Randomized, Controlled Trial of an Intervention for Toddlers With Autism: The Early Start Denver Model

Autism Speaks, Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, USA.
PEDIATRICS (Impact Factor: 5.47). 11/2009; 125(1):e17-23. DOI: 10.1542/peds.2009-0958
Source: PubMed


To conduct a randomized, controlled trial to evaluate the efficacy of the Early Start Denver Model (ESDM), a comprehensive developmental behavioral intervention, for improving outcomes of toddlers diagnosed with autism spectrum disorder (ASD).
Forty-eight children diagnosed with ASD between 18 and 30 months of age were randomly assigned to 1 of 2 groups: (1) ESDM intervention, which is based on developmental and applied behavioral analytic principles and delivered by trained therapists and parents for 2 years; or (2) referral to community providers for intervention commonly available in the community.
Compared with children who received community-intervention, children who received ESDM showed significant improvements in IQ, adaptive behavior, and autism diagnosis. Two years after entering intervention, the ESDM group on average improved 17.6 standard score points (1 SD: 15 points) compared with 7.0 points in the comparison group relative to baseline scores. The ESDM group maintained its rate of growth in adaptive behavior compared with a normative sample of typically developing children. In contrast, over the 2-year span, the comparison group showed greater delays in adaptive behavior. Children who received ESDM also were more likely to experience a change in diagnosis from autism to pervasive developmental disorder, not otherwise specified, than the comparison group.
This is the first randomized, controlled trial to demonstrate the efficacy of a comprehensive developmental behavioral intervention for toddlers with ASD for improving cognitive and adaptive behavior and reducing severity of ASD diagnosis. Results of this study underscore the importance of early detection of and intervention in autism.

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Available from: Jennifer A Gerdts, Oct 01, 2015
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    • "The need for family-centered approaches is widely documented (Kingsley & Mailloux, 2013). Services include parent education or training in implementation of intervention strategies (Beaudoin, Sébire, & Couture, 2014; Dawson et al., 2010). However, many parents, especially those in low-income, non–English-speaking families , do not have access to these services. "
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    ABSTRACT: Objective: Prior research has documented caregiving difficulties in families of children with autism spectrum disorder (ASD). However, Latino families may encounter unique challenges. The purpose of this study was to understand the caregiving experiences of Latino families with children with ASD, including daily activities, coping strategies, and service utilization. Method: Fifteen Latino parents of children with ASD were interviewed. The interviews were transcribed for analysis to identify themes of experiences unique to this population. Results: Latino families of children with ASD encounter many similar issues as non-Latino families but also unique issues that affect service utilization. Four themes were identified: dealing with the diagnosis, dealing with stigma and isolation from family and community, understanding the role of mothers in changing family routines, and utilizing services. Conclusion: To meet the unique needs of Latino families, services need to be provided in culturally sensitive context that address children's needs within family units.
    The American journal of occupational therapy.: official publication of the American Occupational Therapy Association 09/2015; 69(5):6905185010p1-6905185010p11. DOI:10.5014/ajot.2015.017848 · 1.70 Impact Factor
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    • "iduals with ASD . This finding also has implications for ASD interventions . Many intensive , early behavioral interventions for ASD use rewards to reinforce appropriate social behaviors . For example , the Early Start Denver model relies on reinforcers for social interactions , such as parental praise and shared engagement with joint activities ( Dawson et al . , 2010 ) . Likewise , applied behavior analysis ( ABA ) teaches new skills through the use of a predictable delivery schedule of explicit rewards ( Koegel et al . , 1999 ; Jensen and Sinclair , 2002 ) ."
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    ABSTRACT: An econometric choice task was used to estimate the implicit reward value of social and non-social stimuli related to restricted interests in children and adolescents with (n = 12) and without (n = 22) autism spectrum disorder (ASD). Mixed effects logistic regression analyses revealed that groups differed in valuation of images related to restricted interests: control children were indifferent to cash payouts to view these images, but children with ASD were willing to receive less cash payout to view these images. Groups did not differ in valuation of social images or non-social images not related to restricted interests. Results highlight that motivational accounts of ASD should also consider the reward value of non-social stimuli related to restricted interests in ASD (Dichter and Adolphs, 2012).
    Frontiers in Psychology 08/2015; 6:1026. DOI:10.3389/fpsyg.2015.01026 · 2.80 Impact Factor
    • "Adaptive behaviour refers to the skills needed by individuals to function and be selfsufficient within their everyday environments (Sparrow et al. 2005). The Vineland Adaptive Behavior Scales (Sparrow et al. 1984) have been used extensively as a measure of adaptive behaviour in ASD (e.g., Dawson et al. 2010; Eapen et al. 2013; Green et al. 2010; Lane et al. 2013; Paynter et al. 2012). However, there has been little research into the properties of the second edition, the Vineland-II (Sparrow et al. 2005). "
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    ABSTRACT: Adaptive behaviour is a crucial area of assessment for individuals with Autism Spectrum Disorder (ASD). This study examined the adaptive behaviour profile of 77 young children with ASD using the Vineland-II, and analysed factors associated with adaptive functioning. Consistent with previous research with the original Vineland a distinct autism profile of Vineland-II age equivalent scores, but not standard scores, was found. Highe st scores were in motor skills and lowest scores were in socialisation. The addition of the Autism Diagnostic Observation Schedule calibrated severity score did not contribute significant variance to Vineland-II scores beyond that accounted for by age and nonverbal ability. Limitations, future directions, and implications are discussed.
    Journal of Autism and Developmental Disorders 08/2015; DOI:10.1007/s10803-015-2543-1 · 3.06 Impact Factor
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