Naturalistic Developmental Behavioral Interventions (NDBIs) have a strong and growing evidence base. Yet, NDBIs are not implemented on a wide scale within early intervention programs for children on the autism spectrum. Potential reasons for the slow adoption of NDBIs likely stem from the differing theoretical orientations of behavioral and developmental sciences from which NDBI are derived, and a lack of training, knowledge, and support for implementing NDBIs within the behavior analytic community. In support of efforts to promote wide-scale implementation of NDBIs, we clarify their common features, discuss possible misconceptions, offer reasons why NDBIs should be widely implemented, and provide recommendations to the autism service community, intervention developers, and researchers to improve their dissemination and implementation. Lay Abstract Naturalistic Developmental Behavioral Interventions (NDBIs) are a group of early interventions that use a variety of strategies from applied behavioral and developmental sciences. Although Naturalistic Developmental Behavioral Interventions have been demonstrated effective, Naturalistic Developmental Behavioral Interventions are not implemented on a wide scale within early intervention programs for children on the autism spectrum. Potential reasons likely stem from differing theoretical orientations of developmental and behavioral sciences and practitioners’ lack training, knowledge, and support for implementing Naturalistic Developmental Behavioral Interventions. In support of efforts to promote wide-scale implementation of Naturalistic Developmental Behavioral Interventions, we (1) clarify their common features, (2) discuss possible misconceptions, and (3) offer reasons why Naturalistic Developmental Behavioral Interventions should be widely implemented. We also provide recommendations to the autism service community, intervention developers, and researchers.

The COVID-19 pandemic necessitated a rapid transition to virtual service delivery and supervision. This preliminary study examined acceptability and feasibility of virtual supervision for 94 BCBA/BCaBA trainees during COVID-19, including variables that affected perceived satisfaction, effectiveness, and supervision preference for this sample. Results indicate a decrease in accrual of direct client hours during the pandemic, with a third of participants reporting a decrease in individual supervision. In general, participants were satisfied with virtual individual and group supervision as indicated by high satisfaction domain scores and individual item means, with minimal overall change in satisfaction. Participants indicated preference for in-person or hybrid supervision and considered in-person most effective. In general, participants reported that virtual supervision was feasible and supervisors used best-practice strategies. We discuss variables that affected satisfaction (e.g., length of supervisory relationship), preference (e.g., age, services provided), and perceived effectiveness (e.g., time supervisor was a BCBA). We provide practical implications and recommendations for virtual supervision.

Hospitals, with many features that can evoke severe behavior in patients with autism spectrum disorder (ASD), often use restraint as a behavior management strategy. Prior research on restraint in patients with ASD has primarily focused on children or specific departments. Twenty-five physicians and medical trainees from an urban teaching hospital participated in discussions about experiences managing severe behavior in patients with ASD across the lifespan. Twenty themes emerged from thematic analysis of participant transcripts. The five most salient themes included: lack of procedural knowledge with restraint implemented by other hospital professionals; alternative strategies to manage severe behavior; negative perceptions of restraint; helpful role of caregivers; and limited experience treating patients with ASD, and critical need for training in function-based management.

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Functional communication training is an effective treatment for decreasing socially reinforced destructive behavior (Carr & Durand, 1985). Clinicians frequently use multiple schedules to thin the reinforcement schedule (Hanley et al., 2001). Individuals are often taught to wait for functional reinforcers without alternative programmed stimuli. However, concurrently available items and activities are often accessible in the natural environment. In this study, we taught 4 participants a functional communication response to access functional reinforcers. We implemented a multiple schedule during schedule thinning, comparing a control condition (nothing available during SΔ intervals) to separate conditions with items/activities (moderately preferred tangible items, attention, demands) noncontingently available during SΔ intervals. After reaching the terminal schedule in one condition, therapists assessed participant preference across SΔ conditions. For all participants, the terminal schedule was reached with alternative items and activities, and participant preference corresponded with the most efficient schedule thinning condition. Therapists also indicated preference for alternative items/activities.