ESDM – how we measure progress

By January 20, 2020 September 21st, 2024 Early Start Denver Model (ESDM)
Young girl with autism doing self care skills with Occupational Therapist in Bondi Junction, Mascot, sydney

Autism is a complex neurodevelopment condition. Early intervention is key to helping children with autism. The Early Start Denver Model (ESDM) is an intervention for young children with autism. It was developed by the MIND Institute from The University Of California Davis. It is delivered by certified ESDM therapists and we are proud to offer this early intervention to our families.

Choosing an intervention for your child

Now that you have chosen the intervention for your child with autism, understanding the goals for each intervention is the next step. The intervention needs very clear:

  • goals and objectives
  • method to record of your child’s progress
  • system for generalising the skills to other environments
  • process for communicating the progress with you.

The Early Start Denver Model (ESDM) is an early intervention model for young children with autism. It targets the key features of autism, and involves intensive teaching in play-based sessions. Built into the ESDM is a comprehensive process to develop goals and monitor to each child’s progress. This leads to your child being able to independently use their new skills across a number of environments.

Each child’s progress in the ESDM is monitored in the following ways

The curriculum checklist

The first step in monitoring goals is completing the assessment. This helps us to understand:

  • The things that your child does well
  • The areas that challenge your child
  • The sequence of skills to teach your child in each developmental area

We use the Early Start Denver Model (ESDM) Curriculum Checklist as our assessment. This is a play based assessment where the therapist uses toys and social activities to assess your child. The therapist follows the child’s interest and preference for toys. When the child approaches a toy then the therapist will play and engage with the child as they score the child. The Early Start Denver Model Curriculum Checklist has 480 curriculum items across four levels.

  • receptive language
  • expressive language
  • imitation
  • play
  • joint attention
  • social skills
  • cognition
  • fine motor skills
  • gross motor skills
  • behaviour
  • personal independence

Develop the goals

From the curriculum checklist the certified ESDM therapist creates your child’s first set of goals and objectives. We choose 3-4 goals from each developmental area. We choose these goals starting from the point where the child needs more skills in each developmental area. Some children have goals starting in Level 1, while other children have goals that start in Level 2 or Level 3.

Write the teaching steps

The therapist writes teaching steps for each goal. This means that every goal that is chosen for your child has individualised teaching steps to teach your child. It is also used to monitor their acquisition of that goal. The teaching steps are written to progress your child from their current level of ability, to using the skill independently across a number of settings.

Code every session

The ESDM therapist keeps a record of every activity in every session. The data records the level of prompting that is needed to teach your child on that day.  A number of different prompts are used in teaching:

  • full prompt – complete physical assistance to learn the goal
  • verbal prompt – talking to the child to give them verbal assistance to achieve the goal
  • gestural prompt – some physical assistance or a gesture  to achieve the goal
  • a combination of verbal and gestural prompts

Our goal is for your child to independently use or demonstrate the skill with no prompting.

Feedback to parents after each session

The comprehensive nature of the goals and teaching steps in the ESDM mean that the therapist can clearly, and easily, show the parents the child’s progress at every session.

Generalise goals to other environments

Once your child has shown that they independently use the skill 80% of the time, we start the ‘out-of-clinic’ generalisation steps. We want to make sure that your child uses the skill independently at home and day care. If we were teaching your child to use a ring stacker then we need to make sure he does this skill:

  • in the clinic 3 days in a row
  • at home three days in a row, or
  • at daycare three days in a row

When your child does this, the goals are ‘generalised’. When goals are generalised across environments, and with more people, that are more likely to be maintained and used by the child. There is no point teaching a chiild a skill if they only use it in the clinic situation.

Change therapists for a session every 8-10 weeks

Children become used to their regular therapists. They know them well and have a familiar routine with their therapist. Every 8-10 weeks your child will do a session with a different therapist. If the scores for that session are consistent with the other therapists codes, then the child is using the skills consistently. If the scores vary, we will look at ways to help your child be more consistent with a variety of people. This makes a difference in generalising the skill to all the other places that your child is a part of.

Review goals as progress is made

As soon as a goal is generalised, a new goal is added to the list. We write teaching steps for that goal. Once again, the teaching steps are individualised for your child.

Progress summary at the end of each term

We give parents a summary of their child’s progress each time we update goals during the quarterly review. We meet with you and go over your child’ progress. Each goal is reviewed. We discuss the highlights of your child’s progress and talk about the areas that need more development. This is an opportunity to answer all your questions. the review meeting also us to discuss plans for the following term.

We’re here to support you

At OneOnOne Children’s Therapy, we believe that every child deserves the opportunity to grow and thrive.

Our clinics are not just a space for therapy – it’s a place where children can discover their strengths, overcome challenges, and reach their full potential.

By combining innovative therapy techniques with a stimulating and supportive environment, we’re proud to offer a holistic approach to paediatric therapy and early intervention that addresses the unique needs of each child we support.

Reach out for support

If you’re concerned about your child’s development or want to learn more about how the ESDM can help your child, OneOnOne Children’s Therapy is here to help.

Call our Bondi Junction and Mascot clinics on (02) 80657837 or email. You can book a free 30 minute phone call with us to discuss how we can support your child’s unique journey