When your child is first diagnosed with autism, it can feel like you’ve been dropped into a world full of unfamiliar acronyms and terminology. There are many different behavioral intervention options available, and many of them can sound confusingly similar. Figuring out what will best support your child and your family can feel overwhelming at first. However, learning about these options is an important step in understanding your child’s needs and advocating for meaningful support.
As families begin exploring therapy options, they often encounter Applied Behavior Analysis (ABA) and may also hear about Naturalistic Developmental Behavioral Intervention (NDBI) other approaches. While both are grounded in behavioral principles, they can look and feel very different in practice and sometimes, providers will state they are using one model but in reality it looks more like the other. Therefore, understanding the distinctions between ABA and NDBIs can help families make informed decisions that align with their goals and family contexts as well as their child’s learning style.
What is ABA?
There is often some confusion about what ABA is, and in part this is because the term often is used to refer to two different things. In the broad sense, ABA is the application of the science of behavior to socially significant problems. This can include supporting autistic people but also includes things such as education, environmental conservation, workplace safety, and animal behavior amongst others. At the same time, ABA has become the term widely used to refer to (often) high-hour, center- or home-based services delivered by a technician for autistic children.
In this context, ABA is a structured adult-led therapy approach that is used to address core and associated features of autism such as communication, social interaction, and concerning behavior. In ABA programs, broader skills like communication are broken down into individual skills like requesting or labeling. Features which distinguish ABA from NDBI include its highly structured format, use of rewards, and emphasis on adult-directed teaching (Lord et. al. 2018). For younger children, therapy is often recommended for 20 to 40 hours per week across multiple years (Barbaresi, et al. 2006)
What is NDBI?
While NDBIs are derived, at least in part from the science of behavior analysis, there are some differences in how NDBIs are implemented. NDBIs minimize adult-led intervention and instead focus on creating contexts for the child to direct and lead. An emphasis is placed on increasing engagement, play, and communication, as these areas are recognized as foundations for growth and development in childhood. NDBIs are embedded into naturally occurring child and family routines, such as play or mealtime, which can facilitate generalization of skills (Schreibman et al. 2015). NDBIs tend to be delivered for fewer hours than ABA (Rogers et al., 2018) and emphasize parent involvement (Swain et al, 2025).
NDBI vs ABA: Distinguishing ABA and NDBI approaches
It’s helpful for parents to know the difference between NDBIs and ABA because, while both are evidence-based, they can feel very different for a child and for a family. It can be hard to tell them apart because both intervention approaches may use similar tools (like reinforcement, prompting, or data collection), and many programs blend approaches or still use the name “ABA” even when they look more naturalistic. Understanding the difference helps you ask better questions and choose supports that fit your child and family values.
Learning environment
ABA: Sessions may take place in the home or in a clinic, but the learning environment is typically highly structured and adult-directed. For example, the child may sit at a table across from an adult with items such as a car, a spoon, and a pencil placed in front of them. The adult gives a directive such as, “Touch the car.” When the child responds correctly, they receive a reward that is not related to the activity (e.g., bubbles, high five, small snack). While this teaching style provides precise control and supports efficient acquisition of specific skills, sometimes getting those skills to occur in more natural settings is challenging. The child in this example may touch items when directed to do so but may not label them spontaneously when out of sessions for example.
NDBI: Sessions also often occur in the home or in a clinic, but the environment is more naturalistic and play-based. The child is more likely to choose the activity, while the adult flexibly embeds learning opportunities within their natural play. For example,if the child is playing with toy cars, the adult may use predictable language routines (e.g., “Ready, set, go”) to support attention and engagement, while modeling and expanding vocabulary (e.g., “red car,” “little car,” “fast,” “up,” “down”) as cars race through the house. The adult creates opportunities for the child to practice using this language in meaningful, motivating contexts.This leads to teaching strategies being responsive rather than directive, and learning opportunities arise naturally within meaningful interactions. Consequences tend to be natural (e.g., continued play) rather than contrived as in ABA which can promote engagement, social communication, and generalization of skills across settings. Research indicates that encouraging active participation and following typical developmental patterns can be highly effective in supporting skill development (Schreibman et al., 2015).
Child motivation
Traditional ABA: A child’s interests are typically incorporated in a more contrived manner within the traditional models of ABA with the goal of increasing the child’s compliance with learning activities. Most often this is achieved through the selection of reinforcers or scheduled “free play” time rather than incorporating the child’s interests into teaching activities. For example, the adult may ask the child to label a picture (e.g, book) and, following a correct response, provide access to a preferred toy for 30 seconds. In this approach, the child’s interests function primarily as external motivation for responding to the adult’s instructions rather than as part of the learning activity itself. Oftentimes it is recommended that materials and toys related to these interests be withheld from the child outside of therapy so that they are more likely to function as a reinforcer (be rewarding). Play is often used as a reward following structured tasks, and teaching remains largely adult-directed, with limited opportunities for the child to play in ways that are consistent with their preferences.
