Early Start Denver Model
(ESDM) Therapy
1 - 4.5 years
Evidence-based intervention for children with autism spectrum disorder (ASD)
What is ESDM?
ESDM, the Early Start Denver Model, is a comprehensive intervention built upon foundational principles of infant-toddler learning and specifically tailored to address the effects of Autism Spectrum Disorder (ASD) on early development. Drawing upon scientific evidence in developmental psychology and autism research, ESDM emphasizes the critical role of early intervention in optimizing developmental outcomes for children with ASD. Particularly, improving development across cognitive, social-emotional, and language domains. The ESDM approach fosters the child’s spontaneous tendency to engage and interact with others.
ESDM focuses on PLAY and Joint-Activity-Routines (JARs) to engage with the child and use motivational rewards (e.g., positive reinforcement, positive affect) in child-led activities to maximise the child’s motivation to genuinely want to play, learn and grow with you.
Improved eye gaze, responsiveness to their name, dyadic engagement, and joint attention are only some of the important aspects focused on during the ESDM intervention. We understand how important these interactional skills are at home and in school, especially when interacting with siblings, parents, extended families and peers. ESDM is specifically tailored to address these needs. The intervention targets development across the following domains:
Receptive communication
Expressive communication
Social skills
Joint Attention Behaviours
Cognition
Play Skills
Imitation
Fine Motor skills
Gross Motor skills
Personal Independence
ESDM therapy, an evidence-based intervention for children with autism, utilizes play-based activities to address all developmental domains. After the initial consultation, you'll receive a report that can be used for requesting NDIS funding. Ongoing ESDM therapy sessions can be billed under NDIS for participants who are plan-managed or self-managed.
How does it work?
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During the initial consultation (lasting 1-1.5 hours), we assess your child's current skill level using the ESDM Curriculum Checklist. This involves informal play with pre-organized materials, allowing the therapist to observe their communication, social interaction, play, and cognitive abilities in a natural setting. This assessment can take place in your home or at your child's preschool.
The ESDM developmental domains that will be assessed include:
Receptive Communication, Expressive Communication, Social Skills, Imitation, Joint Attention, Play Skills, Cognitive Skills, Fine Motor, Gross Motor, and Personal Independence.
Following the assessment, an initial assessment report will be prepared, which can be used for NDIS funding purposes. This report will be completed within a week after the initial assessment.
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Based on the assessment results, diagnosis, and symptom severity, the therapist will create individualized learning objectives for each developmental domain. Typically, there are three learning objectives for each domain, designed to be achieved within a 10-week period.
These objectives will be drafted within a week of receiving the initial assessment report.
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The child will participate in 10 weeks of intensive ESDM sessions, with 1-2 sessions per week, each sessions lasting for 1 hour.
During these sessions, learning objectives will be targeted through play-based activities, addressing multiple developmental domains and teaching at a high rate. The child will receive least-to-most prompting, with the goal of generalizing these skills by the end of the 10-week period.
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After the 10-week period, the child is expected to acquire and generalize the learning objectives across different environments and with different individuals.
The Certified ESDM Therapist will review the learning objectives, assess the child’s progress, and provide recommendations for further therapy, if required.
What is the evidence behind ESDM? Does it work?
The Early Start Denver Model (ESDM) emerges as an effective early intervention approach, significantly enhancing developmental outcomes among young children diagnosed with autism spectrum disorder (ASD). Of particular significance are the improvements observed in the domains of cognition and language development (Rogers et al., 2020).
The ESDM combines teaching practices from three intervention traditions: ABA, PRT, and the Denver Model.
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Unlike traditional ABA, which often uses a most-to-least prompting approach, ESDM employs a least-to-most prompting strategy.
ESDM prioritizes child-led activities to capture the child's "spotlight of attention", whereas ABA involves therapist-led, structured sessions, potentially leading to a lack of participation due to a lack of interest.
ESDM's child-led approach makes teaching more natural and helps children become more independent. It encourages genuine skill generalization across different environments and with various people, aiming to develop skills and behaviours in situations where the child genuinely wants to learn and play.
What does each developmental domain target?
The ESDM Curriculum Checklist is a comprehensive assessment tool designed to evaluate various developmental domains, including:
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A child's ability to understand and comprehend language and communication from others, such as following instructions, interpreting spoken words, gestures, facial expressions and other non-verbal cues.
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A child's ability to effectively convey their wants, needs, and feelings through various means, including speech, gestures, facial expressions and other forms of non-verbal communication.
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A child's ability to interact, communicate, and engage with others in socially appropriate ways, including skills such as maintaining eye-contact, turn-taking, and reading social cues.
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When a child engages in coordinated attention with a communicative partner, they share a focus of interest, such as an object or event, through behaviours like giving, showing, looking, pointing, and following points.
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A child’s ability to observe and replicate actions, gestures, vocalizations, or facial expressions demonstrated by others, supporting social learning, communication development, and skill acquisition.
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Cognition involves the mental processes of acquiring knowledge, understanding, and problem-solving, encompassing attention, memory, perception, reasoning, and executive function skills.
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The child's engagement in age-appropriate activities promotes social interaction, imagination, exploration, and learning, while also targeting the reduction of repetitive behaviours and encouraging functional and constructive play.
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The child's ability to control and manipulate small hand and finger muscles for precise movements, is strengthened through activities that enhance hand-eye coordination, finger dexterity, and precision control.
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The child's coordination of large muscle groups for activities such as walking, running, jumping, and climbing, is fundamental for whole-body movement, muscle tone, balance, coordination, and spatial awareness.
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The child's ability to perform daily tasks independently, with activities like dressing, grooming, feeding, toileting, and managing personal belongings.
“Every child carries their own unique mix of strengths and challenges. With love, understanding, and the right support, they can flourish and achieve incredible milestones.”
