Early Start Denver Model for Young Children with Autism »

Sally J. Rogers, PhD, is Professor of Psychiatry at the M.I.N.D. Institute, University of California, Davis. A developmental psychologist, she is involved at the international level in major clinical and research activities on autism, including one of the 10 Autism Centers of Excellence network projects funded by the National Institutes of Health/ National Institute of Child Health and Human Development, involving a multisite, randomized, controlled trial of an infant–toddler treatment for autism. She is also the director of an interdisciplinary postdoctoral training grant for autism researchers. Dr. Rogers is on the executive board of the International Society for Autism Research, is an editor of the journal Autism Research, and is a member of the DSM-V workgroup on autism, pervasive developmental disorder, and other developmental disorders. She has spent her entire career studying cognitive and social-communicative development and intervention in young children with disabilities and has published widely on clinical and developmental aspects of autism, with a particular interest in imitation problems. As a clinician, she provides evaluation, treatment, and consultation to children and adults with autism and their families.  

Geraldine Dawson, PhD, is Chief Science Officer at Autism Speaks, Research Professor of Psychiatry at the University of North Carolina at Chapel Hill, Professor Emeritus at the University of Washington (UW), and Adjunct Professor of Psychiatry at Columbia University. Previously, she was Professor of Psychology and Psychiatry at UW and Founding Director of the UW Autism Center, which has been designated a National Institutes of Health Autism Center of Excellence since 1996. While at UW, Dr. Dawson led a multidisciplinary autism research program focusing on genetics, neuroimaging, diagnosis, and treatment. She received continuous funding from the National Institutes of Health for her research from 1980 until 2008, when she left UW to join Autism Speaks. She was Founding Director of the UW Autism Center’s multidisciplinary clinical services program, which is the largest of its kind in the northwestern United States. Dr. Dawson has testified before the U.S. Senate on behalf of individuals with autism and played a key role on the Washington State Autism Task Force. Her research and publications focus on early detection and treatment of autism, early patterns of brain dysfunction (electrophysiology), and, more recently, the development of endophenotypes for autism genetic studies.

From leading authorities, this state-of-the-art manual presents the Early Start Denver Model (ESDM), the first comprehensive, empirically tested intervention specifically designed for toddlers and preschoolers with autism. Supported by the principles of developmental psychology and applied behavior analysis, ESDM’s intensive teaching interventions are delivered within play-based, relationship-focused routines. The manual provides structured, hands-on strategies for working with very young children in individual and group settings to promote development in such key domains as imitation; communication; social, cognitive, and motor skills; adaptive behavior; and play. Implementing individualized treatment plans for each child requires the use of an assessment tool, the Early Start Denver Model Curriculum Checklist for Young Children with Autism. A nonreproducible checklist is included in the manual for reference, along with instructions for use; 8½" x 11" checklists are sold separately in sets of 15 ready-to-use booklets.

Chapter 1 Current Understanding of Infant Learning and Autism 1

How Infants Learn 2

How Brain Development Supports the Acquisition of Social-Communicative Skills 4

How Autism Likely Affects Brain Development and Learning 8

Brain Changes in Early Childhood and Beyond 12

The Role of Early Intervention in Shaping Early Brain Development and Outcome in Autism 13

Chapter 2 An Overview of the Early Start Denver Model 14

Foundations of the ESDM 14

The ESDM Curriculum 17

ESDM Teaching Procedures 19

Evidence of Effectiveness 29

Similarities and Differences between the ESDM and Other Intervention Models for Toddlers with ASD 33

Conclusion 34

Chapter 3 Using the Early Start Denver Model 35

Delivery Settings 35

Delivery to Whom? 36

Delivery by Whom? 36

ESDM Procedures 37

Using the Generalist Model to Deliver Intervention 39

The Interdisciplinary Treatment Team 40

Partnering with Families 50

Transitioning Out of the ESDM Intervention 55

Conclusion 57

Chapter 4 Developing Short-Term Learning Objectives 58

Assessment Using the ESDM Curriculum Checklist 58

Constructing the Learning Objectives 68

Balancing objectives across Domains 68

How Many Objectives? 68

Selecting Skill Content 69

Elements of the Objective 70

Writing Functional Objectives 75

Isaac's 12-Week Learning Objectives 76

Conclusion 79

Chapter 5 Formulating Daily Teaching Targets and Tracking Progress 80

Mapping Out Learning Steps for Each Objective 80

Tracking Progress 87

Summary 94

Appendix 5.1. Learning Objectives and Learning Steps for Isaac 95

Chapter 6 Developing Plans and Frames for Teaching 101

Becoming a Play Partner 102

Joint Activity Routines: Framesfor Teaching 108

Managing Unwanted Behaviors 120

Organizing and Planning the Session 123

When Children Aren't Progressing: A Decision Tree 130

Conclusion 134

Chapter 7 Developing Imitation and Play 136

Teaching Imitation 136

Teaching Play Skills 146

Conclusion 153

Chapter 8 Developing Nonverbal Communication 154

Coordinating Attention Underlies Communication 155

Developing Use and Understanding of Natural Gestures 156

Teaching Conventional Gesture Use 160

Conclusion 166

Chapter 9 Developing Verbal Communication 168

Stimulating Development of Speech Production 169

Receptive Language 179

Conclusion 182

Chapter 10 Using the Early Start Denver Model in Group Settings 184

Considering Characteristics of Autism in Classroom Organization 185

Physical Organization 186

Planning the Daily Schedule and Routines 189

Choreography of the Classroom 192

Staff Planning and Communication 192

Small- and Large- Group Instruction 194

Classroom Behavior Management 197

Transitions and Individual Schedule Systems 198

Curriculum for Peer Relations and Self-Care 202

Kindergarten Transition 206

Conclusion 207

Appendix A Early Start Denver Model Curriculum Checklist and Item Descriptions 209

Introduction 209

Administration 210

Scoring 211

Translating Items into Teaching Objectives 211

Materials Needed 212

Early Start Denver Model Curriculum Checklist for Young Children with Autism 213

Early Start Denver Model Curriculum Checklist: Item Descriptions 230

Appendix B Early Start Denver Model Teaching Fidelity Rating System: Administration and Coding 259

Procedure for Coding Fidelity of Treatment Implementation 259

Early Start Denver Model 261

Early Start Denver Model Fidelity CodingSheet 271

References 273

Index 287