The Early Start Denver Model (ESDM) is an evidence-based intervention program for young children with autism. Developed by Sally Rogers and Geraldine Dawson, the ESDM is a comprehensive early intervention program that focuses on building social communication skills, promoting language development, and reducing challenging behaviors in young children with autism.
The ESDM is based on the principles of applied behavior analysis (ABA) and developmental psychology. It is a play-based intervention that is delivered in a naturalistic setting, such as a child's home or classroom. The program is typically delivered by a team of professionals, including a behavior analyst, speech therapist, and occupational therapist.
The ESDM is designed for children between the ages of 12 months and 48 months who have been diagnosed with autism spectrum disorder (ASD). The program is designed to be delivered for up to 20 hours per week, although the exact number of hours may vary depending on the child's individual needs.
The ESDM is a comprehensive intervention program that covers a wide range of developmental domains, including social communication, language, play, cognition, and adaptive behavior. The program is designed to be flexible and individualized, with the goal of meeting each child's unique needs and strengths.
The ESDM is divided into five main phases:
Assessment and Curriculum Development: During this phase, the child's strengths and needs are assessed using a variety of tools, including standardized assessments, observation, and parent input. Based on this assessment, an individualized curriculum is developed for the child.
Relationship Building: The second phase focuses on building a strong relationship between the child and the therapist. The therapist uses a variety of techniques, such as imitating the child's play and following the child's lead, to build a positive and trusting relationship with the child.
Naturalistic Teaching: The third phase involves teaching skills in a naturalistic setting, such as during play activities. The therapist uses a variety of techniques, such as modeling, prompting, and reinforcement, to teach the child new skills.
Structured Teaching: The fourth phase involves teaching skills in a more structured setting, such as during table activities. The therapist uses a variety of techniques, such as discrete trial training (DTT), to teach the child new skills.
Generalization: The final phase involves promoting the generalization of skills to new settings and situations. The therapist uses a variety of techniques, such as fading prompts and providing reinforcement in naturalistic settings, to promote the generalization of skills.
The ESDM has been shown to be effective in improving a wide range of developmental domains in young children with autism. Research has shown that children who receive the ESDM make greater gains in social communication, language, play, cognition, and adaptive behavior than children who receive other types of interventions.
The ESDM is based on a set of 12 core principles, which include:
Early intervention: The ESDM is designed to be used with children as young as 12 months old, with the goal of promoting positive outcomes in areas such as social communication, language development, and adaptive behavior.
Naturalistic teaching methods: The ESDM uses naturalistic teaching methods that are designed to be more fun and engaging for young children, including play-based activities and positive reinforcement.
Child-centered approach: The ESDM is individualized to the needs and abilities of each child, and it emphasizes the importance of positive reinforcement, shared control, and collaboration between the therapist and the child.
Joint attention: The ESDM focuses on building joint attention skills, which are critical for social communication and language development.
Imitation: The ESDM emphasizes the importance of imitation skills, which are essential for learning new behaviors and developing social skills.
Positive reinforcement: The ESDM uses positive reinforcement to promote positive behaviors and to increase motivation and engagement in learning activities.
Graduated prompting: The ESDM uses graduated prompting techniques to help children learn new skills and to promote independence and self-regulation.
Generalization: The ESDM emphasizes the importance of generalization, which involves helping children apply new skills in a variety of contexts and situations.
Family involvement: The ESDM encourages family involvement in the therapy process, and it provides training and support for families to promote their child's development and learning.
Collaborative approach: The ESDM emphasizes collaboration between the therapist, the child, and the family to promote positive outcomes and to maximize the child's potential for growth and development.
Data-based decision-making: The ESDM uses data-based decision-making to evaluate the child's progress and to make adjustments to the therapy plan as needed.
Interdisciplinary approach: The ESDM encourages interdisciplinary collaboration between different professionals and service providers
In addition to its effectiveness, the ESDM is also a parent-focused intervention. Parents are actively involved in the intervention process, with the goal of promoting the generalization of skills to the home setting. Parents are trained in the techniques used in the ESDM, and are encouraged to use these techniques in their interactions with their child.
The ESDM is also a naturalistic intervention, meaning that it is delivered in a natural setting, such as a child's home or classroom. The goal of this approach is to promote the generalization of skills to new settings and situations.
Another important feature of the ESDM is its focus on building positive relationships between the child and the therapist. The therapist uses a variety of techniques, such as imitating the child's play and following the child's lead, to build a positive and trusting relationship with the child. This relationship is essential for promoting the child's engagement and learning during the intervention process.