I meet a lot of parents that are leery about starting ABA (applied behavior analysis) services with their children. Some share concerns about the high degree of structure that is often associated with DTT (discrete trial teaching), and others have questions about the repetitive drills, and the use of edible reinforcement.
As an SLP and BCBA, I understand the desire for interventions that are developmental in nature and focus on relationships and play. And while ABA services, included DTT can bring about amazing gains in language, imitation, engagement, self-help skills and play development when provided properly by qualified staff, it may not be for everyone and that is okay. In fact, this is why I love the field of ABA, as there are many evidence-based treatment options.
This is where NDBI’s come in (naturalistic development behavioral interventions). NDBI’s are essentially the merging of applied behavior analysis and developmental sciences. NDBI’s are taught in natural settings and use a variety of strategies to address the core deficits found in young autistic children. In fact, NDBI models are now considered state of the art for treating toddlers with autism.
Some commonly known NDBI’s with the most research to support their effectiveness include:
· Incidental Teaching
· Pivotal Response Training
· Reciprocal Imitation Training
· Project ImPACT
· SCERTS
· JASPER
· Early Achievements
For the purposes of this post, I want to delve in a bit deeper into JASPER. What I love about this approach is that addresses the core symptoms of autism, including face-to-face reciprocal social interactions, imitation, joint attention, and play skills rather than generic development skills. Because it is play-based, children LOVE it!
The intervention starts with a play-based assessment as needed to identify the child’s independent and spontaneous level of play. Once the child’s mastered play level is identified, then specific language and engagement targets are chosen to embed into the play sessions. For example, let’s say a child can combine objects together in play such as stack blocks, or place toys into a shape sorter or the back of a dump truck. The initial goal might be to expand on the child’s play skills (e.g., make conventional combinations such as putting play food on plates or placing figures into a bus), while targeting increased engagement, the give gesture to request for help, and pointing to show (joint attention).
Core Features Include:
· Modeling and teaching joint attention skills directly
· Increasing the ability to coordinate attention
· Increasing diversity and flexibility in play skills
· Increasing functional play and reaching higher levels of symbolic play
· Improving states of engagement
· Increasing opportunities for learning and social communication
· Increasing emotional and behavioral regulation
In addition, JASPER uses four core components in its approach to increase joint engagement for young children: environmental arrangement, mirrored pacing, prompting, and communication.
· Environmental Arrangement refers to the toy and material choices to use during playtime, as well as how to modify the environment in such a way to enhance engagement such as reducing distractors, adding visual supports, and setting up materials in a clear manner (e.g., providing an example of what the child can do in play such as having a few blocks stacked or a cupcake on a plate).
· Mirrored Pacing refers to how to follow the child’s lead and “mirror” the child’s interests by imitating the way the child is playing with toys and objects. By doing this, parents and clinicians can help the child learn to take turns and strengthen their ability to have social interactions with other adults and children (Gulrud et al., 2015).
· Prompting consists of different prompting techniques that are based on the child’s current language abilities. These techniques help improve engagement and how the child uses communication and language. For example, if the child points to a toy they want to play with, the parent or clinician could respond by prompting them to say the toy’s name (i.e. “say doll”) and then handing them the doll.
· Communication refers specifically to how parents and clinicians can imitate the language the child uses, and then expand it by adding new words (Gulsrud et al., 2015). For example, if the child says “car,” the adult can expand this by saying, “drive the car.” This technique builds on the child’s existing language, while also teaching them new words.
I am excited to bring this intervention to our clinic. If you are interested in learning more about JASPER, visit http://www.kasarilab.org/treatments/jasper/