BCBA Explains Naturalistic Teaching in ABA Therapy

There are two main teaching methodologies used in ABA therapy: Discrete trial training (DTT) and Naturalistic teaching, also called Natural Environment Teaching (NET). Where DTT is a highly structured approach, typically table-based, during which targets are presented in a fast-paced, repetitive manner, NET is more flexible, focusing on play and naturally occurring situations to teach skills while following the child’s interests and motivations.

NET techniques can help teach children a variety of skills, such as language skills, social skills, play skills, and even academic skills, in a natural and meaningful way. This article will cover the basics of NET, the benefits and challenges of the approach, and how to work with your team to introduce NET concepts into sessions.

What is Naturalistic Teaching in ABA Therapy?

NET is one of many strategies in ABA therapy that are used to reinforce desired behaviors. I often tell parents that in a great NET session, it won’t even look like the therapist is running goals as they will be seamlessly incorporating teaching during activities.

NET is a helpful approach to teaching skills as it molds itself completely to the child’s natural environment, making goals socially significant for the child and their family. The therapist will find ways to manipulate the environment to incorporate goals into play or naturally occurring situations. This is an effective method of therapy for several reasons.

Firstly, especially with early intensive intervention, this type of therapy is usually enjoyable for the child as it’s a child-led approach. This means the child’s motivation is high, and they are willing to participate in therapy for the long hours required. Secondly, running goals in a natural environment means generalization is more likely to occur, as the child is learning the skill in a variety of different and real-life contexts.

By following the child’s lead and contriving opportunities for speech, therapists can engage their clients to communicate what is important to them, such as their wants and needs. Using this child-led approach increases the likelihood that the children will spontaneously and independently communicate, as they will be motivated to request their preferred activities and items. Similarly, social skills are taught by playing games and creating social interactions which creates opportunities for the child to learn and emit the desired behavior.

Examples of Naturalistic Teaching in ABA

Here are some easy examples of naturalistic teaching:

• Engage your child in an activity that they enjoy, such as throwing a ball back and forth, jumping with you on a yoga ball, or tickling them, etc. After 30 seconds or so, when the child is highly engaged and having fun, pause the activity and prompt them to ask for more (verbally, using sign language, etc). Once the child requests “more”, you immediately praise and resume the activity.
• Similarly to above, pause during a fun activity such as blowing bubbles, throwing a car down a ramp, pushing them on a bike, etc, and count to 5 out loud. Once you reach 5, resume the activity. After a few trials, count to 4 and prompt the child to say number 5. Give lots of praise and continue to engage in the activity. After the child can independently say 5, stop at 3 and have them count 4 and 5. This is a fun and engaging way to rote learn numbers and practice social skills.
• Teaching body parts by singing the song “Head, shoulders knees, and toes”. Prompt your child to copy your movements and sing along if they are able.
• Playing with the child’s favorite toy to practice turn-taking and waiting.
• Keep preferred items locked or too high for the child to reach. This helps provide opportunities for them to request “help”, “open” or name the item.

The therapist and caregiver can talk and prompt the child to request attention appropriately when they approach.

Key Principles of Naturalistic Teaching

During a NET session, the therapist will follow the child’s interest to keep them motivated, engaged, and enjoying the session.

The child’s targeted skills will typically be reinforced with items in their environment and will make sense within the context of the session (see examples above). The therapists will be finding and contriving opportunities during activities to run the different goals of the child’s ABA program.

Often, caregivers will be asked to join in a certain activity and will be coached and trained by the therapist to run the goals with their child. This way, caregivers can continue to work on these skills outside of sessions.

NET differs from DTT therapy sessions in several ways. The main difference is in the structure of the session. NET sessions will look different every time as it is a child-led approach, while DTT, being therapist-led, is more consistent.

During a DTT session, a child will typically be seated at a desk and will be presented with an activity to complete in a highly structured way. Once the child has finished with the activity, they can have some downtime with a reinforcing item of their choice. Once the downtime is over, the child will return to the desk for the next round of teaching.

DTT is sometimes recommended with children who might have a hard time focusing and need highly structured sessions to help with skill acquisition. Therapists may sometimes use aspects of DTT in a NET session, as some goals may be too difficult to incorporate during play activities or if the child needs a little more structure to learn certain skills.

Techniques Used in Naturalistic Teaching

There are various techniques used in naturalistic teaching. Common approaches include:

• Incidental teaching: Incidental teaching involves following the child’s lead and interests and waiting for learning opportunities during these activities. This approach aims to increase motivation and promote generalization.
  
  
• Milieu therapy: During milieu teaching, the therapist will be teaching the child communication skills in their natural environment. The environment is either set up or naturally includes items that will motivate the child to want to communicate. Once the child shows interest in an item, the therapist will prompt a functional communication response.
  
  
• Pivotal response training: Pivotal response training is another child-led approach that focuses on teaching “pivotal” skills of child development, such as motivation, self-management, pro-social behaviors, and responding to multiple cues from the environment.

Benefits of Naturalistic Teaching for Children with Autism

The NET approach has many advantages which may make it a good fit for your child. For example, because of the child-led approach, the child is very motivated to participate in the therapy as they are engaging in their preferred activities. Apart from making therapy more enjoyable overall, children are more likely to generalize the skills acquired and use them in different environments as the goals are very specific to their child’s life.

