If your child has just been diagnosed with Autism, you have probably started researching different therapies that will have long term benefits for their development. With so much information out there, it can feel overwhelming to decide which approach is best for your child. One therapy you may come across is the Early Start Denver Model (ESDM). In this article you will learn what ESDM is, how it works and what the research says about its effectiveness so you can make a more informed decision for your family.
What is the Early Start Denver Model?
The Early Start Denver Model (ESDM) is an early intervention therapy for young children with autism spectrum disorder (ASD). It combines principles of Applied Behavior Analysis (ABA) with developmental and relationship based approaches, with a focus on social engagement and communication.
ESDM was developed in the early 1980s by Dr. Sally Rogers and Dr. Geraldine Dawson. They wanted to create a structured yet naturalistic model of therapy that focused on play, positive relationships and developmental milestones in the child’s natural environment.
A Unique Therapy Environment
Unlike therapies that take place in a clinic, ESDM can take place in multiple settings such as at home, in classrooms, in clinics or in community playgroups. This flexibility allows skills to generalise across environments. Therapists create teaching opportunities by embedding learning into everyday routines and natural play, so therapy feels organic rather than rigid.
Who is ESDM for?
ESDM is for very young children, typically between the ages of 1 and 4. In some cases it may start as early as 9 months or go up to 5 years old. It’s especially suited for children in the earliest stages of development, before school age, when the brain is most responsive to intense learning experiences.
How Does ESDM Therapy Work?
While rooted in some ABA principles, ESDM is different in its focus on developmental growth and relationship building. Therapy is structured around social play, communication and natural learning opportunities rather than rigid drills.
- Intensity levels: Research suggests ESDM is most effective when delivered intensively, often 15 to 25 hours a week, spread across multiple sessions.
- Session structure: Sessions are play based, with therapists or parents embedding learning into games, routines and activities the child already enjoys. Teaching opportunities are designed to occur every few seconds, maximising learning moments.
- Reassessment cycles: Children are typically reassessed every 12 weeks. Goals are adjusted based on developmental progress to keep therapy individualised and responsive.
Social Play and Communication
A key component of ESDM is social play. By encouraging positive, shared play experiences, therapists create opportunities for meaningful communication, often before spoken language is fully developed. Children practice gestures, turn taking, imitation and eventually verbal communication, all of which build stronger social relationships.
Parent Coaching and Home-Based Strategies
One of the most powerful aspects of ESDM is parent involvement. Parents are coached directly in ESDM strategies so they can reinforce skills at home during everyday routines like mealtimes, dressing or playtime. This home-based approach means therapy extends beyond formal sessions and multiplies the number of learning opportunities a child has each day.
What are the Benefits of ESDM?
It’s natural to ask, “Does this really work?” Research and real world experience shows ESDM can have a meaningful impact on young children with autism.
- Stronger learning and communication skills: Studies have found that toddlers who received about 20 hours a week of ESDM for two years made significant gains in IQ, language and daily living skills compared to children who received other early interventions. On average children in the ESDM group gained more than twice as many IQ points as those in the control group.
- Long term impact: The benefits continue even after therapy ends. Follow up research shows children who received ESDM maintained stronger communication and thinking skills years later at age six. Meta-analyses also show ESDM consistently improves cognition, language and overall autism symptoms compared to children in control groups.
- Learning in real life, not just in therapy: ESDM takes place during everyday routines like play, mealtimes or getting dressed with parents actively involved. Because learning happens in natural settings, children are more likely to apply these skills in school, friendships and daily life.
Who Delivers ESDM Therapy?
ESDM is typically delivered by a collaborative team that may include:
- Parents (as active participants and daily implementers)
- A licensed psychologist or BCBA
- Speech-language pathologists
- Occupational therapists
- Educators or therapists experienced in developmental interventions
- Pediatricians providing medical oversight
This team approach means therapy addresses multiple areas of development and is consistent across settings.
Questions You Should Ask About ESDM
If you are considering ESDM for your child ask:
- Who will be working directly with my child?
- What goals will we set and how often will we reassess?
- How many hours a week will my child be in ESDM?
- How can I participate in sessions and use strategies at home?
- What does a session look like in different environments?
ESDM at Scottsdale Pediatric Behavioral Services
At Scottsdale Pediatric Behavioral Services we combine ESDM with ABA therapy so your child gets evidence based, flexible and naturalistic teaching. Our therapists maximize teaching moments whether during structured activities, peer interactions or even during breaks. Parents are coached and supported to extend therapy into the home and our parent support groups so you never feel alone in the process.
Interested in seeing how our approach can help your child? Sign up for a free tour today.
