The Domains of ESDM

The Early Denver Start Model, or ESDM, is a behavioral method for early intervention established in the 1980s that is widely used with children with a diagnosis of autism. This relationship-focused approach, which also incorporates Applied Behavior Analysis (ABA) techniques, focuses on building critical skills through play and interactive methods.

There are several bricks and pillars (or “domains”) of ESDM that guide the therapeutic process, each of which focuses on the development of the whole child. These domains, or skills, include:

Expressive communication: sending a message, such as a verbal communication.
Receptive communication: interpreting or understanding a message, such as being able to follow directions.
Play skills: the ability to interact and play, which helps to develop language and social skills (in addition to other skills).
Fine motor skills: coordination of small muscles, such as the muscles used in writing.
Gross motor skills: coordination of large muscles, such as the muscles used in walking.
Personal independence behavior: personal skills needed to lead an independent life, such as socializing and interacting with peers.
Imitation: mimicking modeled behavior, such as watching your therapist keep eye contact while asking a question, then copying that same behavior.
Cognition: skills needed to pay attention, think, learn, etc.
Social skills: skills needed to communicate and interact with others.

Why does ESDM focus on these particular skills?
ESDM is a comprehensive method that allows for therapists to treat the whole child through a comprehensive plan. These skills are critical components of early childhood development, which can be applied to all areas of daily life. For example, building positive expressive communication skills with parents and therapists (a familiar setting) can be applied to successfully communicating with new acquaintances in the community (an unfamiliar setting).

Does every ESDM treatment plan look the same?
Absolutely not! One of the most important aspects of ESDM is the ability to tailor this method to fit the unique needs of every child. Also, since ESDM is incorporated into play and natural routines, there is not one specific structure for ESDM therapy sessions; sessions are entirely individualized. Parents, as well as a multidisciplinary team of professionals, play a significant role in ESDM therapy, in order to provide the most comprehensive care for the child.

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