices were identified as evidence-based when at least two high quality group design studies, five single case design, or a combination of one group design and three single case designed studies showed that the practice was effective. The full report is available on the NPDC on ASD website.
Naturalistic intervention meets the evidence-based practice criteria in the birth to elementary age groups with 10 single case design studies. For the infant and toddler age group, one single-subject design study included toddlers with autism and demonstrated positive outcomes in promoting the development of communication (Ingersoll, et al., 2005). Naturalistic intervention has been used effectively to address social, communication, behavior, joint attention, play, and academic skills. A complete list of the research evidence-base literature for children aged birth to five is included in the Module Resources section.
Refer to the Naturalistic Intervention Fact Sheet from the updated EBP report for further information on the literature for naturalistic interventions.
Knowledge Check
Question:
What are some key advantages of using naturalistic intervention?
Question:
What are some example of target behaviors that may be appropriately addressed through a naturalistic intervention?