The Early Start Denver Model in Italy

Background: Research on the ESDM has been conducted mainly in the United States and exclusively in English speaking countries. To our knowledge, the Prima Pietra Project based at the Pervasive Healthcare Center of the Institute of Clinical Physiology of the National Research Council of Italy (Consiglio Nazionale delle Ricerche, C.N.R.) and of the AOU Polyclinic “G. Martino” in Messina is the first study investigating ESDM within an Italian speaking population. Just recently, very young children have begun to be diagnosed with ASDs in Italy through early screening and identification campaigns, also supported by early risk assessment web-based platforms. As children receive early diagnoses, it is necessary to develop best practices for early intervention.

Objectives: The first aim was to evaluate whether the ESDM could be disseminated to Italian professionals. The second aim was to examine the progress of the children enrolled in the study.

Methods:   Participants comprised 10 toddlers and preschoolers diagnosed with an ASD aged between 24- to 44 months. Autism diagnoses were confirmed with the Autism Diagnostic Observation Schedule, and cognitive abilities were assessed using the Griffiths Developmental Quotient. Children participated in the “Learning ESDM” treatment, an ESDM based intervention in which therapists were learning the model. Children received between 5 to 10 hrs of treatment per week for 6 months and were assessed at entry, after 3 months, and at the end of the intervention.

Results: Preliminary results show that children are making progress as demonstrated by gains on the ESDM Curriculum Checklist and on the Griffiths Developmental Quotient. Therapists are learning the model as demonstrated by improvements on the ESDM fidelity measure.

Conclusions: Our preliminary results suggest that it is possible to learn and deliver the ESDM intervention in an Italian research centre. Children’s progress provides support for the ESDM as an effective early intervention model. Establishing the feasibility and the effectiveness of the ESDM in our study represents an important step toward wider access to this evidence-based model outside the United States.