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Background <p>The Early Start Denver Model (ESDM) is a naturalistic developmental behavioral intervention (NDBI) widely used to support early development in young autistic children. This study examines early developmental trajectories associated with different styles and intensities of ESDM-based intervention compared with community Therapy as Usual (TAU) over a 6-month period. It also explores predictors of individual language development based on the intervention style.</p> Methods <p>A total of 112 autistic children participated in the study and were assessed longitudinally while receiving either higher (6&#xa0;h a week) or lower (3&#xa0;h a week) intensity ESDM, or TAU at higher (6&#xa0;h a week) intensity (<i>N</i> = 29, 32, and 51 participants in each group, respectively).</p> Results <p>The primary findings show that children receiving higher-intensity ESDM exhibited steeper developmental trajectories than children receiving TAU in all the developmental areas such as Language, Personal-Social skills, Performance, Eye-Hand coordination and the General score. Notably, lower-intensity ESDM was associated with steeper developmental gains in individual general development, language, personal social skills, and performance when compared to TAU at double the intensity. Additionally, secondary results indicate that language developmental trajectories are influenced by different factors in the ESDM and TAU groups, with social domain and adaptive behaviors predicting language progress in the ESDM group and baseline cognitive skills predicting language development in the TAU group.</p> Conclusions <p>This study provides observational evidence that different intervention models and intensities may be associated with different short-term developmental trajectories in community settings, particularly where only limited weekly intervention hours are feasible. These findings may help inform service planning in low-resource contexts, while requiring replication in more controlled designs.</p> Trial registration <p>Clinical Trial ID: NCT06494605.</p>

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Early developmental trajectories associated with different styles and intensities of ESDM-based community intervention

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月29日

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  • Liliana Ruta,
  • Elisa Leonardi,
  • Cristina Carrozza,
  • Francesca I. Famà,
  • Agrippina Campisi,
  • Stefania Aiello,
  • C Blandino,
  • I Boccafoschi,
  • M Boncoddo,
  • M Bruschetta,
  • I Crimi,
  • F Di Bella,
  • G Lazzaro,
  • S Martines,
  • A Orsina,
  • M.G. Rosano,
  • Flavia Marino,
  • Alfia Ruggieri,
  • Sabrina Baieli,
  • Daniela Mangiapane,
  • Gaetano Vivona,
  • Sebastiano Marciante,
  • Gaspare Cusimano,
  • Antonio Narzisi,
  • Filippo Muratori,
  • Antonella Gagliano,
  • Costanza Colombi,
  • Gennaro Tartarisco,
  • Marilina Mastrogiuseppe,
  • Sally J. Rogers,
  • Michael V. Lombardo,
  • Giovanni Pioggia

摘要

Background

The Early Start Denver Model (ESDM) is a naturalistic developmental behavioral intervention (NDBI) widely used to support early development in young autistic children. This study examines early developmental trajectories associated with different styles and intensities of ESDM-based intervention compared with community Therapy as Usual (TAU) over a 6-month period. It also explores predictors of individual language development based on the intervention style.

Methods

A total of 112 autistic children participated in the study and were assessed longitudinally while receiving either higher (6 h a week) or lower (3 h a week) intensity ESDM, or TAU at higher (6 h a week) intensity (N = 29, 32, and 51 participants in each group, respectively).

Results

The primary findings show that children receiving higher-intensity ESDM exhibited steeper developmental trajectories than children receiving TAU in all the developmental areas such as Language, Personal-Social skills, Performance, Eye-Hand coordination and the General score. Notably, lower-intensity ESDM was associated with steeper developmental gains in individual general development, language, personal social skills, and performance when compared to TAU at double the intensity. Additionally, secondary results indicate that language developmental trajectories are influenced by different factors in the ESDM and TAU groups, with social domain and adaptive behaviors predicting language progress in the ESDM group and baseline cognitive skills predicting language development in the TAU group.

Conclusions

This study provides observational evidence that different intervention models and intensities may be associated with different short-term developmental trajectories in community settings, particularly where only limited weekly intervention hours are feasible. These findings may help inform service planning in low-resource contexts, while requiring replication in more controlled designs.

Trial registration

Clinical Trial ID: NCT06494605.