Abstract
The Early Start Denver Model (ESDM) is a comprehensive, developmental, relationship-based behavioral treatment for toddlers with ASD. It is both manualized and empirically-validated. The ESDM fuses developmental principles with empirically based teaching strategies from applied behavior analysis incorporated throughout the routines that fill children’s daily lives—during play with both objects and people, caretaking, family meals, bathing, outdoor play, community outings, and so on. The ESDM is one of small number of treatments, including both behavioral and pharmacological, with empirical support for its effectiveness in improving outcomes for young children with ASD. In the first randomized, controlled trial comparing ESDM to standard community care, toddlers received 15 h/week of 1:1 ESDM had significantly better outcomes in terms of their cognitive, language, and social skills, adaptive functioning, and autism diagnosis after 2 years of treatment. Results from ongoing follow-up of this sample suggest that these cognitive gains are maintained through age 6 and that core autism symptoms are reduced, despite the cessation of intensive intervention. Other controlled studies have shown that both parents and professionals trained in ESDM techniques acquire the skills at high fidelity in a relatively short amount of time (weeks), and that use of these techniques is associated with increases in children’s rates of spontaneous language use, imitation, and social initiations as well as their scores on standardized developmental measures. In this chapter, we begin with an overview of the theoretical underpinnings, procedures, and implementation of the ESDM. We also provide an overview of the currently published research involving training, implementation, and child outcomes using the ESDM treatment approach. We conclude this chapter with a discussion of some of considerations for practitioners and families interested in applying the ESDM.
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References
Boyd, B. A., Hume, K., McBee, M. T., Alessandri, M., Gutierrez, A., Johnson, L., et al. (2014). Comparative efficacy of LEAP, TEACHH and non-model specific special education programs for preschoolers with autism spectrum disorders. Journal of Autism and Developmental Disorders, 44, 366–380.
Bryson, S. E., Zwaigenbaum, L., McDermott, C., Rombough, V., & Brian, J. (2008). The autism observation scale for infants: Scale development and reliability data. Journal of Autism and Developmental Disorders, 38, 731–738.
Cohen, I., & Sudhalter, V. (1999). Pervasive Developmental Disorder Behavior Inventory (PDDBI-C). NYS Institute for Basic Research in Developmental Disabilities.
Dawson, G. (2008). Early behavioral intervention, brain plasticity, and the prevention of autism spectrum disorder. Development and Psychopathology, 20, 775–803.
Dawson, G., Carver, L., Meltzoff, A. N., Panagiotides, H., McPartland, J., & Webb, S. J. (2002). Neural correlates of face and object recognition in young children with autism spectrum disorder, developmental delay, and typical development. Child Development, 73, 700–717.
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, 1150–1159.
Dawson, G., Rogers, S., 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, 17–23.
Dawson, G., Webb, S. J., & McPartland, J. (2005). Understanding the nature of face processing impairment in autism: Insights from behavioral and electrophysiological studies. Developmental Neuropsychology, 27, 403–424.
DiClemente, C. C., & Marden Velasquez, M. (2002). Motivational interviewing and the stages of change. In W. R. Miller & S. Rollnick (Eds.), Motivational interviewing (2nd ed., pp. 201–216). New York, NY: The Guilford Press.
Eapen, V., Crnčec, R., & Walter, A. (2013). Clinical outcomes of an early intervention program for preschool children with Autism Spectrum Disorder in a community group setting. BMC Pediatrics, 13, 3.
Estes, A., 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, 580.
Estes, A., Vismara, L. A., Mercado, C., Fitzpatrick, A., Elder, L., Greenson, J., … Rogers, S. J. (2014). The impact of parent-delivered intervention on parents of very young children with autism. Journal of Autism and Developmental Disorders, 44, 353–65.
Fulton, E., Eapen, V., Crnčec, R., Walter, A., & Rogers, S. J. (2014). Reducing maladaptive behaviors in preschool-aged children with autism spectrum disorder using the early start Denver model. Frontiers in Pediatrics, 2, 40.
Ganz, M. L. (2015). The lifetime distribution of the incremental societal costs of autism. Archives of Pediatrics & Adolescent Medicine, 161, 343–349.
Hanft, B. E., Rush, D. D., & Shelden, M. L. (2004). Coaching families and colleagues in early childhood. Baltimore, MD: Brookes Publishing.
Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B. L., DiLavore, P. C., … Rutter, M. (2000). The autism diagnostic observation schedule-generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30, 205–23.
McGee, G. G., Morrier, M. J., & Daly, T. (1999). An incidental teaching approach to early intervention for toddlers with autism. Research and Practice for Persons with Severe Disabilities, 24, 133–146.
McGee, G. G., Paradis, T., & Feldman, R. S. (1993). Free effects of integration on levels of autistic behavior. Topics in Early Childhood Special Education, 13, 57–67.
Mullen, E. M. (1995). The Mullen scales of early learning: AGS edition manual. Circle Pines, MN: AGS.
National Association for the Education of Young Children. (2009). Developmentally Appropriate Practice in Early Childhood Programs Serving Children from Birth through Age 8 (position statement). Young Children (pp. 1–31).
National Research Council. (2001). Educating children with autism. Washington, DC: National Academy Press.
