Augmented Naturalistic Developmental Behavioral Intervention For Toddlers With Autism Spectrum Disorder: A Community Pilot Study

In the United States, all families with children under the age of 3 years with disabilities or delays in development are eligible to receive public Early Intervention (EI) services. Many researchers are investigating Naturalistic Developmental Behavioral Interventions (NDBI), which have shown positive outcomes for young children with ASD. However, NDBIs have been mostly developed and implemented in university laboratories, and their effectiveness when delivered in community settings is not well understood. This pilot study introduces a comprehensive treatment model implemented in a community-based early intervention program that prioritizes caregiver empowerment, caregiver-clinician partnerships, and evidence-based practice (i.e., NDBI). Clinicians reported high satisfaction with the model, positive attitudes toward NDBI, and frequent use of NDBI strategies when providing care to families. Results also show that families across a range of socioeconomic backgrounds received services and children showed significant improvements in cognitive, social communication, and adaptive skills over the course of treatment. Caregivers demonstrated improvements in their ability to use NDBI strategies when interacting with their child. This study provides preliminary support that an evidence-based NDBI treatment program can be adapted to a community-based setting with high acceptability and positive behavioral change at the family level. Future research efforts should include caregiver input regarding model acceptability and examine effectiveness through direct comparison to a control group.