How naturalistic teaching is used in ABA therapy
Naturalistic teaching, or natural environment teaching, in ABA therapy can help children diagnosed with ASD to better develop their social skills, and is one of the core strategies ABA therapists use. Applied Behavior Analysis (ABA) is a form of therapy that can help children and young adults diagnosed with autism to improve their communication, social and self-care skills. An ABA therapy program is tailored to the needs of the client and their family by a team of Behavior Therapist (BTs) and Board Certified Behavior Analysts (BCBAs), who employ a range of training methods to help the young people achieve their goals.
There are two common strategies in ABA therapy, explains Anna Abromovich, a Board Certified Assistant Behavior Analyst at Illuminate: Discrete Trial Training (DTT) and Naturalistic Teaching Strategies (NATS) – also known as Natural Environment Teaching (NET).
“Discrete trial training involves breaking down a target that you want to achieve into small steps, then sitting at a table and using repetition for clients to learn skills,” Anna says.
“It can be difficult for some clients to generalize these skills when they’re in a different situation though. We might have practiced having a conversation at the table, but it’s very different when somebody from the outside starts to have a conversation with you.”
This is where using naturalistic teaching in an ABA therapy session can make all the difference. Naturalistic teaching gives children the ability to develop their language and social skills in any setting.
What is naturalistic teaching in ABA?
As the name suggests, naturalistic teaching in ABA is when therapists and their clients work in natural settings that the children are likely to encounter in their day-to-day lives. “We don’t work in a plain room with just a table and two chairs,” explains Anna. “Here at Illuminate, our building is designed so that every room looks like a different kind of natural environment. We have spaces that are set up as an apartment, a sandbox, a gym and so on.”
Learning how to adapt to different environments and working on different skills in each of those settings is what makes naturalistic teaching so successful, Anna continues. “Children with autism tend to have a difficult time generalizing skills at home and in the community. So if we teach in the natural environment it seems to make more sense to them, and the skills they develop stick better.
“I don’t think there’s a good comprehensive ABA treatment plan that has only discrete trial training,” she adds. “Everything needs to include some sort of natural environment training, if you want the client to be able to generalize their learned skills to a natural setting.”
How involved can parents be in naturalistic teaching?
Due to its less structured nature, naturalistic teaching can be continued beyond the regular ABA therapy sessions that children have at a therapy center. Unlike discrete trial training, naturalistic teaching can easily be worked into a child’s daily routines with their parents, carers and teachers.
“Not everything has to be taught at a table or in repetition,” says Anna. “So we let parents know about the various learning opportunities that they come across on a daily basis which they might recognize. A lot of kids have difficulty with adaptive daily living skills, for example, so things like bathing, brushing teeth and washing hands, and there are always opportunities to facilitate these everyday events so that the child is learning during them.”
ABA therapists can also carry out therapy sessions in a child’s home or other surroundings they are familiar with. “It all depends on what the family needs,” says Anna. “If they had trouble before school, for example, I could go in and plan a routine or a schedule for the parents, and create visual prompts to put into their natural routine to hopefully make them more successful. We could also go in at night, to help with the bathing routine and things like that. But we also offer parent training once a week or every other week to make sure that what we’re doing in the regular therapy sessions is transferring to home.”
What is an example of naturalistic teaching in ABA?
Unlike some other ABA therapy options, naturalistic teaching is generally led by the child. “You take their lead and you work on targets that are natural for that area or skill level,” says Anna. “It takes a little bit more work on the technician’s side to fit targets in as it’s very personalized, and very physical as much as the kid wants it to be physical. You’ve got to engage to make them want to engage back.”
One way to make the sessions feel natural is to involve other children. “Children tend to learn better from their peers than necessarily adults,” says Anna, “so it can be really good to have them observe and imitate.
“So, instead of having the child that you’re working with sitting at a table to learn how to play with a toy, we have them on the floor with other kids and other toys, and we’re teaching them there. To teach social skills we’d go into the gym with a bunch of different kids and start playing, instead of making it a formal structured activity.”
Examples of naturalistic teaching strategies
Even though naturalistic teaching sessions work at the client’s pace and are not usually rigidly structured, there are some strategies which therapists use to help their clients develop their communication and social skills while they’re having fun.
“Instead of just using full vocal prompts to ask the client to do something, we might simply point or gesture,” suggests Anna. “We might have them observe how their peers and other people are acting in the environment.”
Another naturalistic teaching strategy is to set up ‘contrived’ learning opportunities with staged situations that are initiated by the therapist, Anna explains. “For example, you might place a toy up high so the client has to ask for it.” The child can then be encouraged to ask for the toy in the correct way, although of course they would ultimately receive it regardless of their response.
“There are incidental learning opportunities during a naturalistic teaching session too,” Anna adds. “If someone trips and falls in the environment that we’re working in, how should the client react to another peer that’s upset?”
How successful is naturalistic teaching in ABA?
Naturalistic teaching can be a successful aspect of ABA therapy for any child diagnosed with ASD, but it’s particularly rewarding for children and young people who struggle with the more structured learning experience of discrete trial training.
“I’ve had a lot of success in ABA, and a lot of what I do has been natural environment teaching,” says Anna. “I think kids adapt better to naturalistic training. It’s not as aversive. Sometimes, working at the table, all of those trials, it can almost be traumatizing.”
There are a few situations where naturalistic teaching might not be integrated into an ABA therapy plan from the get go. Anna suggests. “Some children might have very limited interests or very limited motivation, and in this case it might be easier to teach them the basics in a controlled setting and then apply them in a natural setting.
“For a lot of the children we work with, though, kids their age would normally want to be playing. So we let them play and just build in those foundational skills that they need to fine-tune a little bit. We don’t really focus as much on academic tasks that’ll help kids be school ready. We’re more about preparing kids for the world and living on their own.”