Study on the effectiveness of the Denver Model of Early Care for Children with Autism and at Risk of ASD. Systematic review

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Abstract

Autism spectrum disorders are a high-frequency group of developmental disorders with a wide variety in the manifestation of key symptoms. The results of numerous studies point to the extremely important role of early initiation of corrective and developmental measures in the further trajectory of the development of a child with autism. To date, the Denver Early Intervention Model, which has been implemented in the practice of providing help to children with ASD for about 25 years, is the most well-known in early intervention services. During this time, a large number of studies have been conducted and evidence of efficacy has been obtained, but the data of scientific studies are very contradictory. The purpose of this work was to review the available scientific literature reflecting the results of research on the application of the Denver model in working with children of early and early preschool age with ASD and the risk of ASD. The effects of the model are considered separately for different types of studies, from case studies to meta-analyses of data, due to differences in results. In general, the presented results of studies on the effectiveness of the Denver model indicate positive results in terms of reducing the severity of autism symptoms, developing social skills and intelligence. At the same time, there is a reduced effect on the generalization of data in meta-analyses, which may be due to the wide variety of diagnostic methods used, which examine one area of development, but reflect different aspects of it.

General Information

Keywords: autism, autism spectrum disorders, Denver model of early intervention, ESDM, proof of efficacy

Journal rubric: Medical Psychology

Article type: review article

DOI: https://doi.org/10.17759/jmfp.2023120407

Funding. The study was conducted with the support of ANO BO “Zhuravlik” and the charity fund “Absolut-help” within the framework of the project “Systemic model of early intervention for children with autism and their family”

Received: 30.10.2023

Accepted:

For citation: Davydova E.Y., Tyushkevich S.A., Davydov D.V., Ilyunceva A.A., Uskova O.A., Movchan A.A. Study on the effectiveness of the Denver Model of Early Care for Children with Autism and at Risk of ASD. Systematic review [Elektronnyi resurs]. Sovremennaia zarubezhnaia psikhologiia = Journal of Modern Foreign Psychology, 2023. Vol. 12, no. 4, pp. 77–90. DOI: 10.17759/jmfp.2023120407. (In Russ., аbstr. in Engl.)

