Step 2 Implementing Naturalistic Intervention
This section describes how to implement naturalistic intervention. To begin using naturalistic intervention, elicit the target behavior using interaction techniques and, if necessary, behavioral strategies like prompting and modeling. It is most common for interaction and behavioral techniques to be used in combination with one another, thereby providing both the foundation of the interaction and the specifics on how the adult interacts with the toddler. In some cases, interaction techniques will be sufficient to elicit the target behavior, and further prompting will not be necessary.
Step 2.1 Engage the toddler in an interaction
Engage the toddler in language-rich and child-directed interactions, making sure you are highly attuned and responsive to the communicative attempts of the toddler. You should also aim to use a toddler’s interests and provide language models that are at a slightly higher level than the toddler’s own language to elicit a target behavior.
Following are some strategies that can be used to maintain a toddler’s interests and provide language models that are at a slightly higher level than the toddler’s own language use. For some toddlers, these techniques will facilitate their use of the target behavior.
Techniques Used to Engage Toddlers
Team members engage the toddler in a language-rich, child-directed, and reciprocal interaction that involves a variety of techniques. The following examples are described in more detail.
a. Following the toddler's lead
b. Being at the toddler's level
c. Responding to the toddler's verbal and nonverbal initiations
d. Providing the toddler with meaningful verbal feedback
e. Expanding the toddler’s utterances
Continue to review details of each technique.
Step 2a. Following the toddler’s lead
Following the toddler’s lead involves allowing the child to direct the interaction and the activity. Rather than the interventionist having a set plan (e.g., to play in the toy house), she waits and sees what the toddler wants to do. If the toddler goes to the toy house, she engages him there; and, if the child goes to the block area, she engages him with the blocks. Remember that the environment has already been arranged to elicit specific targets, so either activity should lead to the desired target.
For some toddlers, the interventionists must be especially observant and patient in order to follow the toddler’s lead. If a toddler has a more passive temperament, it may be difficult to entice the toddler to seek out his or her interests. When this occurs, the interventionist may be tempted to become more directive. For example, an interventionis might say to a toddler, “Here’s a puzzle! Let’s do it!”
However, the interventionist is encouraged to be patient, watch for nonverbal indications of interest (such as the toddler reaching for the puzzle), and match the toddler’s activity level. An example of this might be if the toddler is pouring sand over and over, the interventionist might join the toddler in this activity rather than encouraging her to make a sandcastle.
Step 2b. Being at the toddler’s level
With toddlers, being at their level often means that the interventions may have to lie or sit on the floor while the child is on the floor or couch to share face-to-face interactions. This kind of positioning facilitates shared attention, which is crucial to the interactions.
For toddlers who avoid eye contact, it may be necessary for the interventionist to maneuver her own body to interrupt the toddler’s eye gaze. That is, if the child is looking toward the clock while playing with a koosh ball, the interventionist may need to put her own face in the line of the clock to encourage eye contact and establish shared attention. However, if a toddler finds eye contact unpleasant and is actively avoiding eye contact, it may be best to engage the toddler in an interaction without insisting upon eye contact.
Step 2c. Responding to the toddler’s verbal and nonverbal initiations
When joining toddlers in play, interventionists must be vigilant in watching for toddlers’ communicative cues. A child who wants a snack that is out of reach may glance toward it and vocalize. An attuned interventionist recognizes this as a communicative attempt and responds. Being aware of even the most subtle communicative attempts and responding to these attempts teaches the toddler that communication is powerful. Catching these subtle attempts reduces missed opportunities for engagement, a common error in learning to respond to a toddler’s initiations, especially for toddlers with less apparent or infrequent communication and social behaviors.
Step 2d. Engaging toddler with verbal and motor imitation
This imitation can encourage turn-taking and facilitate the back-and-forth dance of social communication.
EXAMPLE
If a child holds a puzzle piece up to her face and says, “ga,” the interventionist can hold a puzzle piece up to his own mouth and say, “ga.”
Interrupting a routine with a pause or doing something novel that the toddler finds funny or interesting can keep a toddler engaged in an interaction.
EXAMPLE
Make a funny face as you reveal yourself after a few rounds of peek-a-boo or pause at the end of a line of a song, “The itsy bitsy spider went up the water...”
Step 2e. Providing the toddler with meaningful verbal feedback
Responding to a toddler’s communicative attempts with words, or meaningful verbal feedback, gives the child a model while they are sharing attention with the interventionist.
EXAMPLE
A minimally verbal toddler may be trying to place a puzzle piece and say,
“Ta!”
