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Outcome for Children Receiving the Early Start Denver Model Before and After 48 Months

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Abstract

The Early Start Denver Model (ESDM) is an intervention program recommended for pre-schoolers with autism ages 12–48 months. The rationale for this recommendation is the potential for intervention to affect developmental trajectories during early sensitive periods. We investigated outcomes of 32 children aged 18–48 months and 28 children aged 48–62 months receiving the ESDM for one year (approximately 20 h per week). Younger children achieved superior verbal DQ gains compared to their older counterparts. There were no group differences with respect to non-verbal DQ and adaptive behavior (with both age-groups undergoing significant change), or ASD severity (with neither age-group showing improvements on the ADOS). The association between verbal DQ gains and age at intake was moderated by baseline verbal level.

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References

  • Anderson, D. K., Liang, J. W., & Lord, C. (2014). Predicting young adult outcome among more and less cognitively able individuals with autism spectrum disorders. Journal of Child Psychology and Psychiatry, 55, 485–494. doi:10.1111/jcpp.12178.

    Article  PubMed  Google Scholar 

  • Autism Speaks (2015) Retrieved from https://www.asdspeaks.org/what-asd/treatment/early-start-denver-model-esdm

  • Baker-Ericzen, M. J., Stahmer, A. C., & Burns, A. (2007). Child demographics associated with outcomes in a community-based pivotal response training program. Journal of Positive Behavior Interventions, 9, 52–60. doi:10.1177/10983007070090010601.

    Article  Google Scholar 

  • Billstedt, E., Gillberg, I. C., & Gillberg, C. (2007). Asd in adults: Symptom patterns and early childhood predictors. Use of the DISCO in a community sample followed from childhood. Journal of Child Psychology and Psychiatry, 48, 1102–1110. doi:10.1111/j.1469-7610.2007.01774.x.

    Article  PubMed  Google Scholar 

  • Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences. Hillsdale, NJ: Lawrence Erlbaum.

    Google Scholar 

  • Dawson, G. (2008). Early behavioral intervention, brain plasticity, and the prevention of autism spectrum disorder. Development and Psychopathology, 20(3), 775–803.

    Article  PubMed  Google Scholar 

  • Dawson, G., & Bernier, R. (2007). Social brain circuitry in autism. In D. Coch, G. Dawson, & K. Fischer (Eds.), Human behavior and the developing brain. New York: Guilford Press.

    Google Scholar 

  • Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., et al. (2010). Randomized, controlled trial of an intervention for toddlers with autism: The Early Start Denver Model. Pediatrics, 125(1), e17–e23.

    Article  PubMed  Google Scholar 

  • Eapen, V., Črnčec, R., & Walter, A. (2013). Clinical outcomes of an early intervention program for preschool children with Autism Spectrum Disorder in a community group setting. BMC pediatrics, 13(1), 3.

    Article  PubMed  PubMed Central  Google Scholar 

  • Eikeseth, S., Smith, T., Jahr, E., & Eldevik, S. (2002). Intensive behavioral treatment at school for 4-to 7-year-old children with autism: a 1-year comparison controlled study. Behavior Modification, 26(1), 49–68.

    Article  PubMed  Google Scholar 

  • Eldevik, S., Hastings, R. P., Hughes, J. C., Jahr, E., Eikeseth, S., & Cross, S. (2010). Using participant data to extend the evidence base for intensive behavioral intervention for children with autism. American Journal on Intellectual and Developmental Disabilities, 115, 381–405. doi:10.1352/1944-7558-115.5.381.

    Article  PubMed  Google Scholar 

  • Estes, A., Munson, J., Rogers, S. J., Greenson, J., Winter, J., & Dawson, G. (2015). Long-term outcomes of early intervention in 6-year-old children with autism spectrum disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 54(7), 580–587.

    Article  Google Scholar 

  • Feldman, R. (2015). Sensitive periods in human social development: New insights from research on oxytocin, synchrony, and high-risk parenting. Development and Psychopathology, 27, 369–395.

    Article  PubMed  Google Scholar 

  • Fenske, E. C., Zalenski, S., Krantz, P. J., & Mcclannahan, L. E. (1985). Age at intervention and treatment outcome for autistic-children in a comprehensive intervention program. Analysis and Intervention in Developmental Disabilities, 5, 49–58. doi:10.1016/S0270-4684(85)80005-7.