References

  1. Davydova E.Yu., Tyushkevich S.A., Davydov D.V., Ilyunceva A.A., Uskova O.A., Movchan A.A. Issledovaniya effektivnosti primeneniya modeli rannei pomoshchi detyam s riskom RAS. Sistematicheskii obzor [Research into the effectiveness of an early intervention model for children at risk of ASD. Systematic review] [Электронный ресурс]. Open Software Foundation (OSF), 2023. DOI:10.17605/OSF.IO/KQ6W8. URL: https://osf.io/5wm8r (Accessed 11.01.2024). (In Russ.).
  2. Starikova O.V., Dvoryaninova V.V., Balandina O.V. Primenenie programmy rannei pomoshchi na osnove Denverskoĭ modeli rannego vmeshatel'stva dlya detei s RAS [Application of the Early Care Program Based on the Early Start Denver Model for Children with ASD]. Autizm i narusheniya razvitiya = Autism and Developmental Disorders, 2022. Vol. 20, no. 1, pp. 29—36. DOI:10.17759/autdd.2022200104 (In Russ.).
  3. Wang Z., Loh S.C., Tian J., Chen Q.J. A meta-analysis of the effect of the Early Start Denver Model in children with autism spectrum disorder. International Journal of Developmental Disabilities, 2022. Vol. 68, no. 5, pp. 587—597. DOI:10.1080/20473869.2020.1870419
  4. Rogers S.J., Estes A., Lord C. et al. A Multisite Randomized Controlled Two-Phase Trial of the Early Start Denver Model Compared to Treatment as Usual. Journal of the American Academy of Child & Adolescent Psychiatry, 2019. Vol. 58, no. 9, pp. 853—865. DOI:10.1016/j.jaac.2019.01.004
  5. Xu Y., Yang J., Yao J., Chen J., Zhuang X., Wang W., Zhang X., Lee G.T. A Pilot Study of a Culturally Adapted Early Intervention for Young Children With Autism Spectrum Disorders in China. Journal of Early Intervention, 2018. Vol. 40, no. 1, pp. 52—68. DOI:10.1177/1053815117748408
  6. Mirenda P., Colozzo P., Smith V., Kroc E., Kalynchuk K., Rogers S.J., Ungar W.J. A Randomized, Community-Based Feasibility Trial of Modified ESDM for Toddlers with Suspected Autism. Journal of Autism and Developmental Disorders, 2022. Vol. 52, pp. 5322—5341. DOI:10.1007/s10803-021-05390-1
  7. Zhou V., Munson J.A., Greenson J., Hou Y., Rogers S., Estes A.M. An exploratory longitudinal study of social and language outcomes in children with autism in bilingual home environments. Autism, 2019. Vol. 23, no. 2, pp. 394—404. DOI:10.1177/1362361317743251
  8. Asta L., Persico A.M. Differential Predictors of Response to Early Start Denver Model vs. Early Intensive Behavioral Intervention in Young Children with Autism Spectrum Disorder: A Systematic Review and Meta-Analysis. Brain Sciences, 2022. Vol. 12, article ID 1499. 27 p. DOI:10.3390/brainsci12111499
  9. Lord C., Brugha T.S., Charman T. et al. Autism spectrum disorder. Nature reviews Disease primers, 2020. Vol. 6, article ID 5. 23 p. DOI:10.1038/s41572-019-0138-4
  10. Rogers S.J., Vismara L., Wagner A.L., McCormick C., Young G., Ozonoff S. Autism Treatment in the First Year of Life: A Pilot Study of Infant Start, a Parent-Implemented Intervention for Symptomatic Infants. Journal of Autism and Developmental Disorders, 2014. Vol. 44, pp. 2981—2995. DOI:10.1007/s10803-014-2202-y
  11. Campbell D.T., Stanley J.C. Experimental and Quasi-Experimental Designs for Research. Boston: Houghton Mifflin Harcourt, 2010. 84 p.
  12. Colombi C., Chericoni N., Bargagna S., Costanzo V., Devescovi R., Lecciso F., Pierotti C., Prosperi M., Contaldo A. Case report: Preemptive intervention for an infant with early signs of autism spectrum disorder during the first year of life. Frontiers in Psychiatry, 2023 Vol. 14, article ID 1105253. 7 p. DOI:10.3389/fpsyt.2023.1105253
  13. Shi B., Wu W., Dai M., Zeng J., Luo J., Cai L., Wan B., Jing J. Cognitive, Language, and Behavioral Outcomes in Children With Autism Spectrum Disorders Exposed to Early Comprehensive Treatment Models: A Meta-Analysis and Meta-Regression. Frontiers in Psychiatry, 2021. Vol. 12, article ID 691148. 17 p. DOI:10.3389/fpsyt.2021.691148
