Health Problem: Autism spectrum disorder (ASD) is a neurodevelopmental condition that presents in childhood and is characterized by persistent deficits in social communication and social interaction; restricted, repetitive patterns of behavior, interests, or activities; and clinically significant impairment in social, occupational, or other important areas of current functioning. The estimated prevalence of ASD in 2014 was 1 in 59 (1.7%) among children 8 years of age.

Technology Description: Expert consensus supported by studies suggests that earlier interventions for ASD result in better outcomes. The Early Start Denver Model (ESDM) is a comprehensive early behavioral intervention that integrates applied behavior analysis with developmental and relationship-based approaches and was developed to address the needs of children with autism from as young as 12 months of age up to preschool age. This structured intervention is delivered at high intensity (≥ 15 hours per week) in the child’s natural environment (i.e., the home) by trained therapists and parents.

Controversy: The body of literature concerning ESDM is relatively small. The optimal treatment parameters, including type of therapy and intensity of therapy, are yet to be defined.

Key Questions:

  • Is ESDM effective for improving autism severity, cognitive skills, language skills, and adaptive behavior in children with ASD?

  • How does ESDM compare with community interventions for improvement of autism severity, cognitive skills, language skills, and adaptive behavior in children with ASD?

  • IS ESDM safe?

  • Have definitive patient selection criteria been established for ESDM for treatment of children with ASD?

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