Joshua Feder, MD, expands on aligning autism interventions with child and family needs

Joshua Feder, MD, Editor in Chief, Carlat Child Psychiatry Report and Executive Medical Director, Positive Development, continued his discussion on the American Academy of Child and Adolescent Psychiatry’s new policy statement by expanding on the practical differences—and overlaps—between developmental, naturalistic developmental-behavioral, and applied behavioral analysis (ABA) approaches. Feder emphasized that real-world implementation hinges less on the intervention category and more on its fit with the child and family.

Understanding DRBI, NDBI, and ABA

“If you’ve got a kid who you just know is interested in science, and they want to learn all about that, but you really want to teach them to read, right? So, you are talking about science and the things that have information about science, turns out you’ve got to read them. That’s more of a developmental approach,” he said.

He noted that developmental approaches tend to feel more intuitive and organic to many families. “The developmental approaches are often much more free-flowing, play-based — they follow the way that a lot of people, all of us, learn, ” Feder explained.

What practice works best?

However, he stressed that none of the 3 major intervention categories—developmental/relationship-based approaches (such as DIR/Floortime and Positive Development), naturalistic developmental behavioral interventions, or ABA—should be considered exclusive to particular levels of support needs.

“The other thing that is really interesting is that for both ABA, for the naturalistic approaches, and for the developmental approaches, there’s a lot of confusion about which people are the best match,” Feder said. “You hear people saying about all of these different ones, 'well, that’s for this kind of person, that’s for that kind of person.' That’s not the case for any of these approaches. Any of these 3 main approaches. For any of them, they could be for anybody, any functional level. The real key is what’s a good match for the child and for the family in this particular situation.”

AACAP’s call for expanded autism treatment options

Feder emphasized that AACAP’s updated policy is intended to expand access—not narrow it—and to support a more individualized, evidence-based decision-making process that honors family values, preferences, and children’s strengths.

Want to hear more on the AACAP's recently updated recommendations? Click here.

Reference:

Policy statement of expanding access to care for the autism community. American Academy of Child & Adolescent Psychiatry. Press release. October 2025. Accessed December 2, 2025. https://www.aacap.org/AACAP/Policy_Statements/2025/Expanding_Access_Care_for_Autism.aspx