Earlier autism diagnosis, the importance of early intervention, and development of specific interventions for young children have contributed to the emergence of similar, empirically supported, autism interventions that represent the merging of applied behavioral and developmental sciences. “Naturalistic Developmental Behavioral Interventions (NDBI)” are implemented in natural settings, involve shared control between child and therapist, utilize natural contingencies, and use a variety of behavioral strategies to teach developmentally appropriate and prerequisite skills. We describe the development of NDBIs, their theoretical bases, empirical support, requisite characteristics, common features, and suggest future research needs. We wish to bring parsimony to a field that includes interventions with different names but common features thus improving understanding and choice-making among families, service providers and referring agencies.

Abnormal regulation of brain growth in autism results in early overgrowth followed by abnormally slowed growth. Hyperplasia was present in cerebral gray matter and cerebral and cerebellar white matter in early life in patients with autism.

MRI and autopsy evidence of early maldevelopment of cerebellar vermis and hemispheres in autism raise the question of how cerebellar maldevelopment contributes to the cognitive and social deficits characteristic of autism. Compared with normal controls, autistic patients and patients with acquired cerebellar lesions were similarly impaired in a task requiring rapid and accurate shifts of attention between auditory and visual stimuli. Neurophysiologic and behavioral evidence rules out motor dysfunction as the cause of this deficit. These findings are consistent with the proposal that in autism cerebellar maldevelopment may contribute to an inability to execute rapid attention shifts, which in turn undermines social and cognitive development, and also with the proposal that the human cerebellum is involved in the coordination of rapid attention shifts in a fashion analogous to its role in the coordination of movement.

Children with autism exhibit significant deficits in imitation skills which impede the acquisition of more complex behaviors and socialization, and are thus an important focus of early intervention programs for children with autism. This study used a multiple-baseline design across five young children with autism to assess the benefit of a naturalistic behavioral technique for teaching object imitation. Participants increased their imitation skills and generalized these skills to novel environments. In addition, participants exhibited increases in other social-communicative behaviors, including language, pretend play, and joint attention. These results provide support for the effectiveness of a naturalistic behavioral intervention for teaching imitation and offer a new and potentially important treatment option for young children who exhibit deficits in social-communicative behaviors.

Infantile autism is a severe form of psychopathology characterized by profound behavioral deficits. This article reviews a series of investigations which suggest that autistic children show "stimulus overselectivity," a response to only a limited number of cues in their environment, and discusses how such overselectivity may relate to several of the behavioral deficits in autism. These include failure to develop normal language or social behavior, failure to generalize newly acquired behavior to new stimulus situations, failure to learn from traditional teaching techniques that use prompts, and a general difficulty in learning new behaviors. This discussion is followed by the presentation of several studies that suggest possible remedial procedures. Finally, the concept of stimulus overselectivity is related to the literature on other theories of attentional or response deficits in adult schizophrenia, mental retardation, learning disabilities, and autism.Infantile autism, first described by Kanner (1943), is a severe form of psychopathology in children that is characterized by extreme social and emotional detachment. Such children typically do not seek or readily accept affection and do not play with peers. They engage in great amounts of stereotyped, ritualistic, and repetitive motor behaviors and are generally unresponsive to their physical environment. They are inconsistent in their response to sensory input, they typically do not show a startle reflex, and their parents have suspected them to be blind or deaf. Language development is either absent or

Integrating joint attention training into existing interventions may be important for children with autism. In addition, training parents in these techniques may help to maintain joint attention skills outside of the treatment setting.

Three groups of children (autistic, retarded, and normal) were reinforced for responding to a complex stimulus involving the simultaneous presentation of auditory, visual, and tactile cues. Once this discrimination was established, elements of the complex were presented separately to assess which aspects of the complex stimulus had acquired control over the child's behavior. We found that: («) the autistics responded primarily to only one of the cues; the normals responded uniformly to all three cues; and the retardates functioned between these two extremes, (i) Conditions could be arranged such that a cue which had remained nonfunctional when presented in association with other cues could be established as functional when trained separately. The data failed to support notions that any one sense modality is impaired in autistic children. Rather, when presented with a stimulus complex, their attention was overselective. The findings were related to the literature on selective attention. Since much learning involves contiguous or near-contiguous pairing of two or more stimuli, failure to respond to one of the stimuli might be an important factor in the development of autism.

Parents of four nonverbal and four echolalic autistic children were trained to increase their children's speech by using the Natural Language Paradigm (NLP), a loosely structured procedure conducted in a play environment with a variety of toys. Parents were initially trained to use the NLP in a clinic setting, with subsequent parent-child speech sessions occurring at home. The results indicated that following training, parents increased the frequency with which they required their children to speak (i.e., modeled words and phrases, prompted answers to questions). Correspondingly, all children increased the frequency of their verbalizations in three nontraining settings. Thus, the NLP appears to be an efficacious program for parents to learn and use in the home to increase their children's speech.