Effects of Naturalistic Developmental Behavioral Intervention Strategies and Visual Scene Displays on Autistic Children's Joint Engagement

Purpose: Naturalistic developmental behavioral intervention (NDBI) and visual scene displays (VSDs), a type of augmentative and alternative communication (AAC), are research-supported practices focused on naturalistic instruction and increasing social communication skills in young autistic children. The purpose of our study was to extend previous research to understand the effects of embedding VSDs within a dynamic play-based NDBI for young autistic children. Method: We employed a randomized multiple-baseline single-case experimental design across three participants to evaluate the effects of (a) NDBI strategies and (b) NDBI strategies plus aided AAC modeling and just-in-time (JIT) programming of VSDs on joint engagement in young autistic children. Results: When NDBI strategies were introduced, there was a large positive effect on child joint engagement and a corresponding large negative effect on child isolated attention. After aided AAC modeling and JIT programming were introduced, child joint engagement and isolated attention outcomes were mixed. Conclusions: The findings of the current study show promise to using VSDs within dynamic play-based NDBIs as a communication support. Limitations and implications are discussed. Supplemental Material: https://doi.org/10.23641/asha.33916381