The Early Start Denver Model (ESDM)
What Is the Early Start Denver Model?
The Early Start Denver Model (ESDM) is a comprehensive behavioral early intervention approach for children with autism, ages 12 to 48 months. The program encompasses a developmental curriculum that defines the skills to be taught at any given time and a set of teaching procedures used to deliver this content. It is not tied to a specific delivery setting, but can be delivered by therapy teams and/or parents in group programs or individual therapy sessions in either a clinic setting or the child’s home.
Psychologists Sally Rogers, Ph.D., and Geraldine Dawson, Ph.D., developed the Early Start Denver Model as an early-age extension of the Denver Model, which Rogers and colleagues developed and refined. This early intervention program integrates a relationship-focused developmental model with the well-validated teaching practices of Applied Behavior Analysis (ABA). Its core features include the following:
- Naturalistic applied behavioral analytic strategies
- Sensitive to normal developmental sequence
- Deep parental involvement
- Focus on interpersonal exchange and positive affect
- Shared engagement with joint activities
- Language and communication taught inside a positive, affect-based relationship
Who can benefit from the Early Start Denver Model? What Has Research Shown?
The Early Start Denver Model is the only comprehensive early intervention model that has been validated in a randomized clinical trial for use with children with autism as young as 18 months of age. It has been found to be effective for children with autism spectrum disorder (ASD) across a wide range of learning styles and abilities. Children with more significant learning challenges were found to benefit from the program as much as children without such learning challenges. A randomized clinical trial published in the journal Pediatrics showed that children who received ESDM therapy for 20 hours a week (15 hours by trained therapists, 5 hours by parents) over a 2-year span showed greater improvement in cognitive and language abilities and adaptive behavior and fewer autism symptoms than did children referred for interventions commonly available in their communities.
Who is qualified to provide ESDM?
An ESDM therapist may be a psychologist, behaviorist, occupational therapist, speech and language pathologist, early intervention specialist or developmental pediatrician. What’s important is that they have ESDM training and certification.
How can professionals become trained in ESDM?
Qualified professionals attend a training workshop and then submit videotapes showing them using ESDM techniques in therapy sessions. Certification requires that the therapist demonstrates the ability to implement ESDM techniques reliably and according to high standards set by leading ESDM therapists.
This ensures that a certified professional has the knowledge and skills to successfully use the teaching strategies with children with autism. Details on training qualifications and the certification process can be found here.
How can parents be trained in the techniques?
Parental involvement is a crucial part of the ESDM program. If your child is receiving ESDM therapy, the instructor will explain and model the strategies for you to use at home.
In addition, Drs. Dawson and Rogers saw the need for a separate training “manual” for parents. Earlier this year, they published An Early Start for Your Child with Autism, with coauthor Laurie Vismara, PhD. The book has useful tips and hands-on strategies that integrate smoothly into daily activities and play. I think you’ll find it useful whether or not your child’s therapist is trained in ESDM techniques. You can even use it while waiting for your child to begin therapy.
For more information on the Early Start Denver Model, see:
Rogers SJ and Dawson G. (2009) Play and Engagement in Early Autism: The Early Start Denver Model. Volume I: The Treatment. New York: Guilford Press. Also available in Japanese, Italian, Dutch, French, Spanish, and Arabic.
Rogers SJ and Dawson G. (2009) Play and Engagement in Early Autism: The Early Start Denver Model. Volume II: The Curriculum. New York: Guilford Press. Translated into Japanese, Italian, Dutch, French, Arabic, and Spanish.
Rogers SJ, Dawson G, and Vismara L. (2012). An Early Start for your Child with Autism. New York: Guilford Press.
For information on professional training in the ESDM, see Early Start Denver Model Courses – UC Davis Extension and Steps to ESDM Certification