ESDM – is it an NDBI?

By July 1, 2022 May 30th, 2024 Autism, ESDM
Two boys with autism and a Certified ESDM Therapist doing the Early Start Denver Model ESDM early intervention in Sydney

What is an NDBI? It is very challenging for parents to understand the many different interventions that can choose for their child with autism. They have to understand:

  • What the intervention means?
  • How effective it is?
  • What the research says about the model of intervention?
  • Which one is best for their child?

There are so many different interventions: ABA, ESDM, NDBI and more.

What are Naturalistic Developmental Behavioural Interventions (NDBI)?

There are so many terms for parents to understand that can also be confusing. The term ‘Naturalistic Developmental Behavioural Intervention’ (NDBI) is a newer class of interventions for young children with autism and other developmental delays that pulls together from all the research into:

  • How children typically develop, communicate, and learn
  • How children with autism and developmental delay develop, communicate, and learn

There is a large body of research that shows that Applied Behaviour Analysis (ABA) is effective at two things:

  1. Teaching children new skills across many areas
  2. Reducing behaviours such as tantrums and rigid behaviour

NDBI’s combines the principles of Applied Behaviour Analysis (ABA) and developmental science to improve a range of areas in child development including communication, engagement, joint attention, imitation, peer interactions, play skills, social-emotional skills, and challenging behaviours.

What strategies does this approach use?

The overarching approaches and strategies of NDBI intervention include:

  • Providing opportunities for a child’s skill-building in the context of interactive, natural settings across a range of daily routines, social interactions, and play activities
  • Emphasising the use of environmental reinforcers that are directly related to the activity presented
  • Following the child’s play interests to guide activities and capture learning opportunities to increase motivation and engagement for learning interchanges
  • An overarching emphasis on the child’s social engagement and building meaningful interactions within the learning context
  • Explicit focus on coaching parents on the techniques to promote learning, engagement, and connection throughout daily family routines

NDBI’s do not focus on sitting a child at a table and drilling them repeatedly using artificial reinforcements such as tokens or food. An NDBI always teaches in a play routine or a daily activity using natural reinforcements. When a child requests a toy using the most appropriate level of communication for them, they get the toy as the natural reinforcer as well as lots of positive affect and praise.

In a nutshell, NDBI’s combine effective teaching methods based on the science of ABA with the developmental methods known to enhance motivation, engagement and learning. This blend is then used to embed learning into activities that are appropriate and fun for individuals and families regardless of age or developmental level.

Many existing treatment models fall into the NDBI category. At OneOnOne Children’s Therapy we focus on the delivery of NDBI’s for our young children with autism, social communication difficulties, and developmental delay. We use the Early Start Denver Model (ESDM) and Project ImPACT (Improving Parents as Communication Partners). We are proud to be the largest provider of the ESDM in New South Wales, and one of only 3 clinics using Project ImPACT. Our Director, Susan Marden, is a Project ImPACT Trainer Consultant and the first Certified Project ImPACT Coach in Australia.

We believe that NDBI’s are the future of intervention for young children with autism and we look forward to seeing more research to support their effectiveness.

How do I find out more about an NDBI?

For more information about the Early Start Denver Model (ESDM)  and Project ImPACT (Improving Parents as Communication Partners) head to our website at or call us on (02) 80657837. Our clinic the largest Early Start Denver Model (ESDM) clinic in Sydney. Our certified ESDM therapists are trained to the highest levels of fidelity. We are one of a very small number of clinics that offer the highly regarded Project ImPACT training model.

Learn more about the ESDM