Unit 19: The Early Start Denver Model (ESDM): A Comprehensive Behavioral Early Intervention Approach
A variety of treatment methods and approaches are available for Autism Early Intervention, each with its unique strengths and philosophies. Among these, the Early Start Denver Model (ESDM) is an Integrated and Effective Early Intervention Approach. ESDM is a kind of naturalistic behavioral intervention that is designed for little children who have autism spectrum disorder (ASD). Derived from evidence-based practices and integrating the elements of Applied Behavior Analysis (ABA), this model focuses on the social-emotional, cognitive, and linguistic competencies, independence, and overall quality of life. In this blog post, details about ESDM, its advantages, components, and how it can improve the lives of ASD children are investigated.
What is the Early Start Denver Model (ESDM)?
The Early Start Denver Model (ESDM) is an intensive Behavioral Early Intervention approach to autistic children who are between 12 and 48 months. ESDM combines a relationship-oriented developmental model with the tried and true practices of Applied Behavior Analysis (ABA).
This model, established by Sally Rogers, Ph.D., and Geraldine Dawson, Ph.D., considers parents and caregivers to be the principal intervention agents. It is created to stimulate the development of social, emotional, cognitive, language, and adaptive skills and reduce the signs of Autism in small children.
ESDM has a rare delivery setting. It is applicable in the one-on-one therapeutic setting, but also it is designed to work in group settings such as care centers. Although this is not the major one, it is tied in with the child’s daily life and hence the whole world becomes a classroom for him/her.
🎯 GOAL: The main purpose of the ESDM is to facilitate children with autism to interact appropriately and meaningfully with others, thereby reinforcing positive social interaction and communication. The techniques employed are fun and interesting, thus helping the child develop a more proactive approach.
How does ESDM Work?
ESDM is one of the Behavioral Therapies that combines ABA techniques. It is meant to enhance the pace of development in all domains but to reduce the symptoms of autism that can interfere with the way a child interacts with the world.
In real life, the implementation of the Early Start Denver Model (ESDM) is through Play-Based, interactive activities that aim at improving the child’s curiosity about his environment and the people around him. This model is also based on the Communication and Interaction system, which teaches children that their actions have certain consequences in the surrounding environment. ESDM is a manualized package of treatment procedures that is implemented in high-intensity sessions, usually about 20 hours per week. Such sessions require the child, therapist, parent, or caregiver and are characterized by one-on-one interactions. This model includes parental involvement as an essential part, as parents are taught to employ ESDM methods in their day-to-day engagement with their children.
What are the Components of the Early Start Denver Model?
ESDM is an evidence-based intervention program for very young children with autism that is to be implemented by therapists, teachers, and parents in naturalistic environments such as homes, clinics, or schools. Here are the following components of the ESDM that work together to promote social communication and development in children with autism:
Developmental Curriculum
EDSM utilizes a Developmental Curriculum that focuses on critical skills in the domains of cognition, communication, social interaction, and adaptive behaviors. This syllabus is itinerant and can be tailored to the learning variations and capabilities of every child.
Naturalistic Teaching Strategies
ESDM employs naturalist teaching methods that are embedded in the child’s daily activities and routines. These approaches target learning and acquisition of skills in natural, play-based surroundings.
Parental Involvement
Parents participate as active agents in the intervention process. The adoptive parents are taught ESDM techniques in their daily interactions with the child, utilizing consistent therapeutic input over the whole day.
One-on-One Therapy Sessions
ESDM requires long-duration therapy sessions, usually running for at least 20 hours weekly. In these sessions, there are interactions between the child and either the ABA Therapist, parent, or caregiver who is involved.
Applied Behavior Analysis (ABA) Methods
ESDM utilizes ABA Methods, employing positive reinforcement to promote good behaviors and diminish harmful ones.
Interdisciplinary Team
An ESDM team comprises a team of professionals working together to provide the intervention. The team might consist of a psychologist, a Speech-Language Therapist, an Occupational Therapist, and a special education teacher, among other professionals.
Data-Driven Decision Making
On the one hand, data collection should be continuous in the process of ESDM, while, on the other hand, the analysis of the collected data is one of the critical tasks. Such a data-based approach ensures continuous monitoring of the child’s progress and suitability of the applied intervention.
Personalized Treatment Plan
Every child in the ESDM program is provided with an individualized treatment plan that addresses his or her specific needs, skills, and preferences as well as family context.
Focus on Generalization
ESDM stresses the value of generalizing skills across people, settings, and activities. Such an orientation enables children to accept what they have learned from therapy in their day-to-day existence.
Promotion of Independence
The final aim of ESDM is to help children with autism to live independently and improve the quality of life. This is through improving their social, communicative, cognitive, and adaptive abilities.
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Benefits of Early Start Denver Model (ESDM)
✅ Enhances Communication Skills: ESDM was designed to develop both verbal and non-verbal communication skills. This enhanced communication can also result in greater detail and interaction with others.
✅ Promotes Cognitive Development: The model addresses diverse cognitive skills which include problem-solving and attention. In this way, this cognitive development might lead to good academic performance in a child.
