The Advantages of The Early Start Denver Model (ESDM) Behavioral Therapy

The Early Start Denver Model is based on the methods used in Applied Behavior Analysis (ABA) Therapy and has demonstrated remarkable results in infants and toddlers with Autism Spectrum Disorder. We are excited to provide you with an informative post regarding the data-proven benefits of using ESDM versus non ESDM behavioral therapy approaches. ESDM is one of the few approaches of early intervention used with infants and toddlers (12-48 months) that has conclusive data support.

The Necessity of Interaction

Autism often affects young children through a lack of desire for interacting with others. This difference is not a disability in itself, but considering how every interaction an infant has stimulates learning and brain function, those children not seeking out an adequate amount of social interaction do not gain valuable social and communication skills and form critical neural pathways at the same pace as those infants whom have the desire to socially interact.

Young children learn from social interactions of all kinds. If social interaction is less exciting than toys to infants with ASD, then there will be more competing environmental variables when attempting to engage (such as television or any interesting toy). Therefore, Autism could be seen as preventing the child’s desire to engage with others, which begins a domino effect of fewer opportunities to learn social cues and will affect future social interactions.

Another point to consider is that play skills are not a natural born ability. They are learned based off engagement with older siblings, parents, daycare workers etc. Pretend play provides vital building blocks for social interactions, and by utilizing the Early Start Denver Model, it provides a myriad of beneficial engagements for children with ASD.

Maximizing Opportunities to Learn

The Early Start Denver Model focuses on creating social experiences that have the child with ASD actively engaged in the family’s social activities. Tasks that could appear as normal everyday routines actually have the capability to engage the child with ASD and provide learning opportunities. These activities are as simple as grocery shopping, diaper changes, going down a slide, taking a walk, and even feeding pets. These are important activities where children can learn, and ESDM emphasizes the importance of parents coaching their children as well. 

The Data

Research by Geri Dawson in 2010 demonstrates the success of using the Early Start Denver Model in a controlled trial. There were 48 children with ASD between the ages of 18 months and 30 months. The groups were divided into those engaging in 15 hours per week of ESDM as well as additional parent coaching, and the others using community intervention that was available in the city of Seattle at the time. Both groups had similar amounts of time in therapy each week. The children also all had similarly matched IQs at the beginning of the trial, around 60, which is a typical range for children of that age with ASD.

One year later, the children receiving ESDM gained about 17 IQ points on average, compared to the children in the comparison community group that did not include ESDM, gained about 5. The children in the ESDM group increased their IQs so much (to 80) that they no longer fell under the range of intellectual disability.

However, the same is not true for Autism severity, as ADOS scores indicate how much of a gain they can make. The children with more severe autism in the ESDM group did better than the children with severe autism in the community group, but they did not have nearly as high of IQ gain as the children with milder autism to begin with. Neverthless, the ESDM treatment still showed gains with children with severe ASD.

Earlier studies along with Geri’s came to the same conclusion: children receiving a variety of interventions do not tend to make as much progress as children who receive a highly focused, and carefully manualized and organized intervention like ESDM.

Another breakthrough for ESDM was that children in the ESDM group also showed similar responses to typical developing children when it came to brain responses to faces. They proved to have faster and stronger electrical brain responses to faces (a discovery acknowledged in Time Magazine) than they did to toys.

The community group proved to still have stronger brain responses to toys than to faces of people.

The Early Start Denver Model has revolutionized ABA therapy, and we hope this informative blog post has given you a greater insight into its effectiveness. Feel free to comment with any questions, comments or additional experiences pertaining to the Early Start Denver Model!

Infant Eye Tracking & ASD

The Infant Sibling Network (IBIS) is an organization that conducts early brain research. They primarily focus on children born into families with an older sibling who has ASD in order to find potential early signs of ASD manifesting in a younger sibling.

In 2018 they conducted an eye tracking study to measure how young children shifted their gaze towards objects placed in front of them. They studied how and when their gaze was shifted, and the duration between the object’s appearance and the first sign of movement of the eye. To do this, they used MRI to assess the brain structure and function, and clinical assessments involving infants.

They discovered that “7-month-olds who went on to develop ASD were slower to shift their attention from one object to another when compared to 7‐month‐olds who did not develop ASD. Slow eye gaze shifts are believed to make it more difficult for the infant to learn about their environment, placing them at risk for developmental delays.”

They have related that slower shifting of the gaze correlates with the maturity of the “corpus callosum.” The corpus callosum connects the right and left halves of the brain through fibers, transferring the synapses between both sides of the brain.

“The sharing of information between both halves of the brain helps with shifting of eye gaze and attention. Using MRI, we were able to show that the corpus callosum was immature in 7-month-old infants who later were diagnosed with ASD. This finding is consistent with other MRI studies in older youth with ASD that show abnormalities in the brain’s “wiring.” However, prior to our IBIS studies it was not known to occur at such a young age.”

