The Early Start Denver Model (ESDM): A Guide for Families of Young Autistic Children
Published November 9, 2026
The Early Start Denver Model (ESDM) is a play-based early intervention for autistic children aged about 12 to 48 months. It teaches communication, social, play and everyday skills through the child’s own interests and daily routines, with parents and caregivers as active partners. For toddlers and preschoolers, therapy doesn’t always have to look like sitting at a table and completing tasks. An ESDM session can look like blowing bubbles, singing a favourite song or building a tower together, with learning built into every moment. Instead of teaching at the child, the adult teaches with the child. This guide explains what ESDM is, how it works, what the research shows, how it is offered in different countries, and how families can find a certified ESDM therapist.
What is ESDM?
ESDM is a comprehensive early intervention designed for autistic children from about 12 to 48 months of age. Some programs continue to use it with children up to about 5 years old. It was developed by psychologists Sally Rogers and Geraldine Dawson, building on the earlier Denver Model, and is set out in a published treatment manual.
ESDM blends two fields:
Developmental psychology: how young children learn through warm relationships, play and everyday interaction.
Applied behaviour analysis (ABA): especially Pivotal Response Treatment (PRT), which focuses on the child’s motivation and on the child starting communication.
Because of this blend, ESDM belongs to a family of approaches called Naturalistic Developmental Behavioral Interventions (NDBIs). These approaches teach in natural settings, share control between child and adult, and use rewards that are part of the activity itself.
An ESDM therapist may come from several professions, such as psychology, behaviour analysis, speech-language pathology, occupational therapy or early childhood intervention. What matters is that they have completed ESDM training and certification.
How ESDM differs from table-based teaching
Structured, table-based teaching ESDM Setting Table or therapy room Floor play, home, daycare and daily routines Who chooses the activity Mostly the adult Child and adult together (shared control) Materials Chosen by the therapist The child’s favourite toys, songs and games Reward Often separate (a token, a treat) Built into the activity: asking for “more bubbles” gets more bubbles Skills practised One target at a time Several goals woven into each activity Role of parents Often observers Active partners, coached to use strategies daily
How ESDM works
Assessment and goals
ESDM starts with a detailed assessment using the ESDM Curriculum Checklist. The checklist is organised into four levels, roughly matching the developmental skills typical of 12–18, 18–24, 24–36 and 36–48 months. It covers areas such as:
Receptive and expressive communication
Joint attention (sharing focus with another person)
Social skills
Imitation
Play
Thinking skills
Fine and gross motor skills
Personal independence, such as eating, dressing and sleep routines
Related support
- Compare autism services by city — Find assessment, therapy and support listings near you.
- Explore sensory-friendly places — Browse family-recommended places and reported accommodations.
- Read source-checked autism guides — Use practical guides with official sources and review dates.