✅ Improves Behavior: ESDM uses ABA approaches to control challenging behaviors. It promotes positive behavior and decreases the incidence of negative ones.
✅ Holistic Development: Unlike some models that centralize one domain, ESDM targets all developmental areas. This integrated approach guarantees harmonious progress and evolution.
✅ Generalization of Skills: ESDM is characterized by skills generalization across various situations and activities. This allows children to utilize what they have learned in therapy in real-life scenarios.
✅ Data-driven: ESDM relies on an ongoing process of data gathering and analysis for decision-making. This ensures continuous monitoring of a child’s progress and tweaking of the intervention if necessary.
Parent Involvement in ESDM
Parent participation is an important element of the Early Start Denver Model (ESDM). Parents are acknowledged by the model as the main intervention agents for young children with Autism Spectrum Disorder (ASD). Parents and caregivers also learn ESDM techniques as part of the ESDM, to play an active and beneficial role in the teaching process. Therapists teach and demonstrate strategies that they use for families to practice at home and include therapy in their daily routines.
To strengthen the role of parents in their accomplishment of the task, the Parent Training Program is intended to train therapists to teach parents about ESDM techniques. Additionally, this method is also helpful to the parents since they are provided with the necessary instruments and information to participate in the development of their children themselves. Research has demonstrated the effectiveness of Parent-Delivered Interventions at a lower intensity level which represents rather a one-hour per week contact with the therapist. This evidence-based structured approach of parent treatment teaches parents ESDM strategies, for example, how to get the child’s attention or motivate him, thereby promoting the overall development of the child.
Suggested: Unit 16: Parental Involvement in Early Intervention
Difference Between EIBI and ESDM
Early Intensive Behavioral Intervention (EIBI) and the Early Start Denver Model (ESDM) are two popular treatment methods for young children with autism spectrum disorder.
EIBI is an ABA therapy-based program that typically involves preschool children in intensive treatment (10 to 40 hours per week) in various settings. The approach is characterized by 1:1 discrete trial instruction, and research has shown that a higher IQ at intake can be a strong predictor of a positive response to EIBI.
In contrast, ESDM is an example of Naturalistic Developmental Behavioral Intervention (NDBI) that incorporates relationship-based pivot response treatment. This is a standard, commercially available intervention model intended for autism treatment in young children aged 18-48 months. ESDM, unlike EIBI, is intended to be more naturalistic and developmentally appropriate.
Although both EIBI and ESDM have proved to be effective, no differences were observed in expressive communication.
Frequently Asked Questions & Answer
Is Early Start Denver Model Covered by Insurance?
Most types of private health insurance cover services for autism, such as the Early Start Denver Model (ESDM). The coverage varies on the type of insurance you have and the state you live in. In fact, some providers refer to ESDM as ABA therapy which is most commonly covered by insurance. However, not all services provided by Early Start Autism, which involves ESDM are covered by insurance.
Who Provides Early Start Denver Model Services?
Professionals who have training in the model provide EDSM services. These may include psychologists, speech pathologists, occupational therapists, and special education teachers. Parents and caregivers are also involved since they can be taught how to use ESDM methods with their children in everyday life.
Is ESDM an ABA Therapy?
Yes, the Early Start Denver Model is one of the types of ABA therapy. It combines ABA techniques with developmental and relationship-based methods. Although it covers all developmental areas where children are delayed, it mainly targets the improvement of social-emotional, cognitive, and language skills.
What are the Levels of the Early Start Denver Model?
There are age levels for the Early Start Denver Model (ESDM) are as follows:
- Level 1: 12 – 18 months
- Level 2: 18 – 24 months
- Level 3: 24 – 36 months
- Level 4: 36 – 48 months
This suggests that ESDM therapy is structured to cater to different developmental stages in early childhood, with specific strategies and goals for each level.
Conclusion
The Early Start Denver Model (ESDM) is not only an Intervention Technique; it is an inclusive care, child-oriented approach that benefits both children with ASD and their families. ESDM features early intervention and includes parents into the therapeutic process, thus creating a nurturing environment that catalyzes growth. This is exactly the AutismCOE approach which doesn’t only refer to behavioral aspects but takes into account the whole child and his individual needs and potentials. ESDM concentrates on improving the Social Skills, communication, cognition, and behavior of children with ASD, thus being a highly promising way to a better, more self-sufficient future of such children. The path with ASD may be difficult but with proper tools, support, and knowledge, every child will do his best.
Please Note: The content of this blog is for informational purposes only and should not be considered a substitute for professional medical advice, diagnosis, or treatment. Consult a qualified health care professional for personalized guidance tailored to your specific situation.
Bhavika Bhasin (Author)
Bhavika Bhasin is the Research and Marketing officer at AutismCOE. She works with children and adults with ASD. Her clinical research includes evaluating various available autism screening and diagnosis methods and their efficacy. She is currently developing a novel screening exam that is indicated to be more accurate than the existing available exams. She is also writes articles papers for various publications.
