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The Early Start Denver Model

The Early Start Denver Model (ESDM) is a curriculum guide of development across twelve domains based on infant-toddler learning and development and the effects of early autism for children ages 12-60 months. ESDM fuses behavioral, relationship-based, and a developmental, play-based approach into an integrated whole that is completely individualized and yet standardized (The MIND Institute, 2016).  


Home and Community-based

ESDM intervention is provided in the home by trained therapists and trained parents during natural play and daily routines. 

Relationship-Based ​

ESDM is a relationship-based intervention, therapists focus on building strong relationships with children and fostering a strong connection between the child and loved ones.  


ESDM also uses a data-based approach and empirically supported teaching practices that have been found effective from research in applied behavior analysis.


ESDM relies heavily on parents/care-takers participation. It is recommended that a child receive between 15-20 hours of therapy per week using this model, which includes parent-delivered therapy within routines. 


The aim of ESDM is to increase the rates of the development in all domains for children with ASD while simultaneously decreasing the symptoms of autism.  This intervention primarily focuses on boosting children’s social-emotional, cognitive, and language skills, as development in these domains is particularly affected by autism. 

Learn more about Developmental Domains.

A brief overview of ESDM

More recommended videos about ESDM and ABA, ESDM and Toddlers, ESDM and Parents can be found here.

The Benefits of ESDM at Blue Stars Therapy

With a wide range of therapy specialists, Blue Stars Therapy is able to utilize ESDM within a community setting – increasing access to high-quality therapy by expanding on aspects of the model, such as:


Increased Learning Opportunities 

  • The transdiciplinary training our therapists have results in increased learning opportunities for your child. All of our therapists can target multiple goals within one activity, across multiple domains of development. For example, during a color matching game, your therapist can target expressive language skills and cognitive skills (requesting by color, labeling colors, sorting by color) while targeting motor skills (bilateral coordination, in-hand manipulation, crossing midline) while maintaining your child's arousal level to sustain optimal engagement in the activity (modulating touch and movement).​​

Consistent Expectations

  • We utilize a remote data tracking system for coordination and collaboration across the entire team. This is updated on a weekly or daily basis to reflect current supports needed and to promote independence. This tool allows for everyone who interacts with your child to use the same strategies to encourage participation and consistent behavior. Essentially, the expectations for your child will be the same across multiple adults. Consistency and generalization of skills are key for a child to learn expectations for behavior within and outside of a treatment session.

Team Collaboration

  • Our team based approach and inclusion of parents in treatment planning yields positive outcomes. An integral part of the development and modification of treatment plans is the sharing of ideas, materials, and strategies between professionals who work towards a common goal for your child.

Holistic Approach

  • The focus is on your child holistically across all domains of development, not just on your child's areas of difficulty. For example, a speech therapist, occupational therapist, and behavior analyst work together to simultaneously treat a child with behavior, sensory processing, and language difficulties through playing a language based game while incorporating sensory components and using appropriate reinforcement.

Improved Generalization

  • Your child will learn that his or her words and actions have the same effect with multiple people, while he or she is acquiring new skills. Difficulty generalizing skills to other people or other settings is a common issue for children with autism.

  • To "master" a goal, your child must demonstrate generalization across 3 people and at least 3 different settings.

Smoother Transitions and Less Down Time 

  • Our sessions are structured to incorporate opportunities to practice transitions multiple times during a session. Our therapists use joint activity routine structure to engage your child. Each interaction with your child has a clear beginning, middle, variation, and end.

Improved Social Skills 

  • Our therapists are adept at transitioning between the role of a therapist and a peer in play. We use role playing for improved social skills. When a therapist assumes the role of a peer while working on social skills, the therapist modulates his or her behavior to meet the needs of your child, increasing or decreasing predictability to simulate a true peer interaction. This allows your child to "practice" or prepare for social interactions with same-age peers. ​​

  • Our therapists can also assist in settings in which peers are present.  Your child will learn to participate in dynamic exchanges with peers by shifting their attention and eye contact to reference the peer then respond appropriately. 

Less Time for Undesirable Behaviors 

  • Our therapists always have a plan, and that plan is to capitalize on the natural interests of your child. By following your child's lead, undesirable behaviors are reduced. Additionally, our therapists really know how to play, and can use any materials available. Which means they keep the session moving, reducing the time a child has to display inappropriate behaviors such as self stimulatory behavior, avoidance/escape, or injurious behavior to his or herself, others, and objects.

Increased Tolerance for Session Duration 

  • Our experience with ESDM has shown us that children often are able to tolerate longer, more intensive, therapy when therapy adheres to the child-led play and routines-based intervention style.  This keeps the session fresh, varied, and fun. It also makes it possible for therapy to take place anywhere it needs to, such as an outing to the park, grocery store, or on a playdate. 

Advanced Peer Interactions 

  • In a school setting, our therapists can be helpful when working on activities with peer involvement. We firmly believe in pushing into classrooms to support the child. When therapists push in, he or she can act as a mediator, and encourage your child's peers to engage, interact, and respond appropriately to your child, while focusing on supporting your child in the social exchange.

  • For example, if your child is learning to standup for himself when another child takes his or her toy, our therapist can give your child the words to say and also support the peer to comply with your child's request through this exchange for the most natural and positive experience for your child.

Meaningful and Accurate Data Collection 

  • Fidelity and accuracy of data collection is augmented by the use of an online data tracking app, which parents can access.

Learn more about Blue Stars Therapy's ESDM services.

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