"Natural Environment" Behavioral Therapy for Autism

Boy Setting Table

It's still possible to find ABA (behavioral) therapists sitting autistic children in chairs for forty hours a week. Over and over again, the therapists hold out an object such as a spoon, or a fork, or a cup, or a plate, and ask for the proper word or behavioral response. When they get the response they're looking for, they give the child a "reinforcer" or reward - often a small piece of candy.

This form of therapy, which comes out of the behavioral tradition, is called "discrete trials." It's a very clearly defined technique, and because it has extremely concrete goals (learn to say "spoon" when you see a spoon) it is easy to see and report on progress.

Discrete trials may teach very specific skills, but it is not enough. That's because discrete trials teaches behaviors -- period.  It doesn't provide children with a sense of purpose, or empower them in any way.  As a result --

  1. Children learn what they are taught: that when an adult holds out a spoon, the correct response is to say "spoon." This, of course, is only marginally helpful, since it doesn't teach the child what to do with the spoon, how to find the spoon, or how to put the spoon away.
  2. Very often, the outcome of discrete-trials-only therapy is a child who can say the word spoon -- but only under controlled circumstances, and never when he actually wants or needs a spoon!
  3. It means that the child who says "spoon" may well continue to expect to receive a piece of candy -- not a spoon.
  4. The child may not recognize that spoons come in many shapes and sizes -- from serving spoons to slotted spoons to teaspoons.
  1. The child may not fully grasp the fact that spoons exist, and are used, in a wide variety of settings -- in the kitchen, at the restaurant, in the cafeteria, at Grandma's house, and so forth.
  2. The child is not prepared to use spoken language to respond to others in an everyday setting. For example, while he may be able to label a spoon, he may not have the skills to ask for, provide, or describe the use of a spoon. 

    To help children with autism to put their learning to work, therefore, it's absolutely essential to take behavioral therapy (as well as many other types of therapy) out into the real world.  In ABA terms, this is called "Natural Environment Therapy."

    Says behavioral therapist Dr. Laura Schreibman: "You want the natural environment to become reinforcing ... If you say 'I want car' you get a car -- not a candy. You learn purpose as well as behavior. This approach enhances generalization. This is how typical kids learn: they use language functionally in the environment. The content of the program should be functionally significant, and you can conduct naturalistic therapy in a naturalistic environment."

    Therapist Dr. James Partington agrees wholeheartedly: "What you're really looking for is not only developing but also USING skills in naturalistic settings. The real world has to provide reinforcer for the behavior -- not the treat you get."

    All of this is certainly good news. ABA is probably the most commonly provided therapy available, and it's increasingly provided through schools, agencies and state programs.

    The bad news, however, is that discrete trials is all too often the form of ABA provided -- particularly for children with more challenging symptoms. As a result, all too many children miss out on the ordinary interactions, experiences and situations that are a part of a full, rich life. While other children explore, climb, and learn from experience, far too many children with autism sit at a table for hour after hour.

    If your child is in behavioral therapy without engaging in the natural environment, now is the time to take action!


    Interview with Dr. Jim Partington, PhD, board certified behavior analyst and director of Behavior Analysts Inc. in Pleasant Hill, Calif., March, 2008.

    Interview with Dr. Laura Schreibman, Distinguished Professor of Psychology, UC San Diego. March, 2008.

    Simpson, R.L. 2001. ABA and Students with Autism Spectrum Disorders: Issues and Considerations for Effective Practice. Focus on Autism and Other Developmental Disabilities 16(2):68-71.

    Sundberg, M. L. & Partington, J. W. The Need for Both Discrete Trial and Natural Environment Language Training for Children With Autism. In Ghezzi, P. M., Williams, W. L., & Carr, J. E. Autism: Behavior-analytic perspectives. Reno, NV: Context Press. (1999)

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