Does Treatment Fidelity of the Early Start Denver Model Impact Skill Acquisition in Young Children with Autism?

2021 ◽  
Author(s):  
Ashley Zitter ◽  
Hezekiah Rinn ◽  
Zofia Szapuova ◽  
Vanessa M. Avila-Pons ◽  
Kirsty L. Coulter ◽  
...  
Keyword(s):  
Young Children ◽  
Skill Acquisition ◽  
Treatment Fidelity ◽  
Children With Autism ◽  
Early Start ◽  
Early Start Denver Model ◽  
Young Children With Autism

Preliminary clinical outcomes of a short-term low-intensity Early Start Denver Model implemented in the Taiwanese public health system

Autism ◽  
2020 ◽  
Vol 24 (5) ◽  
pp. 1300-1306
Author(s):  
Tzu-Ling Lin ◽  
Chung-Hsin Chiang ◽  
Suk Yin Ho ◽  
Hsin-Chi Wu ◽  
Ching-Ching Wong
Keyword(s):  
Autism Spectrum Disorder ◽  
Young Children ◽  
Public Health System ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Early Start ◽  
Early Start Denver Model ◽  
Young Children With Autism

The Early Start Denver Model is an evidence-based, comprehensive naturalistic developmental behavioral intervention. Randomized controlled studies indicate that long-term, high-intensity Early Start Denver Model in home-based settings can positively impact the clinical outcomes of young children with autism spectrum disorder. However, it is difficult to deliver high-intensity early intervention in an under-resourced country such as Taiwan. This study evaluated the effects of implementing the Early Start Denver Model with adaptations (including low intensity, shorter duration, and delivery in general hospitals by multidisciplinary professionals) within the Taiwanese public health system. A pre- and post-intervention study was conducted. Sixteen children with autism spectrum disorder (mean age of 33.5 months) received 6 months of one-on-one Early Start Denver Model intervention (approximately 8 h per week). The children showed significant post-intervention improvements in language and overall cognitive functioning and reduced symptom severity in communication and play. This study suggests that delivering the Early Start Denver Model in community-based hospitals may be an effective intervention, with a wider reach, for young children with autism spectrum disorder in Taiwan. The next steps in Taiwan are to incorporate a control group and assess the long-term effects of the adapted Taiwanese Early Start Denver Model program. Lay Abstract The Early Start Denver Model is a comprehensive naturalistic developmental behavioral intervention for young children with autism spectrum disorder. Rigorous studies indicate that long-term, high-intensity Early Start Denver Model in home-based settings can help young children with autism spectrum disorder have great progress in language, cognitive development, and adaptive skills and reduce overall symptom severity. In accordance with the current limitations in resourcing for early intervention in Taiwan, this study evaluated the effects of implementing the Early Start Denver Model in the Taiwanese public health system with some adaptations, including lower intensity, shorter duration, and delivery in general hospitals. A total of 16 children with autism spectrum disorder, aged between 25 and 46 months, received approximately 8 h per week one-on-one Early Start Denver Model intervention. After 6 months of intervention, the children showed great improvements in language and overall cognitive functioning and reduced symptom severity in communication and play. This study suggests that directly delivering the Early Start Denver Model in community-based hospitals may be an effective intervention, which can make more young children with autism spectrum disorder in Taiwan access the Early Start Denver Model service.

scholarly journals Distinct patterns of treatment response using the Early Start Denver Model with young children with autism spectrum disorder: a cluster analysis

2021 ◽  
Author(s):  
Michel Godel ◽  
Francois Robain ◽  
Nada Kojovic ◽  
Martina Franchini ◽  
Hilary Wood de Wilde ◽  
...  
Keyword(s):  
Young Children ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Response To Treatment ◽  
Cognitive Level ◽  
Early Start ◽  
Early Start Denver Model ◽  
Rates Of Change ◽  
Cognitive Delay ◽  
Young Children With Autism

