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 www.autismspeaks.org/what-autism/treatment/early-start-denver-model-esdm
|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
Step 1. Formulating Teaching Objectives
A. Before treatment begins, the therapist uses the ESDM Curriculum Checklist for Young Children with Autism Checklist) to assess the child’s current functioning.
B. The team leader identifies two to three short-term (12-week) learning objectives for the child in each of the Checklist’s developmental domains.
C. Identify the skills that are most mature, those that are emerging, and those that are not yet in the child’s repertoire.
D. The teaching target is adjusted across the weeks based on data taken during the sessions. At the end of the 12 weeks, the objectives are revised based on a new Checklist assessment.
E. New objectives are then developed, or the old ones revised.
Step 2. Creating a Task Analysis and Teaching Steps
A. When the objectives are developed, each objective is broken down into a sequence of steps.
B. These steps serve as intermediate teaching targets, leading to full mastery of the objective.
C. The steps guide what will be taught at the next session.
D. Each session focuses on teaching every objective’s “acquisition” step, which is the step the child currently needs to learn; and “maintenance,” which provides practice on the step that was mastered immediately preceding the current acquisition step.
E. During the sessions, the interventionist pauses to complete the Daily Data Sheet.
F. The data sheet ties together the 12-week objectives, the teaching task analysis, and the child’s individual performance. This provides an effective way of tracking the child’s learning.
Step 3. Using the Treatment Notebook
A. The child’s teaching plans are organized into a treatment notebook.
B. This notebook includes objectives, task analyses, Daily Data Sheets, and other relevant information.
C. Space is available for interventionists to write notes on progress; document future appointments; record questions for physician or other professionals on the child’s treatment team; and note important names and phone numbers.