NDBI: Play serves as the primary vehicle for learning in NDBI, with instruction guided by the child’s interests, choices, and initiations for both the activity and the instructional targets. When adults follow the child’s lead in deciding what and how to play, learning becomes more engaging and developmentally appropriate. For example, when a child reaches for bubbles, the adult blows a few bubbles while modeling relevant language (e.g., “bubbles,” “play,” “pop”), and then waits for the child to initiate communication in any way (looking, reaching, speaking) before continuing to blow more bubbles as a natural consequence of the child’s communication all embedded within a play activity the child chose and enjoys. This approach promotes active engagement, intrinsic motivation, and meaningful social interaction.
View of development
Traditional ABA: Traditional ABA views development as learning specific skills and changing behaviors. It focuses mainly on what can be seen and measured, such as whether a child follows directions or gives the correct response. Because of this focus, a child’s feelings and emotional experiences may receive less attention during sessions. For example, if a two-year-old is told “no” when they want a toy and begins to cry, a traditional ABA approach may suggest ignoring the crying so it does not become reinforced. Instead of recognizing how hard it can be for a young child to handle disappointment, the main goal becomes stopping the behavior. In this model, development is seen as something that can be taught through structured practice, with progress measured by visible changes in behavior (Lord et al, 2018).
To develop goals for the child, development is often viewed as filling in “missing” skills. These skills are commonly taught in a set order based on program checklists, rather than on what the child is ready for or interested in. For example, a child may be expected to answer 25 specific “what” questions correctly (such as “What do you use to write?” “Pencil”) even if they are not using a pencil in everyday life. When a child’s developmental stage, interests, and family priorities are not fully considered, goals may feel less meaningful or helpful for the child and their family.
NDBI: NDBI models are based on a holistic approach that values the relationship between children and their caregivers and recognizes the importance of everyday interactions (Sandbank et al., 2024). These models emphasize that skills emerge through natural developmental processes such as shared attention, engagement, and meaningful interactions with trusted caregivers. NDBI-based interventions focus on what is most important and interesting to each child, targeting skills that naturally develop across social, communication, cognitive, and motor domains. Goals are personalized and chosen based on the child’s age, current abilities, and readiness, rather than pushing skills before a child is developmentally prepared.
For example, if a two-year-old is told “no” and becomes upset, an NDBI approach might involve acknowledging the child’s disappointment, offering comfort such as a hug, labeling the situation and emotions, or gently modeling calming strategies like taking deep breaths without requiring the child to comply. These supportive responses help the child feel understood while building regulation, communication, and autonomy over time. NDBI programs recognize that early childhood development is interconnected and intentionally foster engagement in ways that support growth across multiple developmental areas at the same time.
Compliance vs autonomy
Traditional ABA: In traditional ABA, success has often been measured by compliance—how well a child follows adult directions or completes requested tasks. Children are taught to respond to adult-directives in predetermined ways within structured adult-led activities. Behavior and responses that do not conform to these predetermined requirements are labeled “non-compliance” or as errors and viewed as problematic. Non-compliance is typically addressed through strategies designed to increase compliance such as reward systems or loss of privileges and errors are addressed via altering or strengthening teaching strategies. While many environments like school and daycare prize compliance over autonomy over the long term these strategies can have drawbacks. When adults rely on compliance-based approaches, they may achieve short-term behavior suppression, but these strategies do not teach missing skills and often escalate power struggles, stress, and dysregulation—particularly for neurodivergent children (Greene & Ablon, 2006).
NDBI: NDBIs take a flexible, child-centered approach. Rather than focusing on children complying with repeated trials presented by an adult at a table, learning is embedded into everyday activities such as play, routines, and social interactions. NDBI approaches encourage active participation. Adults follow the child’s lead, respect their refusals as communication about preferences, and view all communication as valuable. While NDBIs still use behavioral teaching strategies like reinforcement and prompting, they are applied in ways that are more natural and responsive to your child’s priorities. This approach supports the development of autonomy and self-advocacy skills. Research suggests that child-led, naturalistic play can reduce escape and avoidance behaviors during intervention (Schreibman et al., 2015).
Generalization
Traditional ABA: In a traditional ABA model, skills are often taught in a very structured, adult-led way. This can mean using the same words (for example, “touch the car”), the same materials (such as the same toy car), and the same routine (sitting at a table with a set group of items) each time a child practices a skill. While this structure can help a child learn a new skill, it can also mean that the child only uses the skill in that exact situation. For example, they may be able to do the skill with an adult at a table but struggle to use it in everyday settings.
Because of this, traditional ABA recognizes that skills do not automatically carry over into daily life and that generalization often needs to be taught on purpose (Stokes & Baer, 1977). In simple terms, just because your child can show a skill during therapy sessions in a controlled setting does not always mean they will use that skill naturally at home, at school, or in the community.
NDBI: Rather than teaching and practicing skills in only one specific way, generalization happens more naturally within NDBI approaches because of how these interventions are designed. In NDBI models, children learn skills during real-life activities and everyday routines, which reduces the need to practice the same skill in many different, artificial ways for it to carry over (Schreibman et al., 2015). Child-led motivation, caregiver involvement, and natural reinforcement all support learning in situations that are meaningful to the child. As a result, children practice skills in contexts that closely match their real world, making it easier for those skills to show up at home, in the community, and across daily routines. This approach can help skills develop more smoothly and be used across a wide range of meaningful interactions.