Evidence-based early intervention approaches have been shown to significantly improve many areas of development in young children with autism. Despite having an overall positive impact for most children, there is high inter-individual heterogeneity of response to treatment, and it is currently not possible to predict which child will benefit from which specific intervention. In this study, we analyze developmental trajectories of young children with autism who received two-years of Early Start Denver Model intervention in Geneva, Switzerland (n=47). Using cluster analyses, we distinguish between 3 subgroups based on cognitive level at baseline and rates of change over time. The first subgroup of children had cognitive scores at baseline only slightly below what would be expected for their age and were found to have nearly no cognitive delay by the end of treatment (High at Baseline: HB). The children in the two other subgroups all presented with severe cognitive delay at baseline, with the second group′s cognitive scores improving significantly in the first year of intervention, along with increased communication and daily living skills (High Responders: HR). The third subgroup showed little to no cognitive level change over the course of treatment (Minimal Responders: MR). Furthermore, the rates of change in cognition and adaptative behavior in the HR subgroup were already significantly higher compared to the MR subgroup within the first 6 months of intervention. A rapid and early response to intervention might thus represent a predictor of optimal outcome. Inversely, slower progress by the sixth month of intervention may predict that the child will have a slower response to the treatment overall and may need alternative supports to reach their learning objectives quickly.

Examining parent use of specific intervention techniques during a 12-week training program based on the Early Start Denver Model

Autism ◽  
2019 ◽  
Vol 24 (2) ◽  
pp. 484-498 ◽  
Author(s):  
Hannah Waddington ◽  
Larah van der Meer ◽  
Jeff Sigafoos ◽  
Andrew Whitehouse
Keyword(s):  
Autism Spectrum Disorder ◽  
Young Children ◽  
Parent Training ◽  
Training Program ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Early Start ◽  
Early Start Denver Model ◽  
Young Children With Autism

Contemporary parent-implemented early intervention programs for children with autism spectrum disorder usually incorporate a range of techniques with different theoretical underpinnings. While research suggests that parents often learn to implement interventions with an acceptable degree of overall fidelity, there is limited research into parent use of individual intervention techniques. This study included five mothers of young children with autism spectrum disorder who participated in a 12-week parent training program based on the Early Start Denver Model. Ten-minute play samples were coded for the mothers’ use of 18 specific Early Start Denver Model techniques before, during, and 1 month after the training program. The correlation between the mothers’ use of each Early Start Denver Model technique and their child’s level of engagement and expressive language was also calculated. Results suggest that all mothers increased the number of techniques that they were using from baseline to parent training. Some Early Start Denver Model techniques were moderately or strongly correlated with both child engagement and expressive language. There was considerable variation in outcomes across all mother–child dyads. These preliminary results have implications for how parents are trained/coached to implement interventions for young children with autism spectrum disorder. Lay abstract Parents of young children with autism are often taught to deliver interventions which involve several different types of strategies. Research suggests that parents can usually learn to deliver these interventions but not much is known about their use of each specific intervention strategy. This study included five mothers of young children with autism who participated in a 12-week parent training program based on the Early Start Denver Model. We measured their use of 18 different ESDM strategies before, during, and 1 month after the training program. We found that parents increased the number of strategies that they used during the training program. There were differences between mothers in terms of the ESDM strategies that they used the most during the training. We also found that some of the strategies were more closely related to children’s levels of engagement and language than others. This suggests that parent training should be adapted to suit each parent’s needs.

Implementation of the Early Start Denver Model in an Italian community

Autism ◽  
2016 ◽  
Vol 22 (2) ◽  
pp. 126-133 ◽  
Author(s):  
Costanza Colombi ◽  
Antonio Narzisi ◽  
Liliana Ruta ◽  
Virginia Cigala ◽  
Antonella Gagliano ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Young Children ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Model Group ◽  
Treatment As Usual ◽  
Early Start ◽  
Early Start Denver Model ◽  
Young Children With Autism

Identifying effective, community-based specialized interventions for young children with autism spectrum disorder is an international clinical and research priority. We evaluated the effectiveness of the Early Start Denver Model intervention in a group of young children with autism spectrum disorder living in an Italian community compared to a group of Italian children who received treatment as usual. A total of 22 young children diagnosed with autism spectrum disorder received the Early Start Denver Model in a center-based context for 6 h per week over 6 months. The Early Start Denver Model group was compared to a group of 70 young children diagnosed with autism spectrum disorder who received treatment as usual for an average of 5.2 h over 6 months. Children in both groups improved in cognitive, adaptive, and social skills after 3 months and 6 months of treatment. Children in the Early Start Denver Model group made larger gains in cognitive and social skills after 3 and 6 months of treatment. The Early Start Denver Model group made larger gains in adaptive skills after 3 months of treatment. Our results are discussed in terms of implications for intervention research and clinical practice. Our study supports the positive impact of the Early Start Denver Model in a non-English-speaking community.

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