“This research is important because it pinpoints a specific brain circuit that is developing atypically very early in life, prior to the child showing outward signs and symptoms of ASD. This early marker for ASD within the biology of the child (a “biomarker”) could be very helpful for earlier detection of ASD when combined with other biomarkers. All early detection markers are important for guiding the development of early treatments. Thus, our team is hopeful that these findings may lead to earlier diagnoses, intervention, and subsequent improved outcomes for individuals with ASD.”

Early intervention is critical for children with ASD. It is our hope that studies conducted by organizations like the Infant Sibling Network will lead to earlier diagnoses and early treatment!

For the full article posted on the Philadelphia Children’s Hospital Center for Autism Research blog age, click here.

Enhancing Learning Opportunities: Bath Time

A neuro-typical toddler is learning from his/her environment all day, every day.  At Spectrum Autism Services, LLC. our goal is to ensure that the same can be said for even our earliest learners with ASD.  It is our belief that teaching children to learn and interact with others in their natural environment (home, grocery store, park, library, grocery store, doctor’s office, etc.) is the key to maximizing their success.  As a result, we have created this list of tips for parents to use during bath-time

Tips for making the most of bath-time

  • Stay in your child’s attention spotlight aka position yourself so that you are face to face and at the same level as your little one. Yes…this means the floor : )  This will allow you to capture eye contact and easily participate in your child’s play. (Life hack: get a kneeling mat, your knees/bottom will thank you)
  • Encourage the development of independent life skills.  A typical toddler will often yell “My turn” or “I do” when parents are providing more help than they need.  Children with ASD often need our help learning to perform these tasks independently. When your child is ready to get in the bath provide support but encourage your child to begin undressing/dressing independently.  It may be helpful to partially remove his/her shirt initially and let them attempt to take it the rest of the way off to avoid frustration and make sure the child is successful.  You can also encourage independence by having your child participate in washing himself/herself with soap/bubbles and a washcloth.

Bath-time is a great time to sing/teach sensory social songs with finger movements.  Some of our favorites include:

    1. Itsy Bitsy Spider
    2. Twinkle Twinkle Little Star
    3. Five Little Monkeys
    4. I’m a Little Tea Pot
    5. Wheels on the Bus
  • Imitation is one of the most important skills to teach a child with ASD.  Encourage the development of this skill by imitating your child actions both with and without toys.  Don’t forget to praise his efforts to imitate you as well. Encourage speech by labeling toys in the bath tub and the actions of your water baby : )  Use the 1 up rule (if the child is nonverbal label items/actions with one word, if the child is regularly using single words use 2 words to label items/actions, and so on. When possible limit the number of people in the bathroom to you and your child.  This will allow you both to focus on your interactions with each other free of distractions.
  • Bathing is an enjoyable experience for many children.  Capitalize on this! Laughs and smiles are great signs that your child is having fun and realizing what a great playmate (read: teacher) you are!
  • It is never too early to teach cleaning up. Yes… we are moms too : )  When you are letting the water out (or before if water going down a drain scares your little one) have him/her help place bath toys in a bath tub storage basket.  You can also have him/her put his/her clothes in the hamper.


Preparing Your Loved One for Holiday Travel and Company

The holiday season tends to be filled with social engagements, both with friends and family. In order to make your holidays as comfortable and stress-free as possible, we created a check list for preparing your loved one with Autism Spectrum Disorder for the upcoming activities. Hopefully with implementing some of our go-to advice, your travels or visits can go as smoothly as possible.

Traveling with Your Loved One

  • Upon deciding on a destination for the holidays, speak with your host about what they can do to help make your visit a pleasant one– and let them know your child’s daily meal and nap routine incase of any impediments.
  • Prepare your loved one for the form of travel you will take– a long car ride or flight might warrant noise cancelling headphones.
  • Carry documents of your child’s diagnosis in case of airline/airport requests, or make a medical necklace or bracelet.
  • Most airports have an autism program in place. You can call and find out so you can take a security run through with your loved one.
  • You can let your airline know ahead of time that you are flying with a child with autism. Three days before your trip, call TSA’s hotline, TSA Care’s (855-787-2227), which can help you act as an intermediary with customer care at the airport.
  • Make sure your child has food readily available that they can eat, both while traveling and at the destination. Have a plan in place to buy groceries upon arriving if need be.
  • Discuss or even practice the traditions you will partake in ahead of time with your loved one.
  • Home made travel kits, used here at Spectrum, include: crayons/markets and a coloring book, deck of cards, play-dough on the go, stickers, an old wallet with old gift cards and fake money,  a pack of conversation starters to work on the entire family’s communication skills 😉

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When Family/Friends Come to Town

  • Have your child put items they don’t want others playing with away and out of sight.
  • Let guests know your child’s schedule/routines in order to avoid unnecessary upsets.
  • Prepare your child for the guests that are arriving, letting them know who will be visiting and for how long.
  • Discuss and practice the holiday traditions they will partake in.

In either scenario, whether at home away, try not to over schedule your child. Provide them reprieves regularly with breaks and safe spaces to eliminate overstimulation.

We hope you find this informative, and if you have any additional tips, comment below!