Early Start Denver Model (ESDM) Informed Treatment in Israeli ASD Preschools – a Pilot Study

Background:  

The Early Start Denver Model was previously shown to be effective as an intensive home-based intervention (Dawson et al., 2010). However, in Israel, the majority of young children diagnosed with ASD attend state funded autism daycares and preschools. It is therefore of high importance to assess the efficacy of the ESDM when applied in this setting. Recent attempts to implement this model in a preschool setting have shown encouraging results in terms of children’s developmental gains and the overall feasibility and practicality of the program (Vivanti et al., 2014).

Objectives:  

The current pilot study aimed to examine an ESDM informed adaptation to an existing ASD preschool setting in Israel.

Methods:  

The intervention included 12 children (aged 36-45 months) from three ASD preschools, and was comprised of 2 hours/week of individual ESDM-informed sessions with a therapist in training and a weekly session of parent-child "live-training". Integration of the ESDM-informed adaptation in the daily preschool routine included presentation of the model, the curriculum and learning objectives to the therapeutic and educational staff, and an ongoing demonstration of teaching techniques at various contexts (1:1 sessions, group activities, playground, mealtimes etc). Changes in children's social communication (BOSCC), cognitive ability (MSEL) and adaptive behaviors (VABS-II) were measured before and after 6 months of intervention.

Results:  

After 6 months, children showed significant gains in MSEL receptive language, expressive language and visual reception developmental quotients. Significant gains were also shown in VABS-II scales of communication, socialization and daily living skills, and the Adaptive Behavior Composite. Significant improvements on BOSCC total score were found, as well as improvement in child responsiveness to parent and a reduction in unusual sensory interests.

Conclusions:  

Results indicate the ESDM may be adapted successfully for use in preschools for children with ASD, with positive child outcomes. Future research should focus on parent, and child-parent interaction outcomes, as well as on cultural adaptation and widespread dissemination of the model in a controlled study-design.