By Natalie Parks, PhD, BCBA-D
Trumpet Behavioral Health
Applied behavior analytic interventions have been proven to be effective at increasing adaptive behaviors and at decreasing problematic behaviors (Lovaas, 1987; Shriebman, Kaneko, & Koegel, 1991; Smith, 1998; Charlop-Christy, LeBlanc, & Carpenter, 1999; LeBlanc, Esch, Sidener, & Firth, 2006). Language interventions are common treatments for children with autism and focus on increasing the child’s ability to understand and produce language. While some ABA programs focus on first building skills within a structured learning environment using Discrete Trial Training (DTT; Smith, Donahoe, & Davis, 2001; Lovaas, 2003), it is becoming more and more common for ABA programs to provide a balance between structured learning opportunities and naturalistic teaching strategies (LeBlanc et al., 2006). Naturalistic teaching strategies focus on the generalized environment and are implemented within the home, at daycares, and within general education environments. The focus within these strategies is to teach the child language within the context of naturally occurring activities; thus instruction takes place during play and naturally occurring events rather than during specific instructional times (Charlop-Christy et al., 1999).
Because generalization of treatment is an outcome that is highly valued by all ABA interventionists, naturalistic teaching strategies should be incorporated into all ABA programs that focus on increasing language. There are several different naturalistic teaching strategies and each strategy differs slightly in the target skills, implementation, and prerequisite skills required of the child. This article will discuss some of the most common types of naturalistic teaching so that readers may determine the differences between strategies and understand how these strategies can be easily incorporated into any programming focused on increasing language.
Incidental Teaching (IT)
The primary goal of incidental teaching is to increase spontaneous language and to generalize skills that are learned in more structured contexts (LeBlanc et al., 2006). IT focuses on providing and creating opportunities that increase the child’s motivation to use language. The procedural steps of IT were described by Fenske, Krantz, and McClannahan (2001). First, the adult arranges the environment so that there are several preferred items and activities available to the child. As soon as the child initiates an interaction with an item or activity, the adult requests or prompts the child to engage in some form of language to request the item. Requests may include gestures, sign language, picture exchange systems, or spoken language. Once the child makes the appropriate or modeled request, the adult delivers access to the item of interest. After a short period of interaction with the item, the adult then removes the item and waits for the request to occur before providing access to that item.
Natural Language Paradigm (NLP)
Natural language paradigm (NLP) was first described by Koegel, O’Dell, and Koegel (1987). This procedure is more structured than IT and is good to use with children who do not have much language. In this procedure, the adult and child sit facing each other and the adult presents the child with three highly preferred items and/or activities and asks the child to choose one. Once the child selects an item, the adult models appropriate play and a spoken word or phrase (e.g., “ball” or “roll ball” as the adult is rolling the ball back and forth). The adult then pauses for five seconds to allow the child to imitate the phrase. Any attempt to imitate the phrase results in delivery of the chosen item. The child is allowed to interact with the item for approximately 30 seconds. During this time the adult comments on the child’s activities (e.g. “You are doing a great job rolling that ball!” or “I love how you are playing!”) and provides praise for interacting with the item. After 30 seconds has passed, the adult retrieves the item and models a new way of playing and a different phrase (e.g., “throw ball” while throwing the ball in the air). The child receives access by attempting to imitate the phrase. These interactions continue for 3-4 exchanges followed by the adult presenting three new choices and repeating the process with the new chosen item. Over time, the adult may begin to accept closer approximations to the targeted phrase rather than any vocalization to shape the child’s language into functional speech.
Pivotal Response Training (PRT)
Pivotal Response Training (PRT) targets increasing social-communicative repertoires and the child’s responsiveness to the environment (Koegel, Koegel, & McNerney, 2001). It focuses not only on language, but also on motivation, self-regulation, responding to multiple cues, and self-initiation of social interactions. This intervention has been manualized and has been used for children with autism who engage in problem behaviors, to increase spontaneous vocalizations, enhance the quality of peer interactions, and to improve academic performance (Koegel, Koegel, & Brookman, 2003). This intervention has been used to increase conversational skills and focuses on generalization skills that may have been learned in more structured environments.
The mand-model approach was developed by Rogers-Warren and Warren (1980). It is a modified version of incidental teaching. However, this approach focuses on generalizing previously learned skills rather than teaching new skills. With this approach, teaching begins with the adult arranging several preferred items and activities around the room. The adult then decides on an acceptable response that will be targeted. The response should be one that the child has demonstrated before, but hasn’t been used in all environments or as often as deemed appropriate. When the child attempts to interact with one of the items, the adult presents a question or instruction such as “What do you want?” or “Tell me what you want.” When the learner provides the acceptable response, the adult provides praise (e.g., “Nice job asking!”) and allows the child to interact with the item for a brief time period. If the child does not respond at the predetermined level, the adult may provide a prompt by stating how to respond correctly (e.g., “Use your words.” or “Tell me using a sentence.”) or modeling the correct phrase. This instruction is repeated if the child does not respond correctly and the item is delivered to the child after the third prompt or instruction if s/he does not respond correctly.
There are several strategies that use the principles of ABA in the natural environment to teach language. These strategies have resulted in better generalization of learned skills and ensure that children are using skills within their most natural contexts and activities. Naturalistic teaching strategies are also well designed for parent, teacher, and sibling implementation because they are typically easy to learn and can be incorporated into play and daily interactions. While DTT is still an important and useful component of instructional programs for children with autism, naturalistic teaching strategies can be used to expand this teaching and incorporate new learning opportunities for the child. Programming for children with autism should include a balance between DTT and naturalistic teaching strategies to ensure that children are provided with structured learning environments and that all skills are generalized to natural settings.
Dr. Natalie Parks is the clinical director of Trumpet Behavioral Health – San Jose. She has worked with children with autism and their families for over 14 years. She is a Board Certified Behavior Analyst and a licensed psychologist in the State of California. Dr. Parks has worked extensively both with children who display severe developmental deficits and those who engage in severe problem behavior.
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