Association for Behavior Analysis International

Naturalistic Developmental Behavioral Interventions (NDBIs) utilize natural contingencies and behavioral strategies (Schreibman et al., 2015) and are effective at increasing skills in autistic children. A recent meta-analysis of early interventions for autistic children found that NDBIs outperform other behavioral interventions (Sandbank et al., 2020). Yet most ABA providers report limited training in NDBIs. This symposium describes applied research from 13 institutions on the use of NDBIs in community settings. The first presentation reports improvements in adaptive behavior, social skills, and autism symptoms for autistic children receiving NDBIs within an inclusive preschool setting. The second and third presentations present data on practitioner perspectives on NDBIs, with presentation 2 demonstrating how ABA provider perceptions of NDBIs change over time and with consultation, and presentation 3 illustrating preschool teachers’ experience with and perceptions of NDBIs. Finally, the fourth presentation demonstrates the parent coaching practices of NDBI-trained early intervention (EI) providers, noting barriers and facilitators to parent coaching in the EI system. Dr. Amy Matthews (discussant) will draw on her expertise in the implementation of NDBIs in community settings and will provide recommendations for provider training and scale-up implementation efforts, particularly in publicly funded service systems.

Behavior analysts and other practitioners interested in learning more about the implementation of Naturalistic Developmental Behavioral Interventions (NDBIs) in community settings

The importance of inclusive environments for children with autism spectrum disorder (ASD) is well established, and positive outcomes have been reported for some preschool inclusion programs (e.g., Strain & Bovey, 2011). However, these studies report extensive training from researchers, and limited data are available on the effectiveness of community-based and self-sustaining preschool inclusion programs. Moreover, few studies have reported outcomes from the community-based delivery of naturalistic developmental behavioral interventions (NDBI) in group-based community care. This quasi-experimental study reports outcomes for 26 children, 3-5 years of age at entry and diagnosed with ASD, who were enrolled in a community-based inclusion preschool program delivering NDBI for at least 6 months. Paired sample t-test indicated statistically significant improvements from entry to exit on standardized measures of adaptive behavior (Figure 1), social skills (Figure 2), and autism symptoms (Figure 3). The majority of children were testing in the adequate or higher range across measures after an average of 18 months of intervention (SD=6.5 months). Implications for the effectiveness of inclusive settings for preschool-aged children, considerations in the delivery of NDBI in group inclusive settings, and future directions will be discussed.

Background: Little is known about how ABA provider perceptions of Naturalistic Developmental Behavioral Interventions (NDBIs) change over time. Consultation may also affect provider perceptions of these interventions. We investigated the effect of time and consultation on perceptions of Project ImPACT, an empirically supported NDBI. Methods: We fit 9 two-level multilevel models. We report preliminary analyses from 9 providers across 4 agencies in the Medicaid system (single case design). Providers delivered Project ImPACT during baseline (randomized to 3-6 weeks) and during the 12 weeks of consultation. Providers completed the Perceived Characteristics of Intervention Scale (PCIS) weekly. Results: Perceptions of Project ImPACT were moderately high (see Figure 1). See Table 1 for model parameters. There was an effect of time on trialability and task issues; regardless of whether providers were receiving consultation, each week, providers rated Project ImPACT as easier to try out and more helpful at improving the quality of their work. The effect of time on trialability varied depending on condition. The average rating of trialability was lower during baseline than during consultation and trialability ratings increased each week during baseline, but not during consultation. Though marginal, there was an effect of time on observability; each week, providers rated client improvements from ImPACT to be more observable. There was no effect of consultation. Conclusions: Increased use of NDBIs over time results in more favorable perceptions. Consultation does not appear to change providers’ perceptions. Implications for provider training will be discussed.