O’Neill, R. E., Jenson, W. R., & Radley, K. C. (2014). Interventions for challenging behaviors. In F. R. Volkmar, S. J. Rogers, R. Paul, & K. A. Pelphrey (Eds.), Handbook of autism and pervasive developmental disorders (4th ed., pp. 826–837). Hoboken, NJ: John Wiley & Sons.
Peters-Scheffer, N., Didden, R., Korzilius, H., & Matson, J. (2012). Cost comparison of early intensive behavioral intervention and treatment as usual for children with autism spectrum disorder in The Netherlands. Research in Developmental Disabilities, 33, 1763–1772.
Prochaska, J., Redding, C. A., & Evers, K. E. (2002). The transtheoretical model and stages of change. In K. Glanz, B. K. Rimer, & F. M. Lewis (Eds.), Health behavior and health education (3rd ed., pp. 99–120). San Francisco, CA: Jossey-Bass.
Rogers, S. J., & Dawson, G. (2010). Early start Denver model for young children with autism: Promoting language, learning, and engagement. New York, NY: The Guilford Press.
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 (1st ed.). New York, NY: The Guilford Press.
Rogers, S. J., & DiLalla, D. (1988). A comparative study of the effects of a developmentally based instructional model on young children with autism and young children with other disorders of behavior and development. Topics in Early Childhood Special Education, 11, 29–47.
Rogers, S. J., Estes, A., Lord, C., Vismara, L. A., 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, 1052–65.
Rogers, S. J., Herbison, J. M., & Lewis, H. C. (1984). An approach for enhancing the symbolic, communicative, and interpersonal functioning of young children with autism or severe emotional handicaps. Journal of the Division for Early Childhood, 10, 135–148.
Rogers, S. J., & Lewis, H. (1989). An effective day treatment model for young children with pervasive developmental disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 28, 207–214.
Rogers, S. J., Lewis, H. C., & Reis, K. (1987). An effective procedure for training early special education teams to implement a model program. Journal of the Division for Early Childhood, 11, 180–188.
Rogers, S. J., Vismara, L. A., Wagner, A. L., McCormick, C., Young, G., & Ozonoff, S. (2014). Autism treatment in the first year of life: A pilot study of infant start, a parent-implemented intervention for symptomatic infants. Journal of Autism and Developmental Disorders, 44, 2981.
Rutter, M., Bailey, A., & Lord, C. (2003). Social communication questionnaire. Los Angeles, CA: Western Psychological Services.
Sparrow, S., Balla, D., & Cicchetti, D. (2005). Vineland adaptive behavior scales (2nd ed.). Circle Pines, MN: American Guidance Service.
Stahmer, A. C., & Ingersoll, B. (2004). Inclusive programming for toddlers with autism spectrum disorders: Outcomes from the children’s toddler school. Journal of Positive Behavior Interventions, 6, 67–82.
Strain, P. S., & Bovey, E. H. (2011). Randomized, controlled trial of the LEAP model of early intervention for young children with autism spectrum disorders. Topics in Early Childhood Special Education, 31, 133–154.
Trembath, D., & Vivanti, G. (2014). Problematic but predictive: Individual differences in children with autism spectrum disorders. International Journal of Speech-Language Pathology, 16, 57–60.
Vismara, L. A., Colombi, C., & Rogers, S. J. (2009). Can one hour per week of therapy lead to lasting changes in young children with autism? Autism: The International Journal of Research and Practice, 13, 93–115.
Vismara, L. A., McCormick, C., Young, G. S., Nadhan, A., & Monlux, K. (2013). Preliminary findings of a telehealth approach to parent training in autism. Journal of Autism and Developmental Disorders, 43, 2953–2969.
Vismara, L. A., & Rogers, S. J. (2008). The early start Denver model a case study of an innovative practice. Journal of Early Intervention, 31, 91–108.
Vismara, L. A., Young, G. S., Stahmer, A. C., Griffith, E. M., & Rogers, S. J. (2009). Dissemination of evidence-based practice: Can we train therapists from a distance? Journal of Autism and Developmental Disorders, 39, 1636–1651.
Vismara, L. A., Young, G. S., & Rogers, S. J. (2012). Telehealth for expanding the reach of early autism training to parents. Autism Research and Treatment, 2012, 121878.
Vismara, L. A., Young, G. S., & Rogers, S. J. (2013). Community dissemination of the early start Denver model: Implications for science and practice. Topics in Early Childhood Special Education, 32, 223–233.
Vivanti, G., Dissanayake, C., Zierhut, C., & Rogers, S. J. (2013). Brief report: Predictors of outcomes in the Early Start Denver Model delivered in a group setting. Journal of Autism and Developmental Disorders, 43, 1717–1724.
Vivanti, G., Paynter, J., Duncan, E., Fothergill, H., Dissanayake, C., & Rogers, S. J. (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, 3140–3153.
Wetherby, A. M., & Prizant, B. (2002). Communication and symbolic behavior scales developmental profile (1st ed.). Baltimore, MD: Paul H. Brookes.
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Talbott, M.R., Estes, A., Zierhut, C., Dawson, G., Rogers, S.J. (2016). Early Start Denver Model. In: Lang, R., Hancock, T., Singh, N. (eds) Early Intervention for Young Children with Autism Spectrum Disorder. Evidence-Based Practices in Behavioral Health. Springer, Cham. https://doi.org/10.1007/978-3-319-30925-5_5
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