Autism is a complex neurodevelopment condition. Early intervention is key to helping children with autism. The Early Start Denver Model, or ESDM, is an intervention for young children with autism. It is delivered by our certified ESDM therapists. At our Sydney clinic, OnOnOne Children’s Therapy is proud to offer this early intervention to all our families. Let’s look at how the Early Start Denver Model (ESDM) develops expressive language skills.
This series of posts will help parents understand how the ESDM improves the features of autism so children can grow and learn.
What is expressive communication in the ESDM?
Expressive communication is the ability to communicate with the world around you. It starts very early in a baby’s life, and allows us to build rich relationships with others. It doesn’t just mean talking. Expressive communication includes very complex non-verbal and written communication skills. It includes:
- Using gestures such as waving, pointing, or raising your arms to be picked up
- Using facial expressions
- Make sounds to cry, complain or show surprise
- Saying words to name objects and people around you
- Using phrases and sentences to talk about what is happening
- Developing a large vocabulary of words
- Using correct grammar
- Developing the ability to express more meaning in what you say
- Using writing to communicate
Why are expressive language skills important in the ESDM?
We need receptive communication skills to understand the world, but then we need expressive communication skills to be a part of the world. Expressive Communication skills allow us to get our needs and wants met. It allows us to interact with other people and form relationships. It is a critical part of the learning process at school.
How do you develop expressive language skills in the ESDM?
There are a number of underlying skills that support expressive language skills. These skills need to develop at the right time and in the right order to support expressive language skills:
- Attention and concentration: The ability to notice and look at people when they gesture and talk.
- Receptive language skills: The ability to understand what other people are communicating. These include the ability to use eye contact, understand and use facial expressions, and understand and use gestures.
- Crying: This is how a baby communicates if it is hungry, uncomfortable or tired
- Gestures: The ability to use movements to communicate before you can talk. It includes pointing, waving, and putting up your arms to be lifted up
- Intentional vocalisation: the ability to use sound to communicate how you feel and what you need. This is a baby’s first step towards actual words.
- Words and sentences: These develop rapidly through the preschool years
- Written expression skills: These develop as children move through the school years.
What is autism?
Autism is a condition which means that it affects the brain’s growth and development. It is a lifelong condition, with symptoms that are noticed very early in the child’s life:
Autism interferes with development because it causes:
- Difficulties communication and interacting
- Repetitive and unusual behaviours such as moving their bodies in different ways
- Strong interest in one toy, or topic, or area of interest
- Unusual sensory reactions to what they see, hear, smell, touch or taste
- Strong preference for things to be the same and difficulty with change on many levels
- Autism always affects the way individuals interact with others and how they experience the world around them.
What is the ESDM?
The ESDM is an early intervention model for young children with autism. It targets the key features of autism, and has as strong evidence base for very young children.
The ESDM involves intensive teaching in play-based sessions. It uses a curriculum that has strong focus on building interactions and relationship in everyday routines. The ESDM uses the teaching principles of Applied Behaviour Analysis. These principles have been researched and are the best way to teach children with autism.
It draws upon several approaches, including the original Denver model (Rogers et al 1986). Over 30 years of research has gone in to this ground breaking intervention program. You can find out more about the principles of the ESDM here.
How does autism impact expressive communication?
Autism impacts a child’s expressive communication in some or all of the following ways:
- the ability to use crying to communicate different problems
- using natural gestures before you can talk
- having good fine motor skills to use gestures
- developing intentional vocalisations, or sounds, to communicate
- talking in single words
- talking in phrases or sentences
- developing a broad vocabulary of words they can readily use
- using sentences that are grammatically correct
- speaking in sentences that quickly and easily convey the right meaning
- using writing to communicate at school
- using clear speech so other people understand you
The list of ways that autism can impact a child’s expressive communication is huge. As a baby, the expressive language skills are basic. However, children with autism often don’t develop a strong foundation early in life. This impacts their expressive language skills as they grow up because expressive language skills become very complex. When children with autism can’t communicate with the people around them, the world becomes a very challenging place.
How does the ESDM improve expressive communication?
The Early Start Denver Model (ESDM) has four levels that follow general development for children. However, it focuses on the areas that challenge young children with autism.
One of the strengths of the ESDM is that it takes children back to the earliest expressive communication skills. These are the skills that children learn in the first three months of life. The ESDM systematically builds each skill at every level in the model. As a result, the child develops a better expressive communication skills. As a consequence of a stronger foundation, they learn more complex expressive communication skills as they get older. We can’t teach children to talk if they can’t use sounds to communicate first. We can’t teach children to play with friends if they can’t use simple gestures such as pointing.
The ESDM involves a high rate of teaching. The Certified ESDM Therapists engages and teaches the child every 20-30 seconds. This high rate ensure the there is plenty of repetition for the child to learn.
How do I find out more about the ESDM?
You can read more about the ESDM and how it improves all areas of development:
- Receptive communication skills and the ESDM
- Imitation skills and the ESDM
- Joint attention and the ESDM
OneOnOne Children’s Therapy offers the ESDM. We were one of the first small private intervention clinics in New South Wales to offer this evidence based practice. In our Sydney clinic our certified ESDM therapists constantly strive to deliver the Early Start Denver Model at the highest levels of fidelity so we can improve children’s lives.
If you are interested in learning more about how the Early Start Denver Model can support your child’s learning and development, please call us on (02) 80657837 or email us. OneOnOne Children’s Therapy is located in Bondi Junction in the Eastern Suburbs of Sydney. ESDM is also available via Skype for remote and regional families.