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.
Keywords: Early Start Denver Model (ESDM); autism spectrum disorder; developmental quotient (DQ); early intervention; toddlers.
Copyright © 2019 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.
Effects of Parent-Implemented Early Start Denver Model Intervention on Chinese Toddlers With Autism Spectrum Disorder: A Non-Randomized Controlled TrialB Zhou et al. Autism Res 11 (4), 654-666. PMID 29412514.The development of early screening and diagnosis of autism spectrum disorder (ASD) in China has highlighted the importance of early intervention for young children with A …
Effects of a Brief Early Start Denver Model (ESDM)-based Parent Intervention on Toddlers at Risk for Autism Spectrum Disorders: A Randomized Controlled TrialSJ Rogers et al. J Am Acad Child Adolesc Psychiatry 51 (10), 1052-65. PMID 23021480. - Randomized Controlled TrialParent-implemented intervention studies for early ASD thus far have not demonstrated the large effects seen in intensive-treatment studies. Evidence that both younger age …
Impact of the Early Start Denver Model on the Cognitive Level of Children With Autism Spectrum Disorder: Study Protocol for a Randomised Controlled Trial Using a Two-Stage Zelen DesignS Touzet et al. BMJ Open 7 (3), e014730. PMID 28348195. - Randomized Controlled TrialNCT02608333 (clinicaltrials.gov); Pre-results.
Evidence for the Implementation of the Early Start Denver Model for Young Children With Autism Spectrum DisorderKH Ryberg. J Am Psychiatr Nurses Assoc 21 (5), 327-37. PMID 26511434. - ReviewThe ESDM is an effective intervention that improves cognition, language, and adaptive behavior. ESDM strategies delivered in community group settings and in the home by p …
Behavioral and Pharmacotherapy Weight Loss Interventions to Prevent Obesity-Related Morbidity and Mortality in Adults: An Updated Systematic Review for the U.S. Preventive Services Task Force [Internet]EL LeBlanc et al. PMID 30354042. - ReviewWe found that behavior-based weight-loss interventions with or without weight loss medications resulted in more weight loss than usual care conditions. The degree of weig …
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The Development of the Social Brain in Baby Siblings of Children With AutismDC Dean 3rd et al. Curr Opin Psychiatry 33 (2), 110-116. PMID 31815759.Further replication in very large independent samples is needed to verify the majority of the findings discussed and understand how they are related within individual inf …