Another positive of the NET method is that it creates a less intrusive learning environment compared to more structured DTT sessions. As NET incorporates itself into the child’s natural environment, a therapist can be running goals in several settings, such as schools, parks, shopping malls, etc without anyone else being aware.

Various studies have been conducted which highlight the effectiveness of the NET approach. One study incorporated NET training in different groups of non-verbal autistic children, finding that the groups that received NET showed improved language acquisition across different environments and people.

Another study examined the effect of DTT, NET, and DTT+NET in toddlers between 16 and 35 months. Results showed the children with NET and DTT+NET showed more gains in adaptive skills and a greater reduction in challenging behaviors. Researchers suggested that children with more significant delays benefit more from adding a DTT component to treatment.

Finally, one study examined how effective NET could be to teach children with ASD perspective-taking skills. The children were able to accurately engage in perspective-taking and the skill was generalized across people and stimuli without any direct teaching.

Implementing Naturalistic Teaching at Home

Incorporating naturalistic teaching methods may initially require some extra planning and thought but can soon become second nature and an easy way to encourage and maintain newly acquired skills. Find ways to create opportunities for communication, such as keeping things out of reach, singing songs and allowing time to fill in the blanks, pausing between games, only giving a little bit of a preferred item at a time to encourage asking for more, etc. During playtime, you can work on some social skills, such as practicing sharing, commenting on the play, turn-taking, and imitation.

Once you start, you will realize learning opportunities are everywhere. Initially, start with one goal or two and try to find or contrive situations during your child’s day to create a learning moment. If you are unsure where to start, consult your team and ask them which goals to prioritize. Once you feel comfortable with your first two goals, you can start incorporating more.

Working with ABA Therapists

The best and easiest way to integrate naturalistic teaching methods is by closely observing the ABA team that works at home with your child and aiming to replicate the same style. Make the most of the therapists while they are at home, and try to carve out some time during sessions to ask questions or even run some goals yourself while receiving feedback. If you have some ideas but are feeling unsure whether it’s appropriate or how you would run the goal, your ABA team is there to help create the most effective therapeutic environment for your child, so run any queries by them.

When selecting a provider, discuss with the agency or BCBA supervisor what sort of approach they base their therapy on. Another useful topic of discussion would be how they decide between more structured and less structured approaches as well as how they train therapists or supervisors to conduct NET sessions if they have a DTT background.

During NET sessions, it should appear as if your child is mainly playing fun games and activities with the therapist. Structured work at a desk and “drill” type activities should be kept at a minimum, as most goals will be seamlessly incorporated into the play.

Challenges and Considerations

Although NET is child-led, the therapist still needs to maintain control and structure the session. The therapist needs to find a balance between following the child’s lead and controlling the activities and sessions to be able to make space for learning opportunities. Furthermore, the therapists also need to strike a balance between pushing the child to reach their potential and keeping the child at ease.

Therapists can make easy adjustments to overcome these challenges. For example, if the child wants to engage in an activity in which learning opportunities are hard to come by or have caused challenges in the past, therapists can make session schedules with the child, presenting a forced choice between two alternative preferred activities. Making a schedule also ensures the therapist can intersperse highly and less preferred activities and can switch between more sedentary and more active games or tasks so they can help maintain the child’s motivation and energy levels.

As part of your child’s program, they should always have self-advocacy goals so they can appropriately request breaks to be all done or for different activities.

Resources and Further Reading

For further reading or information, here is a list of resources:

• Nature vs. Nurture in ABA: The Tale of Discrete Trial Training and Natural Environment Teaching (Book) by Travis Breeding.
  
  
• Chapter “Natural Environment Training” in the book “Handbook of early intervention for autism spectrum disorders: Research, policy, and practice” by Jonathan Tarbox et al.
  
  
• Teaching Language to Children With Autism or Other Developmental Disabilities (Book) by Mark Sundberg and James Partington.

Having a support network to lean on is going to be important, for you to have help emotionally as well as to receive practical advice. Autism Speaks has compiled a list to help you find local support groups. Talking to parents will help you understand what you can and should expect from your child’s NET ABA therapy and may help give you some ideas that you can run by your ABA team.

FAQs

What is the difference between incidental and naturalistic teaching in ABA?

Incidental teaching is similar to naturalistic teaching. However, the biggest difference is that in incidental teaching, the therapists do not contrive or manipulate the environment to create learning opportunities. During incidental teaching, the therapist waits for a learning situation in the environment to occur and then teaches during that situation.

Who is qualified to use naturalistic teaching

An ABA therapist can be easily trained by their BCBA supervisor to conduct naturalistic teaching. As with all things, the more opportunities to practice, the better, so an experienced NET ABA therapist would be a preferred choice. However, the most important quality to look out for initially is whether or not the therapist and your child have rapport, whether they know how to play, and whether they are engaging. Those qualities are harder to teach, so if the therapist has those, teaching NET skills is an easier feat.

Conclusión

NET can be a fun, enjoyable, and effective way to teach and develop your child’s functional skills. After the therapist and child have developed a rapport, your child will begin to learn adaptive behaviors quickly, which they will be able to use in their everyday life to communicate and interact with those around them.

Most children will benefit from adding naturalistic teaching methods to their treatment package. If you feel like NET is an approach you would want your child to try, discuss options with your ABA therapy provider. As a parent or caregiver, you know your child the best and are their most powerful advocate. Keep learning and educating yourself, and be open to trying new approaches. If you feel like your current team is not open to NET methods and you do not feel heard, you can change providers until you find a better fit for your child.

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