A multisite randomized controlled two-phase trial of the Early Start Denver Model compared to treatment as usual.

Commentary By Christelle Nel, Trainee in Neurodevelopment, University of Pretoria

In an editorial by Tony Chapman in the September 2019 issue of the Journal of the American Academy of Child and Adolescent Psychiatry, findings of a multi-site randomized control trial on the Early Start Denver Model (ESDM) that was published in the same journal is discussed.

The current study is compared to a similar small-scale (n=48) study on the ESDM that was published by Dawson et al in Pediatrics in 2010. The original study found improvements in IQ and adaptive behavior (on both measures largely in the language/communication domains) and marginal improvements in diagnostic classification but no differences on continuous measures of autism severity.

The present study which included a larger sample size (n=118) and multiple sites, showed a partial replication of the language findings of the initial 2010 study in that only 2 of the 3 sites showed significant language development. Secondary analysis showed no significant differences between the ESDM and community groups regarding developmental quotient, autism severity or adaptive behavior.

The editorial goes on to discuss the difficulties in assessing the efficacy of this type of intervention as well as measurement of outcomes in autism. More research is needed.

Rogers SJ, Estes A, Lord C, Munson J, Rocha M, Winter J | display-authors=etal (2019) A Multisite Randomized Controlled Two-Phase Trial of the Early Start Denver Model Compared to Treatment as Usual.J Am Acad Child Adolesc Psychiatry 58 (9):853-865. DOI: 10.1016/j.jaac.2019.01.004 PMID: 30768394.