The interventionist, available and engaged, can respond,
“Stuck! That piece is stuck! Let’s turn it.”
Step 2f. Expanding the toddler’s utterances
When a toddler is verbal, especially at the one- to three-word phrase level, the interventionist can build on what the toddler says, thereby demonstrating more linguistically sophisticated options, as in this script:
Toddler (with toy cars): “Car.”
Interventionist (pushes car): “Car. Go, car!”
Toddler: “Go, car!”
Interventionist: “Go, car! Fast!”
Step 2 Video example of naturalistic strategies used in a play session
For most children with ASD, it will be necessary to provide additional supports and strategies for learners to demonstrate the target behaviors.
Video: Naturalistic Intervention Strategies as Additional Supports
This video segment gives a brief snapshot of how a play session on the floor may be conducive to eliciting target behaviors by using the strategies described.
Step 2.2 Use strategies based on applied behavior analysis to elicit target behaviors
Use modeling, mand-models, time delay, and/or incidental teaching techniques to elicit the target behavior within intervention contexts and arranged environments that were identified in Step 1.3.
Sometimes, engaging the toddler in a language-rich and responsive interaction within an arranged environment will result in the learner demonstrating the target behavior. However, if the toddler does not demonstrate the target behavior, applied behavior analysis (ABA) techniques can be used to elicit the target behaviors. This should still be within the context of an arranged environment and with an interventionist who is using responsive interaction techniques.
These strategies can be used with pre-linguistic toddlers, with some modifications. Instead of expanding on a verbal response, the communication partner would map language onto the target behavior, such as pointing.
Applied Behavior Analysis Interventions
- Modeling,
- Mand-modeling,
- Modified time delay
- Incidental teaching
Review more about each ABA intervention.
Modeling
Modeling is a verbal or visual demonstration of the correct response requested of a toddler.
Team members implement modeling by:
- establishing shared attention,
- presenting a verbal or physical model,
- expanding the response and providing the requested material (if the toddler responds to the model correctly),
- providing another model (if the toddler does not respond or is inaccurate),
- expanding the response and providing the requested material (if the toddler responds to the model correctly), and
- stating the correct response and providing the material (if the toddler does not respond or does not repeat the model correctly).
Mand-Modeling
Mand-model procedures incorporate a question, choice, or direction (mand) into the activity prior to initiating a modeling procedure.
Team members implement mand-modeling by:
- establishing shared attention;
- presenting a verbal direction (mand) or question;
- expanding the response and providing the requested material (if the toddler responds correctly);
- giving another direction or model (depending on the toddler’s needs for support), if the toddler does not respond or does not respond with a target;
- expanding on the response and providing the requested material (if the toddler gives the target response); and
- saying the target response and providing the material (if toddler still does not give the target response or repeat the model exactly).
Modified Time Delay
Time delay is a practice that focuses on fading the use of prompts during activities. With this procedure, a brief delay is provided between the initial requests/questions and any additional instructions or prompts. The use of modified time delay, or waiting, before providing a verbal prompt allows toddlers to initiate the verbalization and encourages them to become aware of nonverbal cues.
Interventionists implement modified time delay by:
- establishing shared attention;
- waiting 3-5 seconds for the toddler to make a request/comment;
- expanding on the request/comment and providing the requested material/activity (if the toddler initiates at the target level);
- providing a mand or model, depending on the toddler’s need for support (if the toddler does not initiate at the target level;
- expanding on the response and providing the material (if the toddler responds correctly);
- saying the target response and providing the material (if the toddler still does not give the target response or repeat the model exactly).
Incidental Teaching
Incidental teaching can be used to help toddlers elaborate on requests they have made. The interventionist encourages the learner to initiate interactions and manipulates the environment to elicit a request, and then uses a question to encourage an elaboration from the toddler.
Team members implement incidental teaching by:
- setting up the environment to encourage learners to request assistance or materials,
- waiting for learners to initiate the request,
- responding with a request for elaboration (if the learner does not initiate with the target response),
- continuing to prompt for elaboration until the learner responds appropriately, and
- using model, mand-model, or modified time delay procedures, depending on the needs of the learner (if the learner does not initiate a request).
(Adapted from Hancock & Kaiser, 2006)
Practice Scenario: Implementing Naturalistic Intervention
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When you have finished reviewing,
return to the module and take the Knowledge Check.
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Question:
When may it be necessary to use applied behavior analysis (ABA) strategies in a naturalistic intervention?
Question:
Name the four applied behavior analysis interventions that are used to elicit target behaviors within naturalistic contexts.