    Article  Google Scholar 

  • Flanagan, H. E., Perry, A., & Freeman, N. L. (2012). Effectiveness of large-scale community-based Intensive Behavioral Intervention: A waitlist comparison study exploring outcomes and predictors. Research in Autism Spectrum Disorders, 6, 673–682. doi:10.1016/j.rasd.2011.09.011.

    Article  Google Scholar 

  • Gotham, K., Risi, S., Pickles, A., & Lord, C. (2007). The Autism Diagnostic Observation Schedule: Revised algorithms for improved diagnostic validity. Journal of Autism and Developmental Disorders, 37, 613–627. doi:10.1007/s10803-006-0280-1.

    Article  PubMed  Google Scholar 

  • Grindle, C. F., Hastings, R. P., Saville, M., Hughes, J. C., Huxley, K., Kovshoff, H. et al. (2012). Outcomes of a behavioral education model for children with asd in a mainstream school setting. Behavior Modification, 0145445512441199.

  • Hardan, A. Y., et al. (2014). A randomized controlled trial of Pivotal Response Treatment Group for parents of children with autism. Journal of Child Psychology and Psychiatry,. doi:10.1111/jcpp.12354.

    Google Scholar 

  • Harris, S. L., & Handleman, J. S. (2000). Age and IQ at intake as predictors of placement for young children with ASD: A four- to six-year follow-up. Journal of Autism and Developmental Disorders, 30, 137–142. doi:10.1023/A:1005459606120.

    Article  PubMed  Google Scholar 

  • Hayes, A. F., & Matthes, J. (2009). Computational procedures for probing interactions in OLS and logistic regression: SPSS and SAS implementations. Behavior Research Methods, 41(3), 924–936.

    Article  PubMed  Google Scholar 

  • Herschensohn, J. R. (2007). Language development and age. Cambridge: Cambridge University Press.

  • Johnson, M. H., & Munakata, Y. (2005). Processes of change in brain and cognitive development. Trends in Cognitive Sciences, 9(3), 152–158.

    Article  PubMed  Google Scholar 

  • Kuhl, P. K. (2004). Early language acquisition: Cracking the speech code. Nature Reviews Neuroscience, 5, 831–843. doi:10.1038/Nrn1533.

    Article  PubMed  Google Scholar 

  • Kuhl, P. K., Conboy, B. T., Padden, D., Nelson, T., & Pruitt, J. (2005). Early speech perception and later language development: Implications for the” Critical Period”. Language Learning and Development, 1, 237–264.

    Article  Google Scholar 

  • Kuhl, P. K. (2014). Early language learning and the social brain. Cold Spring Harbor Symposia on Quantitative Biology, 79, 211–220. doi:10.1101/sqb.2014.79.024802.

    Article  PubMed  Google Scholar 

  • Lord, C., Rutter, M., DiLavore, P. C., Risi, S., Gotham, K., & Bishop, S. L. (2012). Autism diagnostic observation schedule: ADOS-2. CA: Western Psychological Services Los Angeles.

    Google Scholar 

  • MacDonald, R., Parry-Cruwys, D., Dupere, S., & Ahearn, W. (2014). Assessing progress and outcome of early intensive behavioral intervention for toddlers with asd. Research in Developmental Disabilities, 35(12), 3632–3644.

    Article  PubMed  Google Scholar 

  • Magiati, I., Charman, T., & Howlin, P. (2007). A two-year prospective follow-up study of community-based early intensive behavioral intervention and specialist nursery provision for children with autism spectrum disorders. Journal of Child Psychology and Psychiatry, 48, 803–812.

    Article  PubMed  Google Scholar 

  • Moh, T. A., & Magiati, I. (2012). Factors associated with parental stress and satisfaction during the process of diagnosis of children with Autism Spectrum Disorders. Research in Autism Spectrum Disorders, 6, 293–303. doi:10.1016/j.rasd.2011.05.011.

    Article  Google Scholar 

  • Mullen, E. M. (1995). Mullen scales of early learning. Anoka, MN: AGS Circle Pines.

