The Early Start Denver Model (ESDM)

  • Jill HowardEmail author
  • Geraldine Dawson


The Early Start Denver Model (ESDM; Rogers and Dawson in The Early Start Denver Model for Young Children with Autism: Promoting Language, Learning, and Engagement. Guilford Press, New York, 2010) is an evidence-based early intervention designed to promote developmental and social communication skills in young children with autism spectrum disorder between the ages of 12 and 60 months. The ESDM is characterized as a Naturalistic Developmental Behavioral Intervention (NDBI; Schreibman et al. in Naturalistic Developmental Behavioral Interventions: Empirically validated treatments for autism spectrum disorder. J Autism Dev Disord 45(8):2411–2428, 2015), indicating that it shares commonalities with a number of similar types of early interventions including delivery in natural contexts, shared control between the child and clinician, and use of behavioral principles/natural contingencies. The ESDM is particularly well suited for an interdisciplinary approach to care for young children on the autism spectrum given that it promotes the development of an interdisciplinary treatment team, benefits from collaboration across disciplines, and values the input of varied perspectives. Several other ways in which the ESDM approach provides a range of opportunities to collaborate and coordinate interdisciplinary care are described throughout the chapter.


Pediatrics Autism spectrum disorder Neurodevelopmental Autism Treatment Interdisciplinary Evaluation Management 