Parent mediated NDBI programs and caregiver involvement
At Avela Health, a parent-mediated NDBI approach is used to support young autistic children. Our model differs from many traditional early intervention programs which typically recommend 20 to 40 hours of intensive therapy per week. While well-intentioned, this intensive schedule can limit a child’s opportunity to engage in the activities of childhood like spending time with their family, participating in community-based activities, and in some cases take naps. We utilize a parent mediated NDBI approach because they take a different approach. We directly involve caregivers in therapy and are able to drastically reduce the hours spent in formal therapy. Cutting out the time in therapy creates more opportunities for children to engage in meaningful social activities and develop a stronger sense of belonging within their family and their community (Sandbank et al, 2024).
Recent research suggests that the traditional 20 to 40 hour recommendation is not showing that more hours leads to better outcomes. Instead, using different therapeutic approaches and not relying solely on the high-intensity ABA approach is beneficial (Sandbank et al, 2024). Parents and caregivers play an essential role in guiding the intervention which allows caregivers to use the same strategies across all of the routines and play that their child enjoys. This creates countless opportunities for natural learning in their everyday life.
Is NDBI right for my family?
Recognizing the differences between traditional ABA models and NDBI can be difficult, but it can help you determine the best fit for your family and child.
| Traditional ABA | NDBI | |
| Prompting | Systematic and not necessarily determined by child’s responses | Natural and responsive |
| Target Development | Based on a curriculum checklist | Developed collaboratively with caregivers and based on the child’s current development and interests |
| Materials Used | Adult chosen | Child chosen |
| Generalization | Needs separate generalization programming | Built into the process |
| Reinforcement | Programmed and specific, often not naturally tied to the skill being taught | Natural, feels a part of the play |
Choosing an approach for your child is a big decision, and there’s no one “right” answer for every family or every child. The list of questions below can be a helpful tool—not to test you —but to help you reflect on what already works well for your family and what you want more of.
- Do I want to support my child during play and routines?
- Do I want to be an active part of my child’s therapy?
- Do I want to build a set of strategies that I can use everyday to support my child?
- Do I want to be the primary change agent in our child’s development, or prefer therapists to take that role?
- Do I want an approach that uses prompts to increase compliance with adult goals or that support my child to achieve independence with their priorities?
- Do I want my child to interact with the toys and activities he is interested in during the session or do I prefer he only has access to these items as a reinforcer or reward?
- Do I want to be an active member of my child’s intervention team– helping to develop goals and implement support?
References
Greene, R. W., & Ablon, J. S. (2006). Treating explosive kids: The collaborative problem-solving approach. Journal of the American Academy of Child & Adolescent Psychiatry, 45(9), 1142–1143. https://doi.org/10.1097/01.chi.0000227877.58027.d9
Lord, C., Elsabbagh, M., Baird, G., & Veenstra-Vanderweele, J. (2018). Autism spectrum disorder. The Lancet, 392(10146), 508–520. https://doi.org/10.1016/s0140-6736(18)31129-2
Rogers, S. J., Estes, A., Vismara, L., Munson, J., Zierhut, C., Greenson, J., Dawson, G., Rocha, M., Sugar, C., Senturk, D., Whelan, F., & Talbott, M. (2018). Enhancing low-intensity coaching in parent implemented early start Denver Model Intervention for Early autism: A randomized comparison treatment trial. Journal of Autism and Developmental Disorders, 49(2), 632–646. https://doi.org/10.1007/s10803-018-3740-5
Sandbank, M., Pustejovsky, J. E., Bottema-Beutel, K., Caldwell, N., Feldman, J. I., Crowley LaPoint, S., & Woynaroski, T. (2024). Determining associations between intervention amount and outcomes for young autistic children. JAMA Pediatrics, 178(8), 763. https://doi.org/10.1001/jamapediatrics.2024.1832
Schreibman, L., Dawson, G., Stahmer, A. C., Landa, R., Rogers, S. J., McGee, G. G., Kasari, C., Ingersoll, B., Kaiser, A. P., Bruinsma, Y., McNerney, E., Wetherby, A., & Halladay, A. (2015). Naturalistic developmental behavioral interventions: Empirically validated treatments for autism spectrum disorder. Journal of Autism and Developmental Disorders, 45(8), 2411–2428. https://doi.org/10.1007/s10803-015-2407-8
Stokes, T. F., & Baer, D. M. (1977). An Implicit Technology of Generalization. Journal of Applied Behavior Analysis, 10(2), 349–367. https://doi.org/10.1901/jaba.1977.10-349
Swain, D., Han, J. E., Brown, H., Lord, C., Rogers, S., Estes, A., Kasari, C., Pickles, A., & Kim, S. H. (2025). Caregiver behavioral changes mediate the effects of naturalistic developmental behavioral interventions: Combining evidence from three randomized controlled trials. Autism, 29(7), 1835–1848. https://doi.org/10.1177/13623613251328463
