Does Treatment Fidelity of the Early Start Denver Model Impact Skill Acquisition in Young Children with Autism?

This study looked at whether therapists following the Early Start Denver Model (ESDM) properly affects how much children learn. Researchers watched 40 therapy sessions and found that when therapists followed the ESDM guidelines more closely, children learned better during sessions. This helps explain why some children do better with ESDM than others - it might depend on how well their therapist sticks to the program.

This 2023 study investigated whether treatment fidelity affects outcomes in the Early Start Denver Model (ESDM) for young children with autism. Researchers analyzed 40 videotaped therapy sessions to examine the relationship between therapist fidelity to the ESDM protocol and children's learning responses. The study found that variations in overall fidelity, as well as variations in most individual items on the ESDM fidelity checklist, contributed to differences in children's learning during sessions. This research addresses an important gap in understanding why some children respond better to ESDM than others, suggesting that therapist adherence to the intervention protocol may be a key factor in treatment effectiveness.

Results suggest that ensuring high treatment fidelity in ESDM delivery is crucial for optimal outcomes. Therapists may benefit from ongoing fidelity monitoring and support. This finding could inform training protocols and quality assurance measures for ESDM implementation.

Small sample of 40 sessions limits generalizability. Study design unclear from abstract. No information provided about participant characteristics, therapist training levels, or long-term outcomes beyond immediate session responses.

There is increasing evidence supporting the effectiveness of the Early Start Denver Model (ESDM) for children on the autism spectrum. However, substantial variability in response to the ESDM has been reported across participants. We examined the plausible yet untested hypothesis that variations in the fidelity level of therapists delivering the intervention contribute to variability in children's response to the ESDM. Videotaped sessions (n = 40) of toddlers on the autism spectrum who received the ESDM from trained therapists were coded to obtain measures of therapist fidelity and children's learning in response to the therapists' instruction.

Variations in overall fidelity, along with variations in most items included in the ESDM fidelity checklist, contributed to the children's learning response during the sessions.