Delivery of the Early Start Denver Model in Inclusive Vs. Autism-Specific Classrooms in a Community Preschool Setting in Australia: Implementation and Child Outcomes

Background: The Early Start Denver Model (ESDM) is an early intervention approach developed and empirically tested in the USA across several implementation formats, including 1:1 delivery at the child’s home and at specialized (i.e. autism specific) center-based programs. More research is needed to examine feasibility and effectiveness of ESDM in different cultural and implementation contexts, such as group-based delivery in inclusive (i.e., mainstream) classrooms in non-US countries.

Objectives: We examined the feasibility, acceptability and preliminary effectiveness of adapting the ESDM for delivery in inclusive childcare classrooms in a preschool setting in Melbourne, Australia.

Methods: We randomly assigned 29 preschoolers with ASD to receive ESDM in classrooms that included mostly children who were typically developing (Inclusive setting group) or only children with ASD (Specialized setting). The two groups were compared on a variety of measures at baseline, and after at least 9 months of intervention.

Results: Family uptake into and retention within the trial were very good. Staff in both settings demonstrated similar levels of treatment fidelity. Children in both settings showed equivalent improvements across measures of communication, social engagement, imitation, and adaptive behavior and autism symptoms. Among those in the Inclusive setting alone, children with higher baseline social attention, as measured through eye-tracking, had better social communication outcomes.

Conclusions: Adaptation of the ESDM for group-based delivery to young children with ASD in an inclusive setting appears to be feasible, acceptable, and not less effective than delivery within specialized classrooms.