Developmental Therapies

Description: Developmental therapies, also called social-pragmatic interventions, are intended to promote social communication and other social interactions. The therapist or parent aims to make highly motivating activities available to the child, be responsive to what the child does (e.g., imitating or commenting on actions that the child performs) and encourage ongoing interaction around these activities (e.g., turn-taking, requests, gestures, or alternation of gaze between the activity and the adult).

Examples: Denver Model; Responsive Prelinguistic Milieu Teaching (RPMT), Social Communication, Emotional Regulation, and Transactional Support (SCERTS). See also the sections on Developmentally-based Individual-different Relationship-based (DIR) intervention and Relationship Development Intervention.

Research Summary: Developmental therapies are widely considered to be plausible intervention approaches (National Research Council, 2006). However, only a few studies have tested these interventions. In a small but well-designed study of preschool children with autism, Yoder and Stone (2006) found strengths and weaknesses of a developmental approach (RPMT) relative to an applied behavior analytic approach (Picture Exchange Communication System; see the sections on applied behavior analysis and on the Picture Exchange Communication System). RPMT was more effective than PECS for promoting turn-taking and joint attention (alternation of gaze between an activity and an adult); however, PECS was more effective than RPMT for increasing vocabulary size and frequency of communication.

In an important, well-designed study, Dawson et al. (2010) evaluated the Denver Model, which mixes developmental approaches with applied behavior analytic interventions (especially Pivotal Response Treatment). Twenty-four children who were 18-30 months old when they entered the study and who received two years of services based on the Denver Model were compared to a control group of 24 similar children who received services in their communities. Following intervention, children in the Denver Model obtained significantly higher scores on tests of IQ and adaptive behavior, and displayed significantly fewer autistic behaviors, than children who received community services.

Recommendations: Developmental therapies are an under-researched intervention approach. An important area for future research is to evaluate developmental therapies in studies with strong experimental designs. Professionals should present developmental therapies as under-researched and encourage families who are considering these approaches to evaluate them carefully.

Selected References:

Systematic reviews of scientific studies:

National Research Council (2001). Educating Children with Autism. Washington DC: National Academy Press.

Selected scientific studies:

Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., Donaldson, A., & Varley, J. (2010). Randomized, controlled trial of an intervention for toddlers with autism: The Early Start Denver Model. Pediatrics, e17-e23.

Yoder, P., & Stone, W. L. (2006). Randomized comparison of two communication interventions for preschoolers with autism. Journal of Consulting and Clinical Psychology, 74, 426-425.