Educational approaches for autistic students are often categorized as either developmental or behavioral. (Prizant & Wetherby, 2005). Behavioral approaches utilize practices based on applied behavior analysis (ABA), and are used to change behavior: that is, to increase desirable behavior and decrease undesirable behavior. ABA uses behavioral strategies, largely based on learning theory, to measure behavior, teach skills, and evaluate progress.
Barry M. Prizant, PhD, CCC-SLP
Development approaches are generally more spontaneous and natural in the way that adults respond to a child or the child’s behavior. Developmental approaches look at the interrelationships among different domains (e.g., language, social-emotional, communication, cognition) and take into consideration typical and atypical development, family strengths and dynamics, cultural diversity, with a focus on developmentally appropriate practices to build trusting relationships.
Over the past 5-10 years there have been attempts to meld the two approaches (Schreibman et al., 2015), referred to as Naturalistic Developmental Behavioral Interventions (NDBI), primarily based on behavioral approaches infusing practices from the developmental and relationship-based literature. Notwithstanding, many practitioners and agencies continue to insist on rigidly adhering to more traditional behavioral practices, while claiming that other practices are ineffective and/or invalid, despite evidence to the contrary (Prizant, 2009).
Recent meta-analyses of intervention research are providing evidence that developmental approaches are more effective than behavioral approaches (Sandbank et al, 2020), and have fewer negative side effects. Therefore, it is imperative that all practitioners should learn – indeed be obligated – to think developmentally, as the dangers of not doing so are numerous. This assertion is also based on the author’s 50 years’ experience as a speech-language pathologist, autism researcher, and consultant to programs using approaches ranging from ABA to developmental approaches. There is increasing concern that ABA practitioners now being trained to support autistic children (e.g., BCBA or RBT) have minimal or no background in child and human development, and therefore, little to no training in how to think developmentally. If services are to be respectful and effective in supporting children’s development, it is essential that service providers and ideally, family members, learn to think developmentally (Sandbank et al., 2020).
Developmental approaches support the development of children and older persons based upon principles and practices derived from research on typical and atypical child and human development. “Thinking developmentally” goes well beyond what most practitioners consider when the term developmental approach is used, as it is often misunderstood as only teaching to a developmental checklist. Developmental approaches view the individual as an active learner (i.e., participant), who progresses through developmental stages throughout life. This developmental progression is considered to be a hard-wired neurological endowment that enables an individual to seek out social and non-social learning opportunities. In turn, partners respond with “guided participation” and promote the development of trusting relationships in everyday activities. Child and human development is understood as a transactional process in which there is a constant interplay between an individual’s learning style and environmental influences in the context of relationships, with social experience being of primary significance in development (Prizant et al,, 2006; Laurent, Rubin & Prizant, 2021).
In developmental approaches, observable patterns of behavior are always considered within the context of research-based knowledge of human development, and unique differences observed in autistic individuals. In contrast to behavioral approaches, unobservable factors such as differences in learning style, emotional experience, communicative intent, and the development of trusting relationships are considered valid and essential areas of inquiry. The focus of education/treatment is to enhance progress, mitigate areas of challenge, and put development “back on track” by supporting individuals’ abilities in communication and emotional regulation, the foundations of learning and relationships (Prizant et al., 2006).
