Parent-Child Group Intervention Based on Esdm for Young Children with ASD

Background: Despite strong evidence for the positive impact of early intervention that begins immediately following diagnosis (Koegel et al., 2014), access to high quality treatment is quite limited, and this is particularly true for very young children with ASD. One way of increasing access to intervention is to teach intervention strategies to parents immediately after diagnosis.

Objectives: The first aim of this project was to adapt an existing evidence based intervention, the Early Start Denver Model (ESDM) (Rogers and Dawson, 2010), to a parent-child group delivery in order to increase access to treatment in the period immediately following diagnosis, and thereby improve child outcomes. The second aim was to examine the progress of the children enrolled in the study. The third aim was to evaluate whether parents learned intervention strategies.

Methods: The Parent-Child group ESDM was delivered to 19 young children with ASD, between 24 and 51 months of age, and their caregivers. Each family participating in the study received one 1-hour session per week of the treatment, delivered in a group of 3-5 child-caregiver dyads, for 12 weeks. Social-communication behaviors were measured by the Brief Observation of Social Communication Change (BOSCC) (Lord et al., 2016). Parent learning of the therapy strategies was measured by the ESDM Parent Fidelity Measure (Rogers et al., 2012).

Results: Preliminary data indicated gains in social-communication behaviors in children as measured by the BOSCC. After 12 weeks of intervention the children demonstrated a decrease of 4 points in the BOSCC (t=7.9; p<.01). Changes in the BOSCC scores were negatively correlated to age (r= -.53; p<.05), indicating that the youngest children made the most gains in social communication. Parents improved in their therapy strategies as demonstrated by improved scores in the fidelity measure at the end of the intervention. Acceptability of the program was very good as indicated by retention of all participants. Moreover, results from a five-point Likert-based scale survey indicated that the caregivers agreed or strongly agreed that the program was useful and satisfying.

Conclusions: Our preliminary results suggest that the ESDM delivered in a parent-child group context may be useful to teach intervention skills to parents and to increase social communication in young children with ASD. Additionally, our results suggest that early intervention is most efficacious when started as early as possible in development.