  14. Cidav Z., Munson J., Estes A., Dawson G., Rogers S., Mandell D. Cost Offset Associated With Early Start Denver Model for Children With Autism. Journal of the American Academy of Child & Adolescent Psychiatry, 2017. Vol. 59, no. 9, pp. 777—783. DOI: 10.1016/j.jaac.2017.06.007
  15. Smith T., Scahill L., Dawson G., Guthrie D., Lord C., Odom S., Rogers S., Wagner A. Designing Research Studies on Psychosocial Interventions in Autism. Journal of Autism and Developmental Disorders, 2007. Vol. 37, pp. 354—366. DOI:10.1007/s10803-006-0173-3
  16. Masi A., Azim S.I., Khan F., Karlov L., Eapen V. Dissemination of Early Intervention Program for Preschool Children on the Autism Spectrum into Community Settings: An Evaluation. International Journal of Environmental Research and Public Health, 2022. Vol. 19, no. 5, article ID 2555. 10 p. DOI:10.3390/ijerph19052555
  17. Godel M., Robain F., Kojovic N., Franchini M., Wood de Wilde H., Schaer M. Distinct Patterns of Cognitive Outcome in Young Children With Autism Spectrum Disorder Receiving the Early Start Denver Model. Frontiers in Psychiatry, 2022. Vol. 13, article ID 835580. 16 p. DOI:10.3389/fpsyt.2022.835580
  18. Eapen V., Črnčec R., Walter A. Clinical outcomes of an early intervention program for preschool children with Autism Spectrum Disorder in a community group setting. BMC Pediatrics, 2013. Vol. 13, article ID 3. 9 p. DOI:10.1186/1471-2431-13-3
  19. Devescovi R., Monasta L., Mancini A., Bin M., Vellante V., Carrozzi M., Colombi C. Early diagnosis and Early Start Denver Model intervention in autism spectrum disorders delivered in an Italian Public Health System service. Neuropsychiatric Disease and Treatment, 2016. Vol. 12, pp. 1379—84. DOI:10.2147/NDT.S106850
  20. Gao D., Yu T., Li C.-L., Jia F.-Y., Li H.-H. Effect of parental training based on Early Start Denver Model combined with intensive training on children with autism spectrum disorder and its impact on parenting stress. Zhongguo Dang dai er ke za zhi = Chinese Journal of Contemporary Pediatrics, 2020. Vol. 22, no. 2, pp. 158—163. DOI:10.7499/j.issn.1008-8830.2020.02.014
  21. Whitehouse A.J.O., Varcin K.J., Pillar S. at al. Effect of Preemptive Intervention on Developmental Outcomes Among Infants Showing Early Signs of Autism: A Randomized Clinical Trial of Outcomes to Diagnosis. JAMA Pediatrics, 2021. Vol. 175, no. 11, article ID e213298. 11 p. DOI:10.1001/jamapediatrics.2021.3298
  22. Vivanti G., Paynter J., Duncan E., Fothergill H., Dissanayake C., Rogers S.J., the Victorian ASELCC Team. Effectiveness and Feasibility of the Early Start Denver Model Implemented in a Group-Based Community Childcare Setting. Journal of Autism and Developmental Disorders, 2014. Vol. 44, pp. 3140—3153. DOI:10.1007/s10803-014-2168-9
  23. Rogers S.J., Estes A., Lord C., Vismara L., Winter J., Fitzpatrick A., Guo M., Dawson G. Effects of a Brief Early Start Denver Model (ESDM) — Based Parent Intervention on Toddlers at Risk for Autism Spectrum Disorders: A Randomized Controlled Trial. Journal of the American Academy of Child & Adolescent Psychiatry, 2012. Vol. 51, no. 10, pp. 1052—1065. DOI:10.1016/j.jaac.2012.08.003
  24. Tupou J., Waddington H., van der Meer L., Sigafoos J. Effects of a low-intensity Early Start Denver Model-based intervention delivered in an inclusive preschool setting. International Journal of Developmental Disabilities, 2020. Vol. 68, no. 2, pp. 107—121. DOI:10.1080/20473869.2019.1707434
  25. Zhou B., Xu Q., Li H., Zhang Y., Wang Y., Rogers S.J., Xu X. Effects of Parent-Implemented Early Start Denver Model Intervention on Chinese Toddlers with Autism Spectrum Disorder: A Non-Randomized Controlled Trial. Autism Research, 2018. Vol. 11, no. 4, pp. 654—666. DOI:10.1002/aur.1917
  26. Yu Q., Li E., Li L., Liang W. Efficacy of Interventions Based on Applied Behavior Analysis for Autism Spectrum Disorder: A Meta-Analysis. Psychiatry Investigation, 2020. Vol. 17, no. 5, pp. 432—443. DOI:10.30773/pi.2019.0229
