Matrix of NI by Outcome and Age (years)

Brief Introduction Naturalistic intervention (NI) is a collection of practices designed to encourage specific target behaviors based on learners interests. It occurs within the typical settings, activities, and/or routines in which the learner participates. Description Naturalistic intervention (NI) is a collection of practices including environmental arrangement, interaction techniques, and strategies based on applied behavior analysis principles. These practices are designed to encourage specific target behaviors based on learners interests by building more complex skills that are naturally reinforcing and appropriate to the interaction. Naturalistic intervention occurs within typical settings, activities, and/or routines in which the learner participates. NI meets evidence based criteria with 10 single case design studies. According to the evidence based studies, this intervention has been effective for toddlers (0 2 years) to elementary school age learners (6 11 years) with ASD. NI can be used effectively to address social, communication, behavior, joint attention, play, and academic skills. Brief Adapted from Franzone, E. (2009). Overview of naturalistic intervention. Madison, WI: University of Wisconsin, Waisman Center, The National Professional Development Center on Autism Spectrum Disorders. Wong, C. (2013). Naturalistic intervention (NI) fact sheet. Chapel Hill, NC: The University of North Carolina, Frank Porter Graham Child Development Institute, The National Professional Development Center on Autism Spectrum Disorders. Matrix of NI by Outcome and Age (years) Social Communication Behavior Joint Attention Play Cognitive School Readiness Academic Motor Adaptive Vocational Mental Health 1 1 1 1 1 1 1 1 1 1 1 1 Naturalistic Intervention Research Summary Ages Skills/Intervention Goals Settings Outcome 11 years Social, communication, joint attention, play, learning readiness, academic Home, school, community EBP *The information found in the Research Summary table is updated yearly following a literature review of new research and this age range reflects information from this review. August 201

Research Charlop, M. H., & Trasowech, J. E. (1991). Increasing autistic children s daily spontaneous speech. Journal of Applied Behavior Analysis, 24(4), 747 761. Charlop, M. H., & Walsh, M. E. (1986). Increasing autistic children s spontaneous verbalizations of affection: An assessment of time delay and peer modeling procedures. Journal of Applied Behavior Analysis, 19(3), 307 3. Charlop, M. H., Schreibman, L., & Thibodeau, M. G. (198). Increasing spontaneous verbal responding in autistic children using a time delay procedure. Journal of Applied Behavior Analysis, 18(2), 1 166. Hamilton, B. L., & Snell, M. E. (1993). Using the milieu approach to increase spontaneous communication book use across environments by an adolescent with autism. Augmentative and Alternative Communication, 9, 29 272. Hancock, T. B., & Kaiser, A. P. (2002). The effects of trainer implemented enhanced milieu teaching on the social communication of children with autism. Topics in Early Childhood Special Education, (1), 39 4. doi: 10.1177/02711202000104 Ingersoll, B., Dvortcsak, A., Whalen, C., & Sikora, D. (200). The effects of a developmental, social pragmatic language intervention on rate of expressive language production in young children with autistic spectrum disorders. Focus on Autism and Other Developmental Disabilities, 20(4), 213 2. doi: 10.1177/108837600200040301 Ingersoll, B., Lewis, E., & Kroman, E. (2007). Teaching the imitation and spontaneous use of descriptive gestures in young children with autism using a naturalistic behavioral intervention. Journal of Autism and Developmental Disorders, 37, 46 6. Koegel, L. K., Carter, C. M., & Koegel, R. L. (2003). Teaching children with autism self initiations as a pivotal response. Topics in Language Disorders, 23(2), 134. doi: 10.1097/00011363 2003040000006 Koegel, R. L., Camarata, S., Koegel, L. K., Ben Tall, A., & Smith, A. E. (1998). Increasing speech intelligibility in children with autism. Journal of Autism and Developmental Disorders, 28(3), 241 21. doi: 10.1023/A:1026073897 Koegel, R. L., Koegel, L. K., & Surratt, A. (1992). Language intervention and disruptive behavior in preschool children with autism. Journal of Autism and Developmental Disorders, (2), 1 13. doi: 10.1007/BF01087 Kohler, F. W., Anthony, L. J., Steighner, S. A., & Hoyson, M. (2001). Teaching social interaction skills in the integrated preschool: An examination of naturalistic tactics. Topics in Early Childhood Special Education, 21(2), 93 103. doi: 10.1177/0271120102100203 Laski, K. E., Charlop, M. H., & Schreibman, L. (1988). Training parents to use the natural language paradigm to increase their autistic children s speech. Journal of Applied Behavior Analysis, 2(4), 391 400. McDuffie, A., Machalicek, W., Oakes, A., Haebig, E., Weismer, S. E., & Abbeduto, L. (2013). Distance videoteleconferencing in early intervention: Pilot study of a naturalistic parent implemented language intervention. Topics in Early Childhood Special Education, 33(3), 172 184. doi: 10.1177/02711213476348 August 201

