Meta-analysis of naturalistic developmental behavioral interventions for young children with autism spectrum disorder.
Naturalistic play-based ABA gives preschoolers with autism solid social and thinking gains, plus extra language when parents use clear prompts.
01Research in Context
What this study did
The team pooled 27 group studies of naturalistic developmental behavioral interventions.
All kids were preschoolers with autism.
They looked at language, play, social, thinking, and autism symptoms.
What they found
NDBI gave small-to-medium boosts across every area.
Social play and thinking grew the most.
Language grew too, but the gain was smaller.
How this fits with other research
Han et al. (2025) later looked at the same studies plus more.
Their 2025 map still shows small gains, so the 2019 picture holds.
Jones et al. (2024) drilled deeper: when parents used directive NDBI moves, toddler language shot up.
Romanowich et al. (2013) found naturalistic and discrete-trial both work for words, so you can mix formats.
Why it matters
You now have a green light to keep using NDBI in play, snack, and circle time.
Push social and play targets first—they show the fastest pay-off.
Add brief parent coaching with clear prompts; Jones et al. (2024) show that single tweak can double language speed.
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02At a glance
03Original abstract
Naturalistic developmental behavioral intervention is an emerging class of interventions for young children with autism spectrum disorder. The present article is a meta-analysis of outcomes of group-design studies (n = 27) testing interventions using naturalistic developmental behavioral intervention strategies. Small, significant positive effects of naturalistic developmental behavioral intervention were found for expressive language (g = 0.32), reduction in symptoms of autism spectrum disorder (g = -0.38), and play skills (g = 0.23). Larger effects were found for social engagement (g = 0.65) and overall cognitive development (g = 0.48). A marginal effect was found for joint attention (g = 0.14) and receptive language (g = 0.28). For joint attention, improvement was moderated by hours of professional involvement. Evidence of publication and reporting bias was present for language outcomes. This meta-analysis grows the evidence base for naturalistic developmental behavioral interventions, particularly in the key areas of social engagement and cognition.
Autism : the international journal of research and practice, 2019 · doi:10.1177/1362361319836371