Evaluating a Two-Tiered Parent Coaching Intervention for Young Autistic Children Using the Early Start Denver Model
Start parent ESDM training with a brief group class before moving to 1:1 coaching—fidelity gains hold and kids’ engagement and words go up.
01Research in Context
What this study did
The team tested a two-step parent class for families of 2- to young learners with autism.
Step 1: four group lessons in the Early Start Denver Model. Step 2: four 1:1 home coaching visits.
They tracked how well parents used ESDM moves and how kids played, talked, and copied actions.
What they found
After the group class, parents hit 80 % fidelity. One-on-one coaching pushed most to 90 %.
Kids showed small but clear jumps in eye contact, new words, and copying play acts.
Gains stayed one month later, even though coaching stopped.
How this fits with other research
Ouyang et al. (2024) pooled 32 trials and say: start with ImPACT for quick fidelity, then add ESDM for language. van Noorden shows the same sequence works in real homes.
Schaaf et al. (2015) warned that heavy clinic-style training burns parents out. The new study answers with a light group-first plan that still hits high fidelity.
Bradshaw et al. (2017) used the same design with PRT and saw like gains. The pattern says: brief, staged parent coaching beats long single-strand programs for toddlers.
Why it matters
You can copy the two-step plan next month. Run a 4-week parent group, check fidelity, then offer short booster visits. It saves staff hours and keeps parents engaged. Expect modest child gains in words and play, enough to justify moving up to more intense services if needed.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Schedule a 90-minute group lesson this week, teach three ESDM moves, and send parents home with a 5-minute practice sheet.
02At a glance
03Original abstract
Early intervention can improve the outcomes of young autistic children, and parents may be well placed to deliver these interventions. The Early Start Denver Model (ESDM) is a naturalistic developmental behavioral intervention that can be implemented by parents with their own children (P-ESDM). This study evaluated a two-tiered P-ESDM intervention that used a group parent coaching program, and a 1:1 parent coaching program. We evaluated changes in parent use of the ESDM and parent stress, as well as child engagement, communication, and imitation. Seven autistic or probably autistic children (< 60 months old) and their parents participated. A multiple-baseline design was used to compare individual changes between Baseline 1, Group Coaching (Tier 1), Baseline 2, and 1:1 Coaching (Tier 2). Parent and child behaviors were analyzed from weekly videos and graphed. Parenting stress was measured. All parents improved in their use of ESDM strategies after the Tier 1 intervention. Changes in parent fidelity during Tier 2 were mixed, but all parents maintained higher than baseline levels of fidelity. Six parents demonstrated above 75% ESDM fidelity in at least one session. There were positive changes in parent stress levels pre- post-intervention. Positive results were found for most children’s levels of engagement, imitation, and communication. There were significant positive relationships between parent fidelity and both child engagement and child functional utterances. Group P-ESDM is a promising approach for improving parent fidelity and some child outcomes. Future randomized and controlled studies of group P-ESDM, using standardized outcome measures, are warranted. The online version contains supplementary material available at 10.1007/s41252-022-00264-8.
Advances in Neurodevelopmental Disorders, 2022 · doi:10.1007/s41252-022-00264-8