A Multisite Randomized Controlled Two-Phase Trial of the Early Start Denver Model Compared to Treatment as Usual
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Objective This single-blind, randomized, multisite, intent-to-treat study was designed to replicate and extend Dawson et al.'s (Pediatrics. 2010;125: e17-e23) randomized controlled trial testing the effects of the Early Start Denver Model (ESDM), an intensive play- and routines-based intervention delivered in natural settings.Method A randomized controlled trial was conducted at 3 universities. One hundred eighteen children 14 to 24 months old with autism spectrum disorder were enrolled and randomly assigned to ESDM or community interventions for 27 months. Eighty-one children completed the full treatment course and all assessments; data from all 118 children were used in analyses. Children assigned to the ESDM intervention received 3 months of weekly parent coaching followed by 24 months of 15 hour per week (on average) 1:1 treatment weekly on average in homes or daycare settings from supervised therapy assistants while parents received coaching 4 hours monthly from a certified ESDM therapist.Results For the primary analyses, there were time-by-group and time-by-group-by-site interactions for language outcome. In the significant 3-way interaction involving site, 2 sites showed a significant ESDM advantage and the third site showed no significant group differences. In the planned 2-way analysis that pooled data across all 3 sites, there was a significant advantage found for the ESDM group. For the secondary analyses, there were no significant differences between the ESDM and community groups involving developmental quotient, autism severity, or adaptive behavior. The treatment effect of group on language outcomes was not moderated by baseline developmental quotient, autism severity, or language.Conclusion Results of the primary analysis provide a partial replication of Dawson et al.'s 2010 language findings.Clinical trial registration information Intensive Intervention for Toddlers with Autism; https://clinicaltrials.gov/; NCT00698997.
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Initial studies suggest moderate benefits of generic interventions targeting co-occurring emotional and behavioural problems adapted for youths with ASD.
“Increasingly, more generic interventions that target co-occurring emotional and behavioural problems are being adapted for youths with ASD, and initial studies suggest moderate benefits 189 .”
From Autism spectrum disorder (2020) · cites this paper as [189]
The Discussion (page unavailable) reports language benefits from the Early Start Denver Model for young children with ASD, not benefits from generic interventions adapted to treat co-occurring emotional or behavioural problems in youths. Searches for those problems and for moderate benefits found no passage addressing the attributed claim. (LLM, conf=0.75)
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- Authors
- Rogers, S. J., Estes, A., Lord, C., Munson, J., Rocha, M., Winter, J., Greenson, J., Colombi, C., Dawson, G., Vismara, L. A., Sugar, C. A., Hellemann, G., Whelan, F., & Talbott, M.
- Affiliations
- University of California, Davis (US)
- University of Washington (US)
- Cornell University (US)
- University of Michigan (US)
- University of California, Los Angeles (US)
- Corresponding author
- Rogers, Sally J.
- ORCID
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2019-09
- Volume
- 58
- Issue
- 9
- Pages
- 853-865
- ISSN
- 0890-8567 (ISSN-L)
- PMC
- PMC12088912
- OpenAlex
- W2913192595
- Cited by
- 233
- References
- 28
- Citations by year
- 2026: 15 · 2025: 26 · 2024: 26 · 2023: 23 · 2022: 79 · 2021: 25 · 2020: 30 · 2019: 9
- FWCI
- 20.77
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH081757)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Social Sciences › Psychology › Developmental and Educational Psychology › Language Development and Disorders
- Keywords
- Early Start Denver Model, autism spectrum disorder, toddlers, language outcomes, parent coaching, intensive intervention, community-based intervention, replication, developmental quotient, adaptive behavior, autism severity, naturalistic intervention
- MeSH terms
- Autism Spectrum Disorder, Child, Preschool, Family Therapy, Female, Humans, Infant, Male, Models, Psychological, Parent-Child Relations, Parents, Risk, Time Factors, United States, Early Intervention, Educational
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