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Early Start Denver Model (ESDM)

The Early Start Denver Model (ESDM) is a comprehensive behavioral early intervention approach for children with autism, ages 12 to 48 months (1–4 years). 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.


The Early Start Denver Model (ESDM), an evidence-based program, 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 (Dawson et al., 2010). Although ESDM follows a developmental curriculum, it is not tied to a specific delivery setting, and thus can be delivered by therapy teams and/or parents in group programs or individual therapy settings in either a clinic setting or in the child’s home. The early intervention program integrates a relationship-focused developmental model with well-validated teaching practices based on applied behavior analysis. The core features of ESDM include naturalistic applied behavioral analytic strategies; sensitivity to normal developmental sequence; deep parental involvement; a focus on interpersonal exchange and positive affect; shared engagement with joint activities; and language and communication taught inside a positive, affect-based relationship. An ESDM therapist is required to have specific ESDM training and certification.

Because parental involvement is a crucial part of the ESDM program, the instructor explains and models the strategies for home use. A separate training “manual” for parents is available, An Early Start for Your Child with Autism (Rogers, Dawson & Vismara, 2012). This book has useful tips and hands-on strategies that integrate smoothly into daily activities and play. This volume is useful for parents whether or not the child’s therapist is specifically ESDM-trained.


Dawson, G., Rogers, S. J., Munson, J., Smith, M., Winter, J., Greenson, J., … Varley, J. (2010). Randomized, controlled trial of an intervention for toddlers with autism: The Early Start Denver Model. Pediatrics, 125(1), 17–23. doi: 10.1542/peds.2009-0958

Rogers, S. J., Dawson, G., & Vismara, L. A. (2012). An early start for your child with autism: Using everyday activities to help kids connect, communicate, and learn. New York, NY: Guilford Press.

Early Start Denver Model ESDM (n.d.). Autism Speaks. Retrieved from

Research Summary

Ages (yrs) Skills Settings Outcome
18 months - 6 years Improve maladaptive behaviors, functional use of objects, imitation, goal understanding, cognitive, adaptive, social Center, community, home

Outcomes:     Evidence-based     Emerging     No evidence     Comprehensive

Steps for Implementation


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