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Parents of 82 children with autism learned to use methods from a naturalistic developmental behavioral intervention (NDBI) during their regular daily activities. They received nine months of 1:1 sessions 2 or 3 times per week, and nine months of weekly small-group sessions.

The 1:1 sessions showed more improvement in more skill areas than the group sessions. Both schedules had better results than SLP-only treatment.


I saw Dr. Amy Wetherby from Florida State University present her research findings at the recent convention of the American Speech-Language-Hearing Association. Below are some highlights.

The American Academy of Pediatrics recommends that all children be screened for autism at 18 and 24 months. Diagnosis can be made that early, but half of autistic children are diagnosed after 4–5 years of age.

Why the delay in diagnosis? Often doctors take a “wait and see” approach even if a screening indicates a need to test. Also, many families prefer to wait before pursuing a diagnosis. Finally, more professionals need to be trained in diagnosis and providing evidence-based service delivery (like Wetherby’s).

What’s the harm in waiting? Years of research shows that early intervention gets the best long-term results.

Studies of naturalistic developmental behavioral interventions (NDBIs) have shown improvements in children’s communication development. A limitation to the programs has been that they were implemented by professionals, ranging from about 6 to 20 hours per week. Most early intervention programs don’t fund that amount of professional service.

Wetherby’s 2018 research reported better outcomes than the previous studies. How did they achieve this improvement? By coaching parents to understand and use the NDBI methods for 25 hours a week in their daily activities with their children.

The program is called Early Social Interaction (ESI). There were 82 children in the study, Half started with 1:1 sessions, 3 times weekly for six months and then two times weekly for three months. After that parents received weekly group sessions for nine months. The other half started with the group sessions, followed by the 1:1 sessions.

Sessions focused on coaching the parents on using techniques based on the SCERTS curriculum (an NDBI). You can see video clips of sessions with parents and children here.

Improvements were seen with the group sessions, but the 1:1 sessions showed even more progress in more skill areas.

The study is exciting for many reasons. This was the largest group studied so far. They used schedules that are funded by many early intervention services. They refined methods for coaching parents effectively. These factors make it useful for all speech-language pathologists to incorporate into their practice.

Dr. Wetherby has many resources available for parents and professionals available on her website, Autism Navigator. Here are some highlights:


Families have free access to a course that helps identify that includes side-by-side videos of toddlers with autism and examples of effective early intervention.

The online course, available here, includes information on:

  • core features of autism

  • importance of early intervention

  • prevalence and causes

  • how to identify typical development versus areas of concern

  • using everyday activities to teach communication skills

  • Improvements seen with early intervention

Features in the course include:

  • a library of video clips

  • handouts in English and Spanish (more languages in development)

  • glossary of terms

  • links to websites

  • frequently asked questions

A video player lets you compare clips of 18- to 24-month-old toddlers with typical development and autism. The videos describe what to watch for when observing the videos and your own child’s performance.


You’ll get a printable chart to monitor your child’s skill development between 7 to 24 months.

A collection of videos demonstrates typical development in the domains of language play, emotional regulation, social interaction, emotional regulation, and self-directed learning.

You’ll see examples of milestones at every 2 months, with an explanation of how the parent supports their child’s development of the skill.

Developing these skills works toward the goal of getting children ready for preschool.


You can use this research-based screening if your child is between 9 and 18 months old. This will add your child’s (anonymous) data into the research project.

Your participation in the screening gets you free access to the Social Communication Growth Charts (regular cost $4.99/month).


There’s so much available on the Autism Navigator website, it’s hard to know where to start. Well, they thought of that. Start here to watch one movie a day to find out about the courses and tools, and what will work best for you and your child.




Joyce is very knowledgeable. Not only as a speech therapist but also on how the school system works. Which is very helpful going through the IEP process. She was able to engage with my daughter and was never hesitant to help in any way. I would definitely recommend Joyce to anyone that is looking for a trustworthy, caring and informed speech therapist.

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