McGee, G. G., & Daly, T. (2007). Incidental teaching of age appropriate social phrases to children with autism. Research and Practice for Persons with Severe Disabilities, 32(2), 112 123. doi: 10.211/rpsd.32.2.112 McGee, G. G., Almeida, M. C., Sulzer Azaroff, B., & Feldman, R. S. (1992). Promoting reciprocal teaching via peer incidental teaching. Journal of Applied Behavior Analysis, 2, 117 126. McGee, G. G., Krantz, P. J., & McClannahan, L. E. (198). The facilitative effects of incidental teaching on preposition use by autistic children. Journal of Applied Behavior Analysis, 18, 17 31. Olive, M. L., De la Cruz, B., Davis, T. N., Chan, J. M., Lang, R. B., O Reilly, M. F., & Dickson, S. M. (2007). The effects of enhanced milieu teaching and a voice output communication aid on the requesting of three children with autism. Journal of Autism and Developmental Disorders, 37, 10 113. doi: 10.1007/s10803 000243 6 Seiverling, L., Pantelides, M., Ruiz, H. H., & Sturmey, P. (2010). The effect of behavioral skills training with general case training on staff chaining of child vocalizations within natural language paradigm. Behavioral Interventions, 2(1), 3 7. doi: 10.1002/bin.293 Whalen, C., & Schreibman, L. (2003). Joint attention training for children with autism using behavior modification procedures. Journal of Child Psychology and Psychiatry, 44(3), 46 468. doi: 10.1111/69 7610.0013 Yoder, P., & Stone, W. L. (2006). A randomized comparison of the effect of two prelinguistic communication interventions on the acquisition of spoken communication in preschoolers with ASD. Journal of Speech, Language, and Hearing Research, 49, 698 711. August 201

References Hancock, T. B., & Kaiser, A. P. (2002). The effects of trainer implemented enhanced milieu intervention on the social communication of children with autism. Topics in Early Childhood Special Education, (1), 39 4. Hanock, T. B. & Kaiser, A. P. (2006). Enhanced milieu teaching. In McCauley R. J. & Fey, M. E. (Eds.), Treatment of language disorders in children (pp. 203 9). Baltimore, MD: Paul H. Brooks Publishing. Hwang, B., & Hughes, C. (2000). The effects of social interactive training on early social communicative skills of children with autism. Journal of Autism and Developmental Disorders, 30(4), 331 343. Ingenmey, R., & Van Houten, R. (1991). Using time delay to promote spontaneous speech in an autistic child. Journal of Applied Behavior Analysis, 24(3), 91 96. Kaiser, A. P., Hancock, T. B., & Nietfeld, J. P. (2000). The effects of parent implemented enhanced milieu intervention on the social communication of children who have autism. Early Education and Development, 11(4), 423 446. Koegel, R. L., O Dell, M. C., & Koegel, L. K. (1987). A natural language intervention paradigm for nonverbal autistic children. Journal of Autism and Developmental Disorders, 17(2), 187 200. Matson, J. L., Sevin, J. A., Box, M. L., & Francis, K. L. (1993). An evaluation of two methods for increasing self initiated verbalizations in autistic children. Journal of Applied Behavior Analysis, 26(3), 389 398. Neef, N. A., Walters, J., & Egel, A. L. (1984). Establishing generative yes/no response in developmentally disabled children. Journal of Applied Behavior Analysis, 17(4), 43 460. Wong, C. S., Kasari, C., Freeman, S., & Paparella, T. (2007). The acquisition and generalization of joint attention and symbolic play skills in young children with autism. Research and Practice for Persons with Severe Disabilities, 32(2), 101 109. August 201

