The Early Start Denver Model: Outcomes and Moderators of an Intervention for Toddlers with Autism

Abstract

Effective treatment for young children with autism spectrum disorder (ASD) requires identification and development of effective treatments that address the unique needs of toddlers with ASD as young as 18 months old. The current study aims to expand the current state of the research on the Early Start Denver Model (ESDM) as an effective intervention for toddlers with ASD by examining both treatment outcomes as well as moderators of those outcomes. Three treatment outcomes were examined, each relating closely to the conceptualization and goals of the ESDM and highlighting the anticipated relationship between general areas of development and specific behaviors: 1) shared positive affect, 2) gesture use, and 3) receptive and expressive language). Moderators included initial levels of participant's social orienting skills, response to joint attention, and object use. The current study is a randomized, controlled trial that included forty-eight children diagnosed with ASD between 18 and 30 months of age who were randomly assigned to one of two groups: ESDM or referral to community providers for intervention commonly available in the community. Results included main effects of ESDM treatment for communication outcomes, specifically receptive language (after 1 and 2 years of intervention) and expressive language (after 2 years of intervention). Additionally, significant moderation of treatment effects was noted, particularly response to joint attention and object use moderating language outcomes and both high and low initial levels of object use moderating several child outcomes. Continued focus on which children with ASD and their families benefit from ESDM intervention as well as identification of crucial treatment components will be critical for the dissemination and delivery of the ESDM beyond the research setting to the community at large.