    Google Scholar 

  • Nelson, C. A., Thomas, K. M., & De Haan, M. (2012). Neuroscience of cognitive development: The role of experience and the developing brain. New York: Wiley.

    Google Scholar 

  • Newport, E. L., Bavelier, D., Neville, H. J. (2001). Critical thinking about critical periods: Perspectives on a critical period for language acquisition. In E. Dupoux (Ed.), Language, brain and cognitive development: Essays in honor of Jacques Mehler. Cambridge, MA: MIT Press.

    Google Scholar 

  • Orinstein, A. J., Helt, M., Troyb, E., Tyson, K. E., Barton, M. L., Eigsti, I. M., et al. (2014). Intervention for optimal outcome in children and adolescents with a history of autism. Journal of Developmental and Behavioral Pediatrics, 35(4), 247–256.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ratner, N., & Bruner, J. (1978). Games, social exchange, and the acquisition of language. Journal of Child Language, 5, 391–402.

    Article  PubMed  Google Scholar 

  • Reichow, B., & Wolery, M. (2009). Comprehensive synthesis of early intensive behavioral interventions for young children with ASD based on the UCLA young autism project model. Journal of Autism and Developmental Disorders, 39, 23–41. doi:10.1007/s10803-008-0596-0.

    Article  PubMed  Google Scholar 

  • Rogers, S. J. (2013). Early Start Denver Model. In F. Volkmar (Ed.), Encyclopedia of autism spectrum disorders (pp. 1034–1042). Berlin: Springer.

    Google Scholar 

  • Rogers, S. J., & Dawson, G. (2010). Early start Denver model for young children with ASD: Promoting language, learning, and engagement. New York: Guilford Press.

    Google Scholar 

  • Rogers, S. J., & Pennington, B. F. (1991). A theoretical approach to the deficits in infantile ASD. Development and Psychopathology, 3(02), 137–162.

    Article  Google Scholar 

  • Rogers, S. J., et al. (2012). Effects of a brief Early Start Denver model (ESDM)-based parent intervention on toddlers at risk for autism spectrum disorders: A randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, 51, 1052–1065.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rogers, S. J., & Vismara, L. (2014). Interventions for infants and toddlers at risk for autism spectrum disorder. In F. Volkmar, S. J. Rogers, R. Pelphry, & K. Paul (Eds.), Handbook of autism and developmental disorders (4th ed., pp. 739–769). Hoboken, NJ: Wiley.

    Google Scholar 

  • Rutter, M., Greenfeld, D., & Lockyer, L. (1967). A five to fifteen year follow-up study of infantile psychosis. II. Social and behavioural outcome. British Journal of Psychiatry, 113, 1183–1199.

    Article  PubMed  Google Scholar 

  • Schreibman, L., et al. (2015). Naturalistic developmental behavioral interventions: Empirically validated treatments for autism spectrum disorder. Journal of Autism and Developmental Disorders,. doi:10.1007/s10803-015-2407-8.

    PubMed  PubMed Central  Google Scholar 

  • Shonkoff, J. P., Phillips, D., & U.S. National Research Council Committee on Integrating the Science of Early Childhood Development. (2000). From neurons to neighborhoods: the science of early child development. Washington, DC: National Academy Press.

    Google Scholar 

  • Smith, I. M., Flanagan, H. E., Garon, N., & Bryson, S. E. (2015a). Effectiveness of community-based early intervention based on pivotal response treatment. Journal of Autism and Developmental Disorders, 45, 1858–1872. doi:10.1007/s10803-014-2345-x.

    Article  PubMed  Google Scholar 

  • Smith, T., Klorman, R., & Mruzek, D. W. (2015b). Predicting outcome of community-based early intensive behavioral intervention for children with ASD. Journal of Abnormal Child Psychology,. doi:10.1007/s10802-015-0002-2.

    Google Scholar 

  • Sparrow, S., Cicchetti, D., Balla, D. (2005). Vineland II: A revision of the Vineland adaptive behavior scales: I. Survey/caregiver form. Circle Pines, MN: American Guidance Service

  • Sullivan, K., Stone, W. L., & Dawson, G. (2014). Potential neural mechanisms underlying the effectiveness of early intervention for children with autism spectrum disorder. Research in Developmental Disabilities, 35(11), 2921–2932.

