Enhancing Low-Intensity Coaching in Parent Implemented Early Start Denver Model Intervention for Early Autism: A Randomized Comparison Treatment Trial.
More parent coaching boosts adult skill yet adds no extra child test gains in a twelve-week ESDM program.
01Research in Context
What this study did
Researchers compared two ways to coach parents who were learning the Early Start Denver Model. One group got basic coaching. The other got an enhanced package with extra video calls, home visits, and motivational interviewing.
All families had toddlers with autism. Coaches met parents weekly for three months. The team then checked parent skills and child development scores.
What they found
Parents in the enhanced group showed bigger jumps in how well they used ESDM strategies. Parents in the basic group still improved, just not as much.
Both groups of kids made similar gains on language and cognitive tests. Extra coaching helped parents, but it did not give children an added boost on standard scores.
How this fits with other research
Hong et al. (2018) pooled earlier caregiver studies and saw the same pattern: parent skills rise fast, yet child gains often fade once coaching stops. The new trial lines up with that view — parent mastery moves first.
Abouzeid et al. (2020) ran an even lighter eight-week ESDM course and still lifted parent teaching skills. Together the papers show parent skill can improve under many doses, but child change may need longer or different supports.
Shire et al. (2022) later showed community staff can hit high fidelity when they add follow-up calls. Their work extends the current finding: extra touchpoints help adults, no matter which model they use.
Why it matters
If your main goal is to sharpen parent interaction, pile on the coaching tools — videos, home visits, and check-in calls work. If you also need big child test gains, plan for more than twelve weeks or add direct child teaching. Use the enhanced package when families are ready for the time commitment, but keep realistic targets for child standardized scores.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add one extra video review of parent practice this week and note whether their fidelity jumps.
02At a glance
03Original abstract
Short-term low intensity parent implemented intervention studies for toddlers with autism spectrum disorder (ASD) have found it difficult to demonstrate significantly improved developmental scores or autism severity compared to community treatment. We conducted a randomized comparative intent-to-treat study of a parent implemented intervention to (1) test the effects of an enhanced version on parent and child learning, and (2) evaluate the sensitivity to change of proximal versus distal measures of child behavior. We randomized 45 children with ASD, 12-30 months of age, into one of two versions of parent-implemented Early Start Denver Model (P-ESDM), the basic model, in which we delivered 1.5 h of clinic-based parent coaching weekly, and an enhanced version that contained three additions: motivational interviewing, multimodal learning tools, and a weekly 1.5-h home visit. We delivered the intervention for 12 weeks and measured child and parent change frequently in multiple settings. We found a time-by-group interaction: parents in the enhanced group demonstrated significantly greater gains in interaction skills than did parents in the non-enhanced group. Both interventions were associated with significant developmental acceleration; however, child outcomes did not differ by group. We found a significant relationship between degree of change in parental interaction skill and rate of children's improvement on our proximal measure. Parents in both groups reported satisfaction with the intervention. These findings suggest that parent skills improved more in the enhanced group than the comparison group. Children in the two groups showed similar improvements. Rate of individual parent learning was associated with greater individual child progress on a measure quite proximal to the treatment, though not on standardized assessments.
Journal of autism and developmental disorders, 2019 · doi:10.1007/s10803-018-3740-5