What Happens During ESDM Therapy?

ESDM employs some of the strategies that are derived from ABA therapy. However, the ESDM differs in a number of aspects from classic ABA strategies, such as “discrete trial teaching” in which teaching is directive and occurs in very structured settings. Instead, we follow the child’s lead and interests and engage the child in positive social interaction. This creates an environment that makes learning enjoyable for the child and he/she is more likely to stay motivated and on task.

ESDM focuses on the development of typical children and children with ASD. It includes abilities that are often affected by an ASD, such as:

    • Communication, for example: understanding and using language, gestures (requesting, sharing, giving, pointing) and facial expressions
    • Social skills and engagement, for example: eye contact, attention to others, imitation, turn-taking, greeting, interacting
    • Social and pretend play
    • Personal independence, for example: eating, dressing, personal hygiene, chores
    • Fine and gross motor skills, for example: drawing, writing, walking, jumping

ESDM core features include the following:

  • Naturalistic applied behavioral analytic strategies
  • Sensitive to normal developmental sequence
  • Deep parental involvement
  • Focus on interpersonal exchange and positive affect
  • Shared engagement with joint activities
  • Language and communication taught inside a positive, affect-based relationship

The ESDM teaching strategies are consistent with the principles of applied behavior analysis: (1) capturing child’s attention before an instruction is given; (2) embedding teaching trials in play activities with clear A-B-C formats; (3) using reinforcers related to the activity (when they exist for a particular skill), pairing nonsocial reinforcers with social attention and delivering consequences skillfully and contingently; and (4) using shaping, chaining, prompting, fading and error correction procedures to develop the antecedent-behavior link and to shape a partial performance to a more accurate performance.

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