It was only used a little as a part of a program for our son. The therapist used motivating activities such as teaching imitation through toys that he liked, so that learning would be naturally reinforcing. A child can be taught imitation on a drum because he likes the sound. (natural reward) I am also interested in hearing more about this. We changed to Floortime which is very different, but I am starting to like teaching through naturally rewarding activities and helping him learn to self regulate.