Beyond Trial Counts: Measuring Play and Engagement in Early Intervention for Autistic Children

Introduction

Play is a critical part of childhood development, shaping a child’s learning, social interactions, and communication skills. It evolves naturally, progressing from simple exploratory behaviors to complex symbolic play. For autistic children, structured early intervention helps support these developments. However, behavior analysts often face challenges when trying to measure meaningful engagement and play outcomes in these interventions.

Traditional approaches, such as Natural Environment Teaching (NET), rely on structured skills embedded in play. A newer approach, Naturalistic Developmental Behavioral Interventions (NDBI), blends developmental principles with applied behavior analysis (ABA) for a more child-led structure. Both methods offer value, but how can clinicians measure play and engagement effectively across these approaches?

A recent study by Raulston, Ousley, Hinton, and Ramirez (2024) (DOI: 10.1007/s40617-024-01002-3) explores alternative ways of assessing engagement outside traditional trial-based methods. This article provides a closer look at their findings and why play-based measures matter in early autism intervention.

The Importance of Play and Engagement in Early Intervention

Object Play in Early Childhood

Object play—the way children interact with toys and objects—develops in predictable stages:

1. Exploratory–Relational Play (2-10 months) – Infants examine objects using their senses, such as mouthing or shaking them.
2. Functional Play (10-18 months) – Children begin to use objects in expected ways, like rolling a car or stacking blocks.
3. Pre-Symbolic Play (12-18 months) – Early pretend play emerges, such as feeding a doll with an empty spoon.
4. Symbolic Play (18-30 months) – Play sequences become more imaginative, like acting out a tea party or pretending a block is a phone.

Symbolic play is particularly important because it supports language growth, problem-solving, and social-emotional development. However, autistic children may show differences in how they engage in these play stages, which is why targeted interventions are crucial.

The Role of Engagement in Interactive Play

Engagement during play determines how much a child is learning and interacting. Researchers have identified four distinct engagement states:

1. Onlooker – The child watches others play but does not participate.
2. Person-Engaged – The child interacts with an adult or peer without toys.
3. Object-Engaged – The child focuses solely on manipulating toys or objects.
4. Coordinated Joint Engagement – The child interacts with both objects and other people, showing shared attention.

Coordinated joint engagement is a strong predictor of social communication development. Traditional ABA interventions may prioritize skill-building but overlook engagement. Measuring engagement levels can help practitioners assess whether a child is meaningfully participating in learning opportunities rather than simply completing tasks.

Comparing Natural Environment Teaching (NET) and Naturalistic Developmental Behavioral Interventions (NDBI)

Natural Environment Teaching (NET)

NET is commonly used in applied behavior analysis to promote skill generalization. Key features of this approach include:

• Embedding learning opportunities within natural play settings.
• Using child-selected items to hold motivation.
• Reinforcing correct responses to build target behaviors over time.

While NET is effective in teaching skills, it often focuses on measurable trial-based outcomes rather than broader measures of engagement.

Naturalistic Developmental Behavioral Interventions (NDBI)

NDBI combines behavior analysis with developmental science. It focuses more on child-led interactions and supports spontaneous learning. Some core components of NDBI include:

• Environmental Arrangement: Setting up play materials to naturally prompt engagement.
• Following the Child’s Lead: Letting the child choose activities while the adult integrates learning.
• Balanced Turn-Taking: Encouraging reciprocal interaction instead of adult-directed tasks.

Compared to NET, NDBI places a greater emphasis on joint engagement and social communication. Measuring engagement during these interventions can provide richer insights into a child’s developmental progress.

Alternative Ways to Measure Play and Engagement

Beyond counting correct responses in trials, behavior analysts can use new measurement strategies to assess play and engagement:

1. Engagement State Coding – Tracking how often a child shifts between engagement states.
2. Play Complexity Analysis – Capturing how advanced a child’s play interactions are.
3. Social Interaction Metrics – Measuring reciprocal play and shared attention.

By integrating these approaches, clinicians can move beyond simple trial counts to better understand how a child is meaningfully interacting and learning.

Conclusion

Measuring progress in early autism intervention isn’t just about counting discrete skills—it’s about understanding how children engage, learn, and grow through play. By utilizing frameworks from both NET and NDBI while incorporating more nuanced engagement assessments, behavior analysts can better shape intervention strategies that truly support child development.

To dive deeper into this study, we encourage you to read the full article by Raulston et al. (2024) in Behavior Analysis in Practice: https://doi.org/10.1007/s40617-024-01002-3.

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