  1. Bondy, A. S., & Frost, L. A. (1994). The picture exchange communication system. Focus on Autistic Behavior, 9, 1–19.Google Scholar
  2. Cidav, Z., Munson, J., Estes, A., Dawson, G, Rogers, S. J., & Mandell, D. (2017). Cost offset associated with Early Start Denver Model for children with autism. Journal of the American Academy of Child and Adolescent Psychiatry, 56(9), 777–783.Google Scholar
  3. Dawson, G., Jones, E. J. H., Merkle, K., Venema, K., Lowy, R., Faja, S., … Webb, S. J. (2012). Early behavioral intervention is associated with normalized brain activity in young children with autism. Journal of the American Academy of Child and Adolescent Psychiatry, 51(11), 1150–1159.Google Scholar
  4. 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), e17–e23.Google Scholar
  5. Dawson, G., Toth, K., Abbott, R., Osterling, J., Munson, J., Estes, A., & Liaw, J. (2004). Defining the early social attention impairments in autism: Social orienting, joint attention, and responses to emotions. Developmental Psychology, 40(2), 271–283.Google Scholar
  6. Estes, A., Munson, J., Rogers, S. J., Greenson, J., Winter, J., & Dawson, G. (2015). Long-term outcomes of early intervention in 6-year old children with autism spectrum disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 54(7), 580–587.Google Scholar
  7. Kaale, A., Smith, L., & Sponheim, E. (2012). A randomized controlled trial of preschool based joint attention intervention for children with autism. Journal of Child Psychology and Psychiatry, 53(1), 97–105.Google Scholar
  8. Kasari, C., Freeman, S., & Paparella, T. (2006). Joint attention and symbolic play in young children with autism: A randomized controlled intervention study. Journal of Child Psychology and Psychiatry, 47(6), 611–620.Google Scholar
  9. Koegel, R., & Koegel, L. K. (1988). Generalized responsivity and pivotal behavior. In R. H. Horner, G. Dunlap, & R. L. Koegel (Eds.), Generalization and maintenance: Lifestyle changes in applied settings (pp. 41–66). Baltimore: Brookes.Google Scholar
  10. Mesibov, G. B., & Shea, V. (2010). The TEACCH program in the era of evidence-based practice. Journal of Autism and Developmental Disorders, 40(5), 570–579.Google Scholar
  11. Mesibov, G. B., Shea, V., & Schopler, E. (2004). The TEACCH approach to autism spectrum disorders. New York: Springer Publishers.Google Scholar
  12. Piaget, J. (1963). The origins of intelligence in children. New York: Norton.Google Scholar
  13. Prizant, B. M., Wetherby, A. M., Rubin, E., & Laurent, A. (2003). The SCERTS model: A transactional, family-centered approach to enhancing communication and socioemotional abilities of children with autism spectrum disorder. Infants & Young Children, 16(4), 296–316.Google Scholar
  14. Rogers, S. J., & Dawson, G. (2009). Early Start Denver Model curriculum checklist for young children with autism. New York: Guilford Press.Google Scholar
  15. Rogers, S. J., & Dawson, G. (2010). The Early Start Denver Model for young children with autism: Promoting language, learning, and engagement. New York: Guilford Press.Google Scholar
  16. Rogers, S. J., Estes, A., Lord, C., Vismara, L., Winter, J., Fitzpatrick, A., … Dawson, G. (2012). Effects of a brief Early Start Denver Model (ESDM)-based parent intervention on toddlers at risk for autism spectrum disorders: A randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, 51(10), 1052–1065.Google Scholar
  17. Rogers, S. J., Estes, A., Lord, C., Munson, J., Rocha, M., Winter, J., … Talbott, M. (2019). A multisite randomized controlled two-phase trial of the Early Start Denver Model compared to treatment as usual. Journal of the American Academy of Child and Adolescent Psychiatry, 58(9), 853–865.Google Scholar
  18. Rogers, S. J., Hall, T., Osaki, D., Reaven, J., & Herbison, J. (2000). The Denver model: A comprehensive, integrated educational approach to young children with autism and their families. In S. L. Harris & J. S. Handleman (Eds.), Preschool education programs for children with autism (2nd ed., pp. 95–134). Austin, TX: Pro-Ed.Google Scholar
  19. Rogers, S. J., Herbison, J., Lewis, H., Pantone, J., & Reis, K. (1986). An approach for enhancing the symbolic, communicative, and interpersonal functioning of young children with autism and severe emotional handicaps. Journal of the Division of Early Childhood, 10, 135–148.Google Scholar
  20. Rogers, S. J., & Pennington, B. F. (1991). A theoretical approach to the deficits in infantile autism. Development and Psychopathology, 3, 137–162.Google Scholar
  21. Sameroff, A. (Ed.) (2009). The transactional model of development: How children and contexts shape each other. Washington, DC: American Psychological Association.Google Scholar
  22. Schreibman, L., Dawson, G., Stahmer, A. C., Landa, R., Rogers, S. J., McGee, G. G., … Halladay, A. (2015). Naturalistic developmental behavioral interventions: Empirically validated treatments for autism spectrum disorder. Journal of Autism and Developmental Disorders, 45(8), 2411–2428.Google Scholar
  23. Schreibman, L., & Pierce, K. L. (1993). Achieving greater generalization of treatment effects in children with autism: Pivotal response training and self-management. Clinical Psychologist, 46(4), 184–191.Google Scholar
  24. Vismara, L. A., McCormick, C. E. B., Wagner, A. L., Monlux, K., Nadhan, A., & Young, G. Y. (2018). Telehealth parent training in the Early Start Denver Model: Results from a randomized controlled study. Focus on Autism and Other Developmental Disabilities, 33(2), 67–79.CrossRefGoogle Scholar
  25. Vivanti, G., Paynter, J., Duncan, E., Fothergill, H., Dissanayake, C., Rogers, S. J., & Victorian ASELCC Team (2014). Effectiveness and feasibility of the Early Start Denver Model implemented in a group-based community childcare setting. Journal of Autism and Developmental Disorders, 44(12), 3140–3153.Google Scholar
  26. Zhou, B., Xu, Q., Li, H., Zhang, Y., Wang, Y., Rogers, S. J., & Xu, X. (2018). Effects of parent‐implemented Early Start Denver Model intervention on Chinese toddlers with autism spectrum disorder: A non‐randomized controlled trial. Autism Research, 11, 654–666.Google Scholar

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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Psychiatry and Behavioral SciencesDuke Center for Autism and Brain Development, Duke University School of MedicineDurhamUSA

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