  27. Waddington H., van der Meer L., Sigafoos J., Ogilvie E. Evaluation of a low-intensity version of the early start Denver model with four preschool-aged boys with autism spectrum disorder. International Journal of Developmental Disabilities, 2020. Vol. 66, no. 4, pp. 257—269. DOI:10.1080/20473869.2019.1569360
  28. Hume K., Steinbrenner J.R., Odom S.L., Morin K.L., Nowell S.W., Tomaszewski B., Szendrey S., McIntyre N.S., Yücesoy-Özkan S., Savage M.N. Evidence-Based Practices for Children, Youth, and Young Adults with Autism: Third Generation Review. Journal of Autism and Developmental Disorders, 2021. Vol. 51, pp. 4013—4032. DOI:10.1007/s10803-020-04844-2
  29. Devescovi R., Colonna V., Dissegna A., Bresciani G., Carrozzi M., Colombi C. Feasibility and Outcomes of the Early Start Denver Model Delivered within the Public Health System of the Friuli Venezia Giulia Italian Region. Brain Sciences, 2021 Vol. 11, no. 9, article ID 1191. 17 p. DOI:10.3390/brainsci11091191
  30. Holzinger D., Laister D., Vivanti G., Barbaresi W.J., Fellinger J. Feasibility and Outcomes of the Early Start Denver Model Implemented with Low Intensity in a Community Setting in Austria. Journal of Developmental & Behavioral Pediatrics, 2019. Vol. 40, no. 5, pp. 354—363. DOI:10.1097/DBP.0000000000000675
  31. Colombi C., Narzisi A., Ruta L., Cigala V., Gagliano A., Pioggia G., Siracusano R., Rogers S.J., Muratori F., Prima Pietra Team. Implementation of the Early Start Denver Model in an Italian Community. Autism, 2018. Vol. 22, no. 2, pp. 126—133. DOI:10.1177/1362361316665792
  32. Vivanti G., Duncan E., Dawson G., Rogers S.J. Implementing the Group-Based Early Start Denver Model for Preschoolers with Autism. Cham: Springer International Publishing, 2017. 164 p.
  33. Sinai-Gavrilov Y., Gev T., Mor-Snir I., Vivanti G., Golan O. Integrating the Early Start Denver Model into Israeli community autism spectrum disorder preschools: Effectiveness and treatment response predictors. Autism, 2020. Vol. 24, no. 8, pp. 2081—2093. DOI:10.1177/1362361320934221
  34. Estes A., Munson J., Rogers S.J., Greenson J., Winter J., Dawson G. Long-Term Outcomes of Early Intervention in 6-Year-Old Children With Autism Spectrum Disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 2015. Vol. 5, no. 7, pp. 580—587. DOI:10.1016/j.jaac.2015.04.005
  35. Malucelli E.R.S., Antoniuk S.A., Carvalho N.O. The effectiveness of early parental coaching in the autism spectrum disorder. Jornal de Pediatria, 2021. Vol. 97, no. 4, pp. 453—458. DOI:10.1016/j.jped.2020.09.004
  36. Grzadzinski R., Carr T., Colombi C., McGuire K., Dufek S., Pickles A., Lord C. Measuring Changes in Social Communication Behaviors: Preliminary Development of the Brief Observation of Social Communication Change (BOSCC). Journal of Autism and Developmental Disorders, 2016. Vol. 46, pp. 2464—2479. DOI:10.1007/s10803-016-2782-9
  37. Murad M.H., Asi N., Alsawas M., Alahdab F. New evidence pyramid. BMJ Evidence-Based Medicine, 2016. Vol. 21, no. 4, pp. 125—127. DOI:10.1136/ebmed-2016-110401
  38. Vivanti G., Dissanayake C., The Victorian ASELCC Team. Outcome for Children Receiving the Early Start Denver Model Before and After 48 Months. Journal of Autism and Developmental Disorders, 2016. Vol. 46, pp. 2441—2449. DOI:10.1007/s10803-016-2777-6
  39. Bent C., Glencross S., McKinnon K., Hudry K., Dissanayake C., Victorian ASELCC Team, Vivanti G. Predictors of Developmental and Adaptive Behaviour Outcomes in Response to Early Intensive Behavioural Intervention and the Early Start Denver Model. Journal of Autism and Developmental Disorders, 2023. 14 p. [published online ahead of print, 2023 May 12]. DOI:10.1007/s10803-023-05993-w
  40. Li H.-H., Li C.-L., Gao D., Pan X.-Y., Du L., Jia F.-Y. Preliminary application of Early Start Denver Model in children with autism spectrum disorder. Zhongguo Dang dai er ke za zhi = Chinese Journal of Contemporary Pediatrics, 2018. Vol. 20, no. 10, pp. 793—798. DOI:10.7499/j.issn.1008-8830.2018.10.002
