Neuroplasticity mechanisms of NDBIs in autism: a review from brain connectivity to behavioral improvement

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition characterized by deficits in social communication and interaction. In recent years, Naturalistic Developmental Behavioral Interventions (NDBI), particularly the Early Start Denver Model (ESDM), have demonstrated significant efficacy in enhancing social cognitive functions in children with autism. This review synthesizes current neuroimaging research on ESDM and related NDBI approaches, with a focus on how these interventions promote neuroplasticity by remodeling brain connectivity within social cognitive networks. We examine the neural substrates underlying behavioral improvements and discuss the critical factors influencing intervention outcomes, including timing, intensity, and duration. By integrating findings on brain network reorganization and functional enhancement, this article aims to provide theoretical insights and practical guidance for optimizing clinical interventions and informing future research directions in ASD treatment.