Early Start Denver Model (ESDM)

The Early Start Denver Model (ESDM) is a play-based early intervention for young autistic children. It mixes applied behavior analysis (ABA) with methods that focus on how kids grow and bond with people. Parents and therapists use play, back-and-forth and shared attention. The goal is to build your child's language, social and learning skills. Lessons follow what your child likes during games and daily routines.

The Centers for Disease Control and Prevention (CDC) lists ages 12 to 48 months, and a federal Medicaid guide says infants and toddlers. A 2010 trial found bigger gains with ESDM than with usual care, but a larger 2019 trial only partly matched its language results. That trial also found no difference in autism severity or daily skills.

For your child, ESDM happens in play and daily routines, not at a table. It can take place at home or in other everyday places. Parents are part of the model, and in the 2010 trial they also used ESDM at home. That Medicaid guide says providers need ESDM certification. Whether Medicaid pays for it depends on your state.

• Whether it fits: Ask your Board Certified Behavior Analyst (BCBA) whether a play-based approach like ESDM fits your child's age and goals, and how it compares with other ABA for toddlers.
• Training: Ask whether the people working with your child are trained or certified in ESDM, and whether your insurance or Medicaid plan covers it.
• Your role at home: Ask how you would learn to use play-based strategies in daily routines, such as through parent training.