Naturalistic Intervention (NI) involves teaching strategies that are integrated into the learner's everyday activities and routines. Instead of separate, structured teaching sessions, NI uses the natural environment to create learning opportunities. Educators or service providers set up the environment to encourage the learner’s interest, provide support to help them engage in the desired behaviour, and build on the behaviour as it occurs. They also use natural consequences to reinforce the skills being taught (Steinbrenner et al., 2020).
Step 1: Initial Observation
Observe if the child can request continuation of a **social routine independently using the Speech Generating Device (SGD).
Procedure:
The child and their mother engage in a preferred social routine (e.g., tickling for or singing “Monkeys on the Bed”). The mother pauses the activity for 10 seconds. Observe whether the child independently selects the correct icon on the iPad® to request the continuation of the routine. If the child does not request within 10 seconds, the mother resumes the routine without any prompting.
Example:
Jeremy's mother pauses tickling him after a few seconds and Jeremy has the chance to use the SGD to request more tickles. If he does not request, the mother resumes tickling him after the pause.
Step 2: Teach
Teach the child to request continuation of the routine using the SGD with reduced prompting over time.
Procedure:
The parent engages in the routine (e.g., peek-a-boo). When the mother pauses, if the child does not request continuation within 10 seconds, use the following least-to-most prompting strategy:
Gesture Prompt: Gesture toward the iPad® to guide the child’s attention to the SGD.
Vocal Prompt: Verbally encourage the child, e.g., "Use the iPad to ask for peek-a-boo."
Partial Physical Prompt: Gently guide the child's hand towards the correct icon.
Full Physical Prompt: Assist the child in selecting the correct icon fully if necessary.
Praise:
Independent Request: If Grace selects the “peek-a-boo” icon without any assistance, her mother provides enthusiastic praise like, "Great job asking for more peek-a-boo!"
Prompted Request: If prompts are used, her mother gives neutral praise like, "Good job asking for more peek-a-boo."
Example:
Grace’s mother pauses during the “foot rub” routine. Grace takes a few seconds to select the “foot rub” icon on her iPad® after a vocal prompt, receiving neutral praise.
Step 3: Extra Teaching Phase (Additional Support)
Provide extra teaching opportunities for children needing additional practice.
Procedure:
For children like Jeremy, who struggle to request certain routines like tickles, provide five errorless learning trials before each session. These trials involve full prompts to prevent mistakes, allowing Jeremy to practice requesting tickles with complete assistance.
Praise:
Similar to the teaching phase, but focus on fading the prompts while increasing the use of independent praise as prompts reduce.
Example:
During the errorless learning trials, Jeremy’s mother uses full physical prompting to guide him in selecting the “tickle” icon. Over time, the prompts are reduced, and Jeremy starts requesting tickles with less help.
Step 4: Follow-Up
Check if the child can still request continuation of the social routine independently after some time.
Procedure:
One to two months after the intervention, revisit the same routines (e.g., piggyback rides for Jeremy or pulling silly faces for Grace). Observe if the child can use the iPad® to request these routines without prompting, following the same procedure as the initial observation.
Example:
After two months, Jeremy’s mother pauses during a piggyback ride. Jeremy independently selects the “piggyback” icon on his iPad® to request the continuation, indicating that he retained the skill.
Step 5: Generalisation
Ensure the child can request continuation of routines across different social settings and with different partners.
Procedure:
Test the child’s ability to use the SGD in new contexts, such as with an instructor (e.g., Jeremy working with the first author) instead of the mother. Use the same procedure as in the initial observation to check if the child can generalize the learned skill.
Example:
In a generalization test, Grace successfully requests continuation of the foot rub with the researcher instead of her mother by selecting the correct icon on her iPad®. Jeremy, on the other hand, successfully requests bouncing on the moon hopper with the researcher but struggles to request piggyback rides.
** Social routines are defined as fun activities that occur between two or more people, where the child's attention is directed towards the other person or the social interaction, rather than focusing on an object, as is common in requesting routines (Rogers & Dawson, 2010).
Rogers, S. J., & Dawson, G. (2010). Early Start Denver Model for young children with autism: Promoting language, learning, and engagement. Guilford Press.
Steinbrenner, J. R., Hume, K., Odom, S. L., Morin, K. L., Nowell, S. W., Tomaszewski, B., Szendrey, S., McIntyre, N. S., YücesoyÖzkan, S., & Savage, M. N. (2020). Evidence-Based Practices for Children, Youth, and Young Adults with Autism. The University of North Carolina at Chapel Hill, Frank Porter Graham Child Development Institute, National Clearinghouse on Autism Evidence and Practice Review Team
Waddington, H., Carnett, A., van der Meer, L., & Sigafoos, J. (2021). Teaching Two Autistic Children to Request Continuation of Social Routines with Their Parents Using an iPad®-Based Speech-Generating Device. Advances in Neurodevelopmental Disorders, 353–363. https://doi.org/10.1007/s41252-021-00215-9