Abstract:Objective To investigate the clinical effect of the Early Start Denver Model (ESDM) in children with autism spectrum disorder (ASD). Methods Forty children aged 2-5 years who were diagnosed with ASD from September 2017 to January 2018 were enrolled in the study and were randomly divided into conventional intervention group and ESDM intervention group (n=20 each). Both groups were assessed by the Aberrant Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), and Clinical Global Impression-Severity (CGI-S) scale before intervention and by the ABC, CARS, CGI-S scale, and Clinical Global Impression-Improvement (CGI-I) scale after 3 months of intervention. Results After 3 months of intervention, the total scores of ABC and CARS were both significantly decreased in the two groups (P < 0.01); the scores on the social withdrawal and hyperactivity subscales of ABC were significantly decreased in the conventional intervention group (P < 0.01), and the scores on the mood swings, social withdrawal, hyperactivity, and stereotyped behavior subscales of ABC were significantly decreased in the ESDM intervention group (P < 0.01). Compared with the conventional intervention group, the ESDM intervention group had significantly greater changes in total score of ABC, scores on three subscales of ABC (mood swings, social withdrawal, and hyperactivity), and total score of CARS after intervention (P < 0.05). After 3 months of intervention, the CGI-I scoring system showed that the disease improvement was significantly better in the ESDM intervention group than in the conventional intervention group (P < 0.05). Conclusions Both conventional intervention and ESDM intervention can improve the social withdrawal and hyperactivity in children with ASD aged 2 to 5 years, but ESDM is more effective in improving the aberrant behavior of children with ASD.
LI Hong-Hua,LI Chun-Li,GAO Di et al. Preliminary application of Early Start Denver Model in children with autism spectrum disorder[J]. CJCP, 2018, 20(10): 793-798.
Developmental Disabilities Monitoring Network Surveillance Year 2010 Principal Investigators; Centers for Disease Control and Prevention (CDC). Prevalence of autism spectrum disorder among children aged 8 years-autism and developmental disabilities monitoring network, 11 sites, United States, 2010[J]. MMWR Surveill Summ, 2014, 63(2):1-21.
Zhou B, Xu Q, Li H, et al. Effects of parent-implemented Early Start Denver Model intervention on Chinese toddlers with autism spectrum disorder:a non-randomized controlled trial[J]. Autism Res, 2018, 11(4):654-666.
[7]
Colombi C, Narzisi A, Ruta L, et al. Implementation of the Early Start Denver Model in an Italian community[J]. Autism, 2018, 22(2):126-133.
Dawson G. Early behavioral intervention, brain plasticity, and the prevention of autism spectrum disorder[J]. Dev Psychopathol, 2008, 20(3):775-803.
[13]
Dawson G, Webb SJ, Wijsman E, et al. Neurocognitive and electrophysiological evidence of altered face processing in parents of children with autism:implications for a model of abnormal development of social brain circuitry in autism[J]. Dev Psychopathol, 2005, 17(3):679-697.
[14]
Thorup E, Nyström P, Gredebäck G, et al. Altered gaze following during live interaction in infants at risk for autism:an eye tracking study[J]. Mol Autism, 2016, 7:12.
[15]
Leung RC, Pang EW, Cassel D, et al. Early neural activation during facial affect processing in adolescents with Autism Spectrum Disorder[J]. Neuroimage Clin, 2014, 7:203-212.
[16]
Schunke O, Schöttle D, Vettorazzi E, et al. Mirror me:imitative responses in adults with autism[J]. Autism, 2016, 20(2):134-144.
[17]
Dawson G, Rogers S, Munson J, et al. Randomized, controlled trial of an intervention for toddlers with autism:the Early Start Denver Model[J]. Pediatrics, 2010, 125(1):e17-e23.
[18]
Fulton E, Eapen V, Crnčec R, et al. Reducing maladaptive behaviors in preschool-aged children with autism spectrum disorder using the early start denver model[J]. Front Pediatr, 2014, 9(2):40.
[19]
Eapen V, Crnčec R, Walter A. Clinical outcomes of an early intervention program for preschool children with Autism Spectrum Disorder in a community group setting[J]. BMC Pediatr, 2013, 13(1):3.
[20]
Vivanti G, Paynter J, Duncan E, et al. Effectiveness and feasibility of the early start denver model implemented in a group-based community childcare setting[J]. J Autism Dev Disord, 2014, 44(12):3140-3153.
[21]
Dawson G, Jones EJ, Merkle K, et al. Early behavioral intervention is associated with normalized brain activity in young children with autism[J]. J Am Acad Child Adolesc Psychiatry, 2012, 51(11):1150-1159.
[22]
Ryberg KH. Evidence for the implementation of the early start denver model for young children with autism spectrum disorder[J]. J Am Psychiatr Nurses Assoc, 2015, 21(5):327-337.
[23]
Rogers SJ, Estes A, Lord C, et al. Effects of a brief Early Start Denver Model (ESDM)-based parent intervention on toddlers at risk for autism spectrum disorders:a randomized controlled trial[J]. J Am Acad Child Adolesc Psychiatry, 2012, 51(10):1052-1065.