    Article  PubMed  PubMed Central  Google Scholar 

  • Tabachnick, B. G. & Fidell, L. S. (2007). Using multivariate statistics (5th ed.). Boston, MA: Allyn and Bacon.

    Google Scholar 

  • Vivanti, G., Dissanayake, C., Zierhut, C., Rogers, S. J., & Victorian ASELCC Team. (2013). Brief report: predictors of outcomes in the early start Denver model delivered in a group setting. Journal of Autism and Developmental Disorders, 43(7), 1717–1724.

    Article  PubMed  Google Scholar 

  • Vivanti, G., Paynter, J., Duncan, E., Fothergill, H., Dissanayake, C., Rogers, S. J., & Victorian ASELCC Team. (2014). Effectiveness and feasibility of the Early Start Denver Model implemented in a group-based community childcare setting. Journal of Autism and Developmental Disorders, 44(12), 3140–3153.

    Article  PubMed  Google Scholar 

  • Vivanti, G., & Rogers, S. J. (2014). Autism and the mirror neuron system: Insights from learning and teaching. Philosophical Transactions of the Royal Society B: Biological Sciences, 369(1644), 20130184.

    Article  Google Scholar 

  • Warren, Z., McPheeters, M. L., Sathe, N., Foss-Feig, J. H., Glasser, A., & Veenstra-VanderWeele, J. (2011). A systematic review of early intensive intervention for autism spectrum disorders. Pediatrics, 127(5), e1303–e1311.

    Article  PubMed  Google Scholar 

  • Webster, A., Feiler, A., Webster, V., & Lovell, C. (2004). Parental perspectives on early intensive intervention for children diagnosed with autistic spectrum disorder. Journal of Early Childhood Research, 2, 25–49.

    Article  Google Scholar 

  • Zwaigenbaum, L., Bauman, M. L., Choueiri, R., Kasari, C., Carter, A., Granpeesheh, D., et al. (2015). Early intervention for children with autism spectrum disorder under 3 years of age: Recommendations for practice and research. Pediatrics, 136(Suppl 1), S60–S81.

    Article  PubMed  Google Scholar 

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Acknowledgments

The present research was supported by the Australian Government Department of Social Services. We thank Jenny Mayes, Denise Williams and Anu Massey for their assistance in running the Victorian ASELCC program. We also thank Kristelle Hudry, David Trembath, Josie Barbaro, Wojciech Nadachowski, Elfriede Ihsen, Nusrat Ahmed, Heather Nuske, Megan Clark, Lisa Rumsey, Megan Grant, Carmela Germano, and Cathy Bent from the Olga Tennison Autism Research Centre for assistance with the assessment and data collection process. Thank you also to Prof Sally J. Rogers and to Prof. Margot Prior for constant encouragement and support. Finally, we thank all the children who took part in the project, as well as the parents who gave so generously of their time by filling forms and questionnaires.

Author Contributions

GV and CD designed research; GV and Victorian ASELCC Team performed research; GV analyzed data; and GV and CD wrote the paper. All authors read and approved the manuscript.

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Authors and Affiliations

  1. AJ Drexel Autism Institute, Drexel University, 3020 Market Street Suite 560, Philadelphia, PA, 19104, USA

    Giacomo Vivanti

  2. Olga Tennison Autism Research Centre, School of Psychological Science, La Trobe University, Bundoora Campus, Melbourne, VIC, Australia

    Giacomo Vivanti & Cheryl Dissanayake

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  1. Giacomo Vivanti
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  2. Cheryl Dissanayake
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The Victorian ASELCC Team

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Correspondence to Giacomo Vivanti.

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The Victorian ASELCC Team in alphabetical order: Kristy Capes, Ed Duncan, Jessica Feary, Carolyne Jones, Liz Kirby, Benaaz Master, Dianna Pell, Katherine Pye, Jennifer Reynolds, Shannon Upson, Cynthia Zierhut.

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Vivanti, G., Dissanayake, C. & The Victorian ASELCC Team. Outcome for Children Receiving the Early Start Denver Model Before and After 48 Months. J Autism Dev Disord 46, 2441–2449 (2016). https://doi.org/10.1007/s10803-016-2777-6

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