Abstract
This meta-analysis examined the effects of the Early Start Denver Model (ESDM) for young children with autism on developmental outcome measures. The 12 included studies reported results from 640 children with autism across 44 unique effect sizes. The aggregated effect size, calculated using a robust variance estimation meta-analysis, was 0.357 (p = 0.024), which is a moderate effect size with a statistically significant overall weighted averaged that favored participants who received the ESDM compared to children in control groups, with moderate heterogeneity across studies. This result was largely driven by improvements in cognition (g = 0.412) and language (g = 0.408). There were no significant effects observed for measures of autism symptomology, adaptive behavior, social communication, or restrictive and repetitive behaviors.
Highlights
The estimated prevalence of autism spectrum disorders (ASD) has continuously increased in recent decades with the most current prevalence rates estimating that 1 in 54 children under 8 years of age are diagnosed with ASD [1]
Naturalistic developmental behavioral interventions (NDBIs) are one class of ASD interventions that are geared towards the needs of young children [5]
Across 12 studies that included 44 unique effect sizes, the overall aggregated effect size was g = 0.357 (p = 0.024). This moderate [33] and statistically significant effect size indicates an overall advantage for children in the Early Start Denver Model (ESDM) intervention groups compared to children in control groups (p = 0.024). (For reference, this represents a gain of 7.84 more points on the Mullen Developmental Quotient than the comparison group.) These significant differences were mostly driven by improvements in cognition (g = 0.412) and language (g = 0.408)
Summary
The estimated prevalence of autism spectrum disorders (ASD) has continuously increased in recent decades with the most current prevalence rates estimating that 1 in 54 children under 8 years of age are diagnosed with ASD [1] This includes an increasing prevalence of young children being diagnosed partly due to the more widespread use of early screening measures and adaptations to diagnostic tools that has led to children being diagnosed with ASD as early as 12–18 months [2]. Children this young need early intervention services that have been designed for and tested with them, given the many developmental and social-emotional differences of infants and toddlers when compared to preschoolers and older children [3]. The term NDBI describes interventions that use strategies involving naturally–occurring environments and activities, child-responsive interaction styles, and teaching content and strategies derived from developmental science as well as the science of applied behavior analysis
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