Randomized, controlled trial of a mixed early start Denver model for toddlers and preschoolers with autism.

Researchers compared two early intervention approaches in 249 young autistic children (2-4 years old). The Early Start Denver Model showed better results than Discrete Trial Teaching for movement skills, social skills, and language in some children. Both programs involved 25 hours per week for 12 weeks with one-on-one sessions, group activities, and parent training. The benefits varied depending on the child's age and autism severity level.

This large randomized controlled trial compared a mixed Early Start Denver Model (M-ESDM) with mixed Discrete Trial Teaching (M-DTT) in 249 autistic children aged 24-47 months. Both groups received 25 hours weekly of intensive intervention for 12 weeks using individual, group, and parent coaching approaches. M-ESDM showed superior outcomes in gross motor and personal-social skills across age groups, and language development in preschoolers with mild/moderate autism and toddlers. Autism symptom severity was reduced only in toddlers with severe autism.

However, M-ESDM did not outperform M-DTT in fine motor skills, adaptability, language in preschoolers with severe autism, or symptom reduction in other subgroups.

Results suggest M-ESDM may be particularly beneficial for developing gross motor, personal-social, and language skills in young autistic children. However, effectiveness varies by child characteristics including age and autism severity. Clinicians should consider individual profiles when selecting between ESDM and DTT approaches.

The study duration was relatively short at 12 weeks, which may not capture longer-term outcomes. The abstract does not provide details about randomization procedures, blinding methods, or potential confounding variables that could affect interpretation of results.

The early start Denver model (ESDM) has been extensively studied as a promising early intervention approach for young children with autism spectrum disorder (ASD). Various methodological drawbacks from earlier ESDM investigations must be rectified to expand the application scopes. For this purpose, the present study recruited a very large sample of 249 autistic children (aged 24-47 months), and used a randomized controlled design to compare outcomes from a mixed ESDM (M-ESDM) intervention with a mixed discrete trial teaching (M-DTT) intervention which remains one of the most commonly-used programming for early intervention. Over the course of a 12-week period, both groups (i.e., M-ESDM and M-DTT groups) received 25 h of intensive intervention per week using individual, group, and parent coaching techniques.

Findings showed that: (i) the M-ESDM significantly outperformed the M-DTT in enhancing children's developmental abilities in gross motor and personal-social skills for toddlers and preschoolers, as well as in language for preschoolers with mild/moderate ASD and toddlers; and (ii) the M-ESDM dramatically reduced the severity of autistic symptoms in toddlers with severe ASD only, when compared to the M-DTT. However, the M-ESDM did not outperform the M-DTT in terms of improving children's developmental abilities in adaptability and fine motor for toddlers and preschoolers, as well as in language for preschoolers with severe ASD. In addition, when compared to the M-DTT, the M-ESDM did not show an advantage in reducing the severity of autistic symptoms in toddlers with mild/moderate ASD and preschoolers. Clinical Trial Registration: Chinese Clinical Trial Registry.

Registration number ChiCTR200039492.