  41. Maenner M.J., Warren Z., Williams A.R. et al. Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020. MMWR Surveillance Summaries, 2023. Vol. 72, no. 2, pp. 1—14. DOI:10.15585/mmwr.ss7202a1
  42. Gaines R., Korneluk Y., Quigley D., Chiasson V., Delehanty A., Jacobson S. Quickstart for toddlers with autism spectrum disorder: A preliminary report of an adapted community-based early intervention program. Autism & Developmental Language Impairments, 2022. Vol. 7, article ID 23969415221138699. 15 p. DOI:10.1177/23969415221138699
  43. Dawson G., Rogers S., Munson J., Smith M., Winter J., Greenson J., Donaldson A., Varley J. Randomized, Controlled Trial of an Intervention for Toddlers With Autism: The Early Start Denver Model. Pediatrics, 2010. Vol. 125, no. 1, pp. e17—e23. DOI:10.1542/peds.2009-0958
  44. Fulton E., Eapen V., Črnčec R., Walter A., Rogers S. Reducing maladaptive behaviors in preschool-aged children with autism spectrum disorder using the Early Start Denver Model. Frontiers in Pediatrics, 2014. Vol. 2, article ID 40. 10 p. DOI:10.3389/fped.2014.00040
  45. Vinen Z., Clark M., Paynter J., Dissanayake C. School Age Outcomes of Children with Autism Spectrum Disorder Who Received Community-Based Early Interventions. Journal of Autism and Developmental Disorders, 2018. Vol. 48, pp. 1673—1683. DOI:10.1007/s10803-017-3414-8
  46. Devescovi R., Bresciani G., Colonna V. et al. Short-Term Outcomes of an ESDM Intervention in Italian Children with Autism Spectrum Disorder following the COVID-19 Lockdown. Children, 2023. Vol. 10, no. 4, article ID 691. 11 p. DOI:10.3390/children10040691
  47. Vismara L.A., McCormick C.E.B., Wagner A.L., Monlux K., Nadhan A., Young G.S. Telehealth Parent Training in the Early Start Denver Model: Results From a Randomized Controlled Study. Focus Autism Other Developmental Disabilities, 2018. Vol. 33, no. 2, pp. 67—79. DOI:10.1177/1088357616651064
  48. Fuller E.A., Oliver K., Vejnoska S.F., Rogers S.J. The Effects of the Early Start Denver Model for Children with Autism Spectrum Disorder: A Meta-Analysis. Brain Sciences, 2020. Vol. 10, no. 6, article ID 368. 17 p. DOI:10.3390/brainsci10060368
  49. Tateno Y., Kumagai K., Monden R., Nanba K., Yano A., Shiraishi E., Teo A.R., Tateno M. The Efficacy of Early Start Denver Model Intervention in Young Children with Autism Spectrum Disorder Within Japan: A Preliminary Study. Soa Chongsonyon Chongsin Uihak = Journal of the Korean Academy of Child and Adolescent Psychiatry, 2021. Vol. 32, no. 1, pp. 35—40. DOI:10.5765/jkacap.200040
  50. Talantseva O.I., Romanova R.S., Shurdova E.M., Dolgorukova T.A., Sologub P.S., Titova O.S., Kleeva D.F., Grigorenko E.L. The global prevalence of autism spectrum disorder: A three-level meta-analysis. Frontiers in Psychiatry, 2023. Vol. 14, article ID 1071181. 11 p. DOI:10.3389/fpsyt.2023.1071181
  51. Horner R.H., Carr E.G., Halle J., McGee G., Odom S., Wolery M. The Use of Single-Subject Research to Identify Evidence-Based Practice in Special Education. Exceptional Children, 2005. Vol. 71, no. 2, pp. 165—179. DOI:10.1177/001440290507100203
  52. Geoffray M.-M., Denis A., Mengarelli F. et al. Using ESDM 12 hours per week in children with autism spectrum disorder: Feasibility and results of an observational study. Psychiatria Danubina, 2019. Vol. 31, no. 3, pp. 333—339. DOI:10.24869/psyd.2019.333
  53. van Noorden L.E., Sigafoos J., Waddington H.L. Evaluating a Two-Tiered Parent Coaching Intervention for Young Autistic Children Using the Early Start Denver Model. Advances in Neurodevelopmental Disorders, 2022. Vol. 6, pp. 473—493. DOI:10.1007/s41252-022-00264-8
  54. Vinen Z., Clark M., Dissanayake C. Social and Behavioural Outcomes of School Aged Autistic Children Who Received Community-Based Early Interventions. Journal of Autism and Developmental Disorders, 2023. Vol. 53, pp. 1809—1820. DOI: 10.1007/s10803-022-05477-3

