Heterogeneity of Response to Early Start Denver Model: Identifying Developmental Trajectories and Predictors of Cognitive Outcomes.
I Ilaridou, N Kojovic, T Chataing and 5 others
PMID 42544723WHAT IT FOUND
On average, 125 autistic children showed a 17-point developmental quotient increase after 2 years of ESDM, but responses split into three groups.
Baseline adaptive skills and autism features were linked to later cognitive outcome.
Key findings
01The main cognitive measure rose by an average 17 DQ points, with more than 14 points gained in the first year.
02The sample separated into three response groups: 45 children in Progressive Group A, 52 in Progressive Group B, and 28 in the Persistent Support Needs Group.
03Higher baseline adaptive skills, lower autism features, and younger age were associated with a higher final cognitive outcome in the full sample.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study had no control group or comparison with community services, so the gains cannot be separated from other supports or time. ESDM is a multi-component intervention, so the study cannot show which part of the program contributed to the outcomes. The children were assessed with different cognitive tools, namely Mullen, PEP-3, and WPPSI-IV, which are not fully equivalent. Subgroup findings were based on smaller groups, especially the Persistent Support Needs Group with 28 children, so stable predictors were harder to identify. The sample came from one centre in Geneva and included 24 girls and 101 boys, so results may not apply to all settings or sexes. ADOS module changes over time may have influenced autism feature scores, especially at the later assessment.
Declared interests
The study was funded by Swiss National Science Foundation programs, including NCCR Evolving Language and Synapsy, and by Geneva-based foundations and hospital foundations. The authors state the funders provided financial support only and were not involved in design, data collection, analysis, or interpretation. The authors declare no conflicts of interest.
The easy way to misread this
Do not read the average 17-point DQ increase as proof that ESDM caused it. The study had no control group or comparison with community services, so the gains cannot be attributed to ESDM alone.