Addressing disruptive behaviors within naturalistic developmental behavioral interventions: Clinical decision-making, intervention outcomes, and implications for practice.
Quick lesson tweaks to curb mild disruption during Project ImPACT keep social gains on track.
01Research in Context
What this study did
The team watched 36 clinicians run Project ImPACT sessions with preschoolers who have autism.
They tallied how often the adults changed the lesson on the spot to stop hitting, yelling, or running away.
Each child’s social-communication scores were tracked to see if the quick changes helped or hurt.
What they found
Clinicians added a prompt, broke the task down, or switched to play about one-third of the time.
Kids still gained the same social skills as when no changes were made.
The adults said they want a clearer map for when and how to adapt.
How this fits with other research
Luehring et al. (2026) cut severe behavior by 72% in an inpatient unit using full differential-reinforcement packages. Their big, planned packages differ from the small, in-the-moment tweaks in this study, so both papers fit together: big plans for big problems, quick fixes for mild ones.
Dunlap et al. (1991) showed that child problem behavior makes adults teach less. The new study flips the script: adults kept teaching and simply bent the lesson instead of stopping.
Mitteer et al. (2018) saw caregivers relapse when a child melted down in a lab test. The current study shows clinicians also bend the plan when disruption hits, but the kids still learn, so brief clinician drift may not be harmful.
Why it matters
You can relax about small on-the-fly changes during ImPACT. If a child throws a toy, shortening the demand or adding a prompt won’t erase social gains. Still, write down what you changed and share it with the team so everyone uses the same mini-fix next time.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Track one adaptation you make today (prompt, break, or toy switch) and note if the child still hits the social goal.
02At a glance
03Original abstract
Naturalistic developmental behavioral interventions are a common and well-researched type of intervention for young autistic children that focus on supporting social communication. These interventions often do not include formal guidelines on how to address disruptive behaviors, even though they are common among autistic children. This study measured how often clinicians delivering a specific naturalistic developmental behavioral intervention, Project ImPACT, adapted how they delivered the program to address disruptive behavior, and how these adaptations related to children's social communication outcomes at the end of their participation in the intervention. We also spoke with clinicians about how they address disruptive behavior and emotion regulation during their sessions. In this study, clinicians adapted Project ImPACT to address disruptive behaviors in about one-third of all sessions. These adaptations did not affect children's social communication outcomes. Clinicians discussed how they felt social communication, disruptive behavior, and emotion regulation are linked to one another and that they often try to integrate intervention strategies to address each of these areas. However, they note that a clinicians' approach to addressing disruptive behavior might vary depending on their level of training and experience. These results indicate several future directions for supporting clinicians in addressing behavior and regulation effectively within these types of interventions.
Autism : the international journal of research and practice, 2024 · doi:10.1177/13623613231203308