The elements that are definitive of developmental approaches are:
- Sequences of developmental milestones in child development guide practices, including selection of developmentally appropriate goals and objectives
- Programming in more natural social contexts, activities, and routines, in order to build on a child’s intent, interests, and motivations
- Respect for and integration of perspectives of autistic individuals, and their unique learning styles and insights
Perhaps the most recognized aspect of thinking developmentally is that of being mindful of developmental sequences in a range of developmental domains. Despite the availability of an extensive research literature in all developmental domains – including some differences that have been documented in ASD – it is not uncommon to observe violations of developmental thinking in ABA programs. A few simple examples include:
- Focusing on compliance training and not responding to the intentional use of communicative gestures and vocalizations
- Prompting students to say whole sentences even though the student’s spontaneous language level is at an earlier stage
- Utilizing “planned ignoring” or other behavior reduction measures when students are distressed (i.e., emotionally dysregulated), even though developmentally, they do not yet have the emotional regulatory strategies to maintain a well-regulated state (Prizant & Laurent, 2016)
Extensive use of developmentally appropriate supports, including the use of interpersonal and learning supports (Prizant et al., 2006) is another imperative when thinking developmentally. Interpersonal supports include how partners flexibly adjust their behavior in order to be responsive, to model appropriate language and provide developmental support to foster initiation and support self-esteem, self-confidence and self-awareness. Learning supports include how activities are structured in a predictable manner to support learning, the use of visual and organizational supports, and how partners modify activities and the learning environment. Learning supports are calibrated to a child’s developmental needs and therefore evolve over time as child progresses.
Thinking developmentally also entails thinking from the child’s or person’s perspective. The most talented teachers and therapists, and the most successful parents attempt to understand a child’s experience in order to guide their own actions and reactions. Traditional ABA approaches consider it “unscientific” – indeed an anathema – to take into account unobservable variables or personal experience, holding instead to the premise that observable behavior is the only legitimate source of inquiry. In contrast, thinking developmentally requires that in order to respond appropriately, partners must attempt to read communicative intent, be cognizant of an individual’s interests and attentional focus, and attempt to understand his or her emotional experience and emotional regulatory state. Certainly, examining observable behavior plays an essential role, but interpreting what is observed requires a developmental perspective. For example, the behavioral pattern of leaving a desk and bolting out of the classroom may be categorized behaviorally as “escape-motivated” behavior. With developmental thinking, we must go beyond the strictly observable and ask: “Given the child’s developmental status, what is the child’s developmental needs, and WHY is the child trying to “escape,” and what are the developmentally appropriate supports that are needed to help the child remain engaged?” Thus, an important consideration is that a child’s behavior and needs are reflective of his/her stage of development, and knowing this guides adults in using appropriate teaching strategies.
In summary, thinking developmentally is an essential perspective in supporting autistic individuals. With research documenting the effectiveness of developmental approaches, training for educators and therapists must incorporate a strong developmental perspective.
Dr. Barry M. Prizant is a research and clinical scholar on the topic of ASD. He is also a faculty member at Brown University.
References
Laurent, A.M, Rubin, E, & Prizant, B. M. (2021). The SCERTS Model: Social communication, emotional regulation, and transactional supports. In Prelock, P. and McCauley, R. Treatment of autism spectrum disorder: Evidence-based intervention strategies for communication and social interactions. Second edition. Baltimore: Paul Brookes Publishing.
Prizant, B. M. (2009). Treatment options and parent choice: Is ABA the only way? Spring. Autism Spectrum Quarterly, 28-32.
Prizant, B.M., and Laurent, A.C. (2016). Emotional regulation and autism spectrum disorders. Journal of the Ohio Speech-Language-Hearing Association, 6, 34-40.
Prizant, B.M., & Wetherby, A. M. (2005) Critical considerations in enhancing communication abilities for persons with autism spectrum disorders. In F. Volkmar, A. Klin & Paul, R. (Eds.), Handbook of autism and pervasive developmental disorders (3rd Edition).
Prizant, B.M, Wetherby, A. M., Rubin, E., Laurent, A. C., & Rydell, P. J. (2006). The SCERTS Model: A Comprehensive Educational Approach for Children with Autism Spectrum disorders (Volume 1 & 2 – Assessment and Program Planning) Baltimore, MD: Paul Brookes Publishers
Sandbank M, Bottema-Beutel K, Crowley S, et al. (2020). Project AIM: autism intervention meta-analysis for studies of young children. Psychological Bulletin,146, 1-29.
[…] and interests are more effective in promoting communication development in autistic children. Recognizing that each child’s journey is unique is […]