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The Early Start Denver Model (ESDM) is an interdisciplinary early intervention approach to autism that aims to alleviate symptoms of autism and accelerate children’s development. 

Download: Early Start Denver Model (ESDM)

Background: Picture of ESDM LogoThe current ESDM model is the latest product of an interdisciplinary team of clinical experts and researchers in Autism at UC Davis and University of Washington. The Early Start Denver Model (ESDM) is an all-inclusive early intervention approach for children with autism. ESDM integrates the teaching objects of the Applied Behavior Analysis program (ABA) along with a relationship-focused approach. ESDM aims to help alleviate symptoms of autism and accelerate children’s development, with particular emphasis on cognitive, social-emotional and language domains. ESDM promotes attention social cues and focuses on:

  • Use of reinforcers directly related to child’s goals and responses
  • Incorporating child’s choice into sessions
  • Joint activities and engagement
  • Positive, affect-based relationship with language and communication

Population: The intended recipients of this behavioral approach range between 12 to 60 months, for those infants and toddlers at risk for or have been previously diagnosed with Autism.

Description: Research suggests that infants and toddlers with sensitive and responsive caretakers followed the child’s lead and used language to narrate the child’s activities and interests experienced improved language, developed secure social relations with adults and peers, and increased positive social interaction and responses to others.

The first phase of ESDM lasts approximately five weeks and the second phase varies by individual. ESDM programs usually involve 20-25 or more hours per week of scheduled therapy. Families are encouraged to use ESDM strategies in their daily lives. ESDM is best when delivered in therapy teams, either in a clinical setting or in the child’s home and has been found effective across the Autism Spectrum. ESDM can be provided by ESDM-trained behavior analysts, special education teachers, speech therapists and other providers. Parents can also be taught to use ESDM strategies.

Creates positive emotional experiences with another person and “recalibrates” the child’s mind to improve social motivation.

  • For those children who enjoy social situations, therapy seeks to build off of it.
  • For those children who don’t like social situations therapy seeks to tie social engagements to rewards (objects/activities).
  • Encourage children to request or self initiate social interaction for social or non-social rewards
  • Rewards must be controlled so satiation does not occur.
  • Accomplished ESDM interventionists can deliver a learning opportunity every 10 seconds.

Cost: Costs for the program consists of purchasing the manual ($42.40-$75.00) and the curriculum checklist ($42.50-$50.00). To become certified in ESDM, there is a one-day introductory workshop ($375) and a three-day advanced workshop ($895) that is required. There are prerequisite requirements before attending the workshops. Please visit the UC Davis ESDM training website for more information.

Strengths: 

  • Evidence based (see below)
  • Can be provided by parents who have received training which could reduce the cost to the family.

Weaknesses: 

  • Cost could be prohibitive
  • Time consuming- 25 hours or more of therapy per week
  • Efficacy decreases as child ages

Additional Information: 

One randomized controlled trial by Dawson & Rodgers (2010) was conducted on children between the ages 18 and 30 months who were diagnosed with autism. Children were randomly assigned to the ESDM intervention or referred to community providers for intervention commonly available. Children in the ESDM intervention showed significant improvements in IQ, adaptive behavior, and autism diagnosis. More specifically, the ESDM group maintained its rate of growth in adaptive behavior as compared to a normative sample of typically developing children. In addition, the control group exhibited greater delays in adaptive functioning than the ESDM group.

For more information on professional training in the ESDM:

See Early Start Denver Model Courses on the UC Davis Extension and Steps to ESDM Certification website

Find other Contemporary Approaches to Intervention here!

Special thanks to Vidya Parashar, Miki Shibata and Andrew Angeles. 

Sources:

Baik, L. (2013). Early Start Lab. Retrieved from http://www.ucdmc.ucdavis.edu/mindinstitute/research/esdm/

Dawson, G. & Rogers, S. (2010). Randomized, controlled trial of an intervention for toddlers with Autism: The Early Start Denver Model. Pediatrics, 125(1), 17-23.

Rogers, S. & Dawson, G. (2009). Play and Engagement in Early Autism: The Early Start Denver Model. Volume I and Volume II: The Treatment. New York: Guilford Press. Also available in Japanese, Italian, Dutch, French, Spanish, and Arabic.

Rogers, S., & Dawson, G. (2010). Early Start Denver Model for young children with Autism. New York: Guilford Press.

Rogers, S.J., Dawson, G., & Vismara, L. (2012). An Early Start for your Child with Autism. New York: Guilford Press.

Autism Speaks  (2013). The Early Start Denver Model (ESDM). Retrieved from http://www.autismspeaks.org/what-autism/treatment/early-start-denver-mod…