Social-communicative gestures at baseline predict verbal and nonverbal gains for children with autism receiving the Early Start Denver Model.
Kids who start ESDM with richer parent-reported gestures make bigger language gains—so screen gestures at intake and target them early.
01Research in Context
What this study did
Researchers tracked kids with autism for one year while they got the Early Start Denver Model. Parents filled out a six-item form about how often their child used gestures like pointing or waving.
The team wanted to know if kids who scored higher on gestures at the start made bigger language gains later.
What they found
Kids who began ESDM with richer gesture repertoires grew more in both talking and nonverbal skills. Parent ratings on the short scale forecasted the size of one-year gains.
How this fits with other research
Yang et al. (2023) ran a large RCT and found medium positive effects for mixed-delivery ESDM, giving firmer evidence than this small pre-post study. The newer trial supersedes the current design.
Vivanti et al. (2016) used the same one-year ESDM setup but showed that younger age at intake drove bigger verbal gains. Dominik et al. now add gesture repertoire as a second baseline predictor.
Bent et al. (2023) extend the idea to group-based ESDM. They found that stronger sustained attention, not gestures, predicted nonverbal gains. Together the papers tell us different child skills matter for different ESDM formats.
Why it matters
Screen every new client with the free six-item Gestural Approach Behavior scale during intake. If scores are low, weave extra gesture training into the first months of ESDM. The five-minute parent survey gives you a quick forecast of which kids may need more language support later.
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02At a glance
03Original abstract
Although there is growing evidence of the effectiveness and importance of certain early intervention programs for children with autism spectrum disorders, little is known about predictive information before intervention to search for the most accurate therapeutic approach for the individual child and his family. In children with autism spectrum disorder, atypical gesture use is one core deficit with consequences for the development of social interaction and language, but there is little knowledge about the relevance of early gesture use in predicting developmental outcomes of children receiving early interventions targeting social-communicative behaviors such as the Early Start Denver Model. In this study, we found that the parent-rated "Gestural Approach Behavior" subscale of the Pervasive Developmental Disorder Behavior Inventory was predictively associated with clinically assessed developmental changes after 1 year of intervention. This subscale was as strong a predictor as nonverbal development before intervention. Our findings suggest that children who use more gestures in daily life might be better equipped to respond to learning opportunities offered by early interventions targeting social communication strategies such as the Early Start Denver Model. Furthermore, we conclude that the parent-rated questionnaire might be a valuable and economic set of questions with high relevance for clinical assessments.
Autism : the international journal of research and practice, 2021 · doi:10.1177/1362361321999905