Steps for Implementation Step 1. Identifying a Target Behavior A. Select a specific target behavior to be the focus of intervention. It should focus on: i. prelinguistic or linguistic communication and/or ii. social skills B. Confirm that the target behaviors are in the learner s IEP or IFSP. Step 2. Collecting Baseline Data A. Prior to intervention, determine the learner s current use of the target skill. B. Collect data on the target skills a minimum of three times in more than one environment. Step 3. Identifying the Contexts for Intervention A. Determine the learner s daily schedule. B. Determine what motivates the learner. C. Identify the contexts in which naturalistic intervention will be embedded, including: i. learner directed activities, ii. routine activities, and/or iii. planned activities. Step 4. Providing Training to Team Members A. Determine who will teach the skill. B. Provide adequate training to team members before initiating naturalistic intervention. Step. Arranging the Environment to Elicit the Target Behavior A. Choose motivating materials/activities to engage learners and promote the use of target skills. B. Manage and distribute teaching materials in a way that encourages learners to communicate. C. Arrange the intervention context and environment to: i. encourage the use of the target act/skill and ii. maintain learners interest. Step 6A. Engaging the Learner in an Interaction A. Engage the learner in language rich, learner directed, and reciprocal interactions that involve the following techniques: i. Following the learner s lead ii. Being at the learner s level iii. Responding to the learner s verbal and nonverbal initiations iv. Providing meaningful verbal feedback v. Expanding the learner s utterances August 201

Step 6B. Using Strategies Based on Applied Behavior Analysis (ABA) to Elicit Target Behaviors A. Select a behavioral intervention (modeling, mand modeling, modified time delay, or incidental teaching) to elicit the target act. B. Implement modeling by: i. Establishing shared attention ii. Presenting a verbal model iii. Expanding the response and providing the requested material (if the learner responds to the model correctly) iv. Providing another model (if the learner does not respond or does not repeat the model exactly) v. Expanding the response and providing requested material (if the learner responds to the model correctly) vi. Providing the material and stating the corrected response (if the learner does not respond or does not repeat the model exactly) C. Implement mand modeling by: i. Establishing shared attention ii. Providing a verbal direction (mand) or question iii. Expanding the response and providing the requested material (if the learner responds correctly) iv. Providing another direction or a model (depending on learner s needs for support) if the learner does not respond or does not respond with the target behavior v. Expanding the response and providing the requested material (if the learner gives the target response) vi. Providing the material and stating the target response (if the learner still does not give the target response or repeat the model exactly) D. Implement modified time delay by: i. Establishing shared attention ii. Waiting 3 seconds for the learner to make requests/comments iii. Expanding on the request/comment and providing the requested material/activity (if the learners initiates at the target level) iv. Providing a mand or model, depending on the learner s needs for support (if the learner does not initiate at the target level) v. Expanding the request and providing the material (if the learner responds correctly) vi. Providing the material and stating the target response (if the learner still does not give the target response or repeat the model exactly) August 201

E. Implement incidental teaching by: i. Setting up the environment to encourage the learner to request assistance or materials ii. Waiting for learner to initiate the request iii. Responding with a request for elaboration (if learner does not initiate with the target response) iv. Continuing to prompt for the elaboration until learner responds appropriately v. Using model, mand model, or modified time delay procedures, depending on the needs of learner (if learner does not initiate a request with the target act) Step 7: Using Data Collection to Monitor Learner Progress and Determine Next Steps A. Collect data to evaluate the success of the intervention and guide future decision making. August 201