Information About the Authors

Elizaveta Y. Davydova, PhD in Biology, Associate Professor, Leading Researcher, Federal Resource Center for Organization of Comprehensive Support to Children with Autism Spectrum Disorders, Associate Professor of the Department of Differential Psychology and Psychophysiology Faculty of “Clinical and Special Psychology”, Moscow State University of Psychology and Education, Moscow, Russia, ORCID: https://orcid.org/0000-0002-5192-5535, e-mail: el-davydova@mail.ru

Svetlana A. Tyushkevich, PhD in Psychology, Senior Researcher of the scientific laboratory of the Federal Resource Center for Organization of Comprehensive Support to Children with ASD, Moscow State University of Psychology & Education, Moscow, Russia, ORCID: https://orcid.org/0000-0002-9029-2830, e-mail: tyushkevichsv@yandex.ru

Denis V. Davydov, PhD in Biology, Leading Researcher of the Federal Resource Center for Organization of Comprehensive Support to Children with Autism Spectrum Disorders, Moscow State University of Psychology & Education (MSUPE), Moscow, Russia, ORCID: https://orcid.org/0000-0003-0993-3803, e-mail: davydovdv@mgppu.ru

Anna N. Ilyunceva, Junior Researcher, laboratory of complex speech research in children with autism and other developmental disorders, Moscow State University of Psychology & Education, Russia, ORCID: https://orcid.org/0009-0007-2966-3261, e-mail: lyuncevaaa@mgppu.ru

Olga A. Uskova, Junior Researcher, Federal Resource Center for Organization of Comprehensive Support to Children with Autism Spectrum Disorders, Moscow State University of Psychology & Education, Russia, ORCID: https://orcid.org/0009-0004-5878-0828, e-mail: uskovaoa@mgppu.ru

Anna A. Movchan, Junior Researcher, Federal Resource Center for Organization of Comprehensive Support to Children with Autism Spectrum Disorders, Moscow State University of Psychology & Education, Moscow, Russia, ORCID: https://orcid.org/0009-0000-5112-2735, e-mail: movchanaa@mgppu.ru

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