The Early Start Denver Model (ESDM) is a model of intervention for young children with autism. The model has a strong emerging evidence base for young children with autism, and research is ongoing. The ESDM is based on scientific evidence about how young children develop and learn, how having an ASD affects early development and learning, and how best to teach young children The ESDM is a play based approach that fuses developmental- and relationship-based approaches with some of the teaching strategies of Applied Behavior Analysis. The goal is to embed the learning into child play activities and regular family routines.
Professor Sally Rogers and her colleagues developed the ESDM over an almost 30-year period at the M.I.N.D. Institute at the University of California, Davis, in Sacramento, USA. The ESDM is a set of specific strategies that can be used by professionals and parents/caregivers to work with young children with an Autism Spectrum Disorder (ASD) in a clinic setting and in a natural learning environment, such as a day care centre or at home. The ESDM follows a comprehensive curriculum that is based on the development of typical children and children with an ASD. Each child has an individualised learning plan. The ESDM works in partnership with families and the parent is able to become a ‘co-therapist’.
The ESDM covers many developmental areas. The goal is to continually brings the child back into the social loop during every activity. This ensures that the child develops skills across all areas of development, while building a solid social communication foundation while they do this.
Each child is assessed using the ESDM Curriculum Checklist, and a comprehensive list goals and teaching steps are written. The ESDM therapist carefully selects play activities and materials, and then organises the room in such a way that it attracts the child’s attention and facilitates transition from one activity to the next. A number of objectives are interwoven into every activity and detailed records are kept from each session.
Individual ESDM sessions address the following developmental areas:
- Receptive and Expressive Communication
- Joint Attention
- Social with adults and peers
- Fine Motor
- Gross Motor
The therapist carefully selects toys and activities for every session. This means that they are able to 5-6 goals on every toy or activity that the child selects. It is an important part of the ESDM that the sessions alternates between floor based social activities, and table top toy based activities.
Individual ESDM sessions are conducted by Certified ESDM therapists. Each certified ESDM Therapist has a qualification as either a Speech Pathologist, Psychologist or Occupational Therapist.
Generalisation is a key component to the ESDM. This means that children in the ESDM model can use their skills with a variety of people, in a variety of settings. It is important that the skills move beyond the supportive environment of our clinic rooms.
One of the ways we do this is through the group ESDM program. Children who have been in Individual ESDM sessions may move to the group ESDM sessions. These are small groups of up to 4 children. We aim to match children in their developmental abilities so that skills can be generalised to peers, and social communication can thrive.
We believe that parents are instrumental in the intervention of their child with autism. The M.I.N.D. Institute has shown, through research, that parents can deliver very effective intervention at home through their daily activities. We use the parent model of ESDM to support parents so they can follow through on the goals that they wish to prioritise from their child’s ESDM curriculum.
The parent model of ESDM is a 12 week course that has the parent, child and therapist in a one hour work and play session. We use the parent ESDM manual, ‘An Early Start For Your Child With Autism’ during these sessions.
Training and certification in the ESDM
To use the ESDM as an intervention, each therapist has to:
- Complete the Online Introductory Workshop
- Complete the 3 day Advanced Training Workshop
- Submit assessments, goals and objectives, teaching steps and videos to a certified ESDM Trainer
Once the therapist has submitted the required number of videos and passed the fidelity scores, then they can be certified in the ESDM.
Working towards certification in the ESDM takes approximately 6 months and requires about 100 hours of training. All of our certified ESDM therapists at our clinic in Bondi Junction have completed this intensive level of training. This investment in delivering an evidence based model of intervention for young children with autism means that children are able to move towards reaching their potential.