What is the Early Start Denver Model (ESDM), and How Does it Work?
The Early Start Denver Model (ESDM) is an evidence-based, comprehensive intervention designed to support young children with autism spectrum disorder (ASD) and their families. ESDM was developed for children aged 12 to 48 months and focuses on promoting language, social skills, cognitive abilities, and adaptive behaviors through a combination of play-based activities and parent involvement.
What is ESDM?
The Early Start Denver Model is a behavioral therapy model that incorporates elements of applied behavior analysis (ABA), developmental psychology, and relationship-based approaches. It was created to provide early, individualised support for young children with ASD, helping them build essential developmental skills during their most critical years of brain development.
ESDM combines both structured learning opportunities and naturalistic learning experiences, making it an ideal intervention for young children. The goal is to teach skills in a way that feels fun, engaging, and motivating for the child, which helps promote better learning outcomes.
Key Components of ESDM
Play-Based Learning: ESDM is based on using play as a central tool for learning. Therapy sessions are designed to be interactive, with therapists and caregivers playing with the child in ways that help them develop social, communication, and cognitive skills.
Parent Involvement: Parents and caregivers are an essential part of the ESDM process. The model emphasizes training parents to implement strategies at home and in daily routines, ensuring that learning continues outside of therapy sessions. This helps create a supportive and consistent environment for the child.
Individualized Approach: Each child is unique, so ESDM is highly individualised. Therapists conduct a thorough assessment of the child’s strengths, needs, and developmental level to design a personalised plan. This plan is flexible and can be adjusted as the child progresses.
Comprehensive Focus: ESDM addresses a broad range of developmental areas, including social communication, motor skills, play, self-regulation, and adaptive behaviours. It also works on building a strong relationship between the child and the therapist, creating a positive and trusting learning environment.
Positive Reinforcement: ESDM relies on positive reinforcement to encourage desired behaviors. Therapists use praise, rewards, and other motivating strategies to reinforce skills and behaviours that support the child’s development.
How Does ESDM Work?
ESDM is typically delivered through a combination of one-on-one therapy sessions and parent training. The model is delivered by trained therapists who work closely with the child and family. The therapy sessions usually take place in natural settings such as the home, school, or community, allowing the child to generalize skills to everyday situations.
Therapists follow a structured framework that focuses on specific goals for each child. These goals might include improving communication skills (such as learning to use gestures or words), increasing social interactions (such as initiating play with peers), and enhancing adaptive behaviors (such as self-help skills).
In therapy sessions, therapists might engage the child in activities like pretend play, joint attention games, or teaching functional communication, all while providing positive reinforcement. Parents are trained to implement these same techniques at home, ensuring that learning occurs throughout the day.
ESDM vs. ABA: What’s the Difference?
While both ESDM and Applied Behavior Analysis (ABA) are widely used interventions for children with autism, they differ in their approach, methods, and the emphasis they place on certain aspects of the child’s development.
1. Approach
ABA: ABA is a more structured and systematic approach to teaching behavior. It is often used to teach children specific skills, such as communication or social interactions, by breaking them down into smaller tasks and reinforcing correct responses. ABA generally involves discrete trial training (DTT), where tasks are presented in a very structured and repetitive manner.
ESDM: ESDM is a more holistic, play-based approach that integrates learning within everyday activities and routines. It focuses on the child’s developmental milestones and encourages learning through natural interactions, rather than strictly structured drills.
2. Focus on Relationships
ABA: ABA focuses more on the child's behaviour and responses to external stimuli, typically with a strong emphasis on compliance and skill acquisition through repetition and reinforcement.
ESDM: ESDM places a strong emphasis on building a positive, responsive relationship between the child and therapist (or parent), aiming to promote emotional and social development. It prioritises the child's emotional engagement and uses play to motivate learning.
3. Parent Involvement
ABA: Parent involvement in ABA tends to be less direct in some cases, although many ABA programs do involve training parents. The focus remains more on the child’s behaviour, with parents typically learning how to reinforce specific behaviours at home.
ESDM: ESDM places a heavy emphasis on parent involvement, training parents to become active participants in their child’s therapy. Parents are taught strategies to support the child’s development in everyday contexts, creating a more consistent and integrated learning environment.
Why ESDM May Be a Better Option Than ABA
While both ABA and ESDM have proven effectiveness in helping children with autism, there are several reasons why ESDM may be considered a better fit for certain children and families:
Developmental Focus: ESDM incorporates developmental psychology into its approach, ensuring that therapy aligns with the child’s natural growth and developmental trajectory. This is particularly beneficial for younger children who are still in the early stages of brain development.
Naturalistic Learning: ESDM’s emphasis on play and naturalistic learning means that children are often more engaged and motivated. They learn in a way that feels less like traditional schooling and more like engaging in fun activities with their parents or therapists, which can lead to better retention of skills.
Social and Emotional Growth: ESDM places greater importance on social and emotional development by fostering strong relationships with parents and therapists. This approach not only helps children develop specific skills but also enhances their emotional well-being, which is crucial for long-term success.
Flexible and Individualised: While ABA can be very effective for some children, ESDM offers a more flexible, individualised model that focuses on the child’s unique strengths and challenges. It’s less rigid and allows therapists to adapt the therapy to the child’s needs in a more holistic way.
Family-Centered: The focus on training parents ensures that the therapy extends beyond therapy sessions, creating a more consistent environment for the child and enhancing the likelihood of long-term success.
Evidence Behind ESDM
Research has shown that ESDM is an effective intervention for young children with autism. Studies have demonstrated that children who receive ESDM therapy show improvements in communication, cognitive skills, and social behaviors. The earlier a child starts ESDM, the more significant the potential for progress, making early diagnosis and intervention crucial for the best outcomes.
Conclusion
The Early Start Denver Model is a highly effective, evidence-based therapy that provides comprehensive support for young children with autism spectrum disorder. By focusing on play, individualised care, and active family involvement, ESDM creates an environment where children can thrive and develop essential skills for lifelong success.
For parents and caregivers of children with autism, ESDM offers a structured yet flexible way to promote development during the critical early years, setting the foundation for future growth and learning.
If you’re considering ESDM for your child, it's essential to consult with a certified professional to develop a personalised plan. By working together, therapists and families can help children with autism build the skills they need to succeed in everyday life.