The New Treatment on the Early Intervention Scene: What is the Early Start Denver Model (ESDM)?

By Dr. Katy Dorendorf

The Early Start Denver Model (ESDM) is a relationship-based early intervention program for young children with autism spectrum disorder (ages 12 to 48 months) and their families developed by Drs. Sally Rogers and Geraldine Dawson. At the core of the Early Start Denver Model is a respectful understanding that parents are a child’s most impactful and influential teachers. Therefore the model focuses on parent and family involvement in the treatment process as well as the transfer of therapeutic skills to parents to ensure a child’s positive developmental progress continues even after treatment ends. The primary goal of the Early Start Denver Model is to increase a child’s developmental rate across domains while decreasing the symptoms of autism spectrum disorder that impact the child’s functioning. Specifically, the Early Start Denver Model focuses on improving children’s social-emotional skills, language development, and early problem solving abilities, as these areas are typically the most impacted by the symptoms of autism spectrum disorder. The techniques, curriculum, and goals of the Early Start Denver Model are based on a thorough understanding of early child development and infant-toddler learning, as well as knowledge of how autism spectrum disorder impacts these processes. The Early Start Denver Model integrates a play-based, relationship-focused developmental model with the well-established and research-based teaching practices of Applied Behavior Analysis. Core program features include:

  • naturalistic applied behavioral analytic strategies,
  • sensitivity to the natural developmental patterns all children experience,
  • deep parental involvement and parent coaching in application of the skills,
  • child direction of activities and shared engagement within joint activities,
  • curriculum that addresses all domains of early development (e.g., language, play, imitation, social, motor, cognitive, independence, behavior, etc.),
  • and language and communication skills taught within a positive, affect-based relationship.

Overall, the Early Start Denver Model melds behavioral, relationship-oriented, and developmental, play-based approaches into an integrated whole that is then completely individualized to each child and their family. Many parents are drawn to the Early Start Denver Model because its naturalistic approach is easily integrated into their daily routines and does not significantly interrupt their day-to-day lives. Also it allows parents and therapists to take advantage of a child’s natural motivations and current strengths to encourage development in areas of weakness. Simply stated, ESDM helps parents learn how to talk and play with their children in a way that encourages their long-term development and success.

Who can benefit from the Early Start Denver Model?

The Early Start Denver Model was found to be effective for children with autism spectrum disorder across a wide range of learning styles and abilities and is currently the only comprehensive early intervention model validated in a randomized clinical trial (the gold standard of research methods) for use with children with autism as young as 18 months of age (published in the journal Pediatrics). Initial research demonstrated that children with significant learning challenges were found to benefit from the program as much as children without such learning challenges indicating an effectiveness across functioning levels not often found in other models. The study demonstrated that children who received Early Start Denver Model therapy for 20 hours a week (delivered by both trained therapists and parents) over two years showed greater improvement in cognitive abilities, language abilities, and adaptive behavior as well as fewer autism related symptoms than did children who were referred for interventions commonly available in their communities such as applied behavior analysis, speech language therapy, and occupational therapy. More recently another study was published demonstrating the long-term effectiveness of the Early Start Denver Model even after the discontinuation of the treatment. Notably, researchers found that children who received Early Start Denver Model therapy continued to demonstrate improvement in adaptive behaviors and reduction in the core symptoms of autism spectrum disorder two years after ceasing the treatment ( While additional studies are needed to confirm the initial findings of the Early Start Denver Model’s effectiveness over time, early results are very promising. If you would like to learn more about the Early Start Denver Model please visit the links below or contact Dr. Katy Dorendorf at 561.429.2397.

For more information on the Early Start Denver Model see:

Rogers SJ, Dawson G, and Vismara L. (2012). An Early Start for your Child with Autism. New York: Guilford Press.