The effectiveness of early parental coaching in the autism spectrum disorder☆
Just two hours of ESDM parent coaching each week for 12 weeks lifts developmental scores for toddlers with autism.
01Research in Context
What this study did
Malucelli et al. (2021) ran a 12-week randomized trial at an outpatient clinic. Toddlers with autism got either weekly two-hour parent coaching in Early Start Denver Model skills or routine follow-up visits.
Parents in the coaching group practiced ESDM strategies while therapists watched and gave feedback. Kids' development and parent-child play were measured before and after.
What they found
Children whose parents received ESDM coaching made bigger developmental gains than the routine-care group. Parent-child interaction also improved.
The study adds to the evidence that short, clinic-based parent coaching can move the needle for toddlers with ASD.
How this fits with other research
Geoffray et al. (2025) seems to disagree. Their large European trial gave toddlers 12 hours of ESDM per week for two years and saw no added benefit over usual care. The key difference is dose and setting: Malucelli used brief weekly clinic sessions; Geoffray used intensive long-term delivery. Lower intensity may actually be easier for families to absorb.
Ouyang et al. (2024) pooled 32 trials and found parent-mediated ESDM, PRT, and ImPACT all help kids develop. They recommend starting with ImPACT for parent fidelity, then layering ESDM for language and motor skills. Malucelli's results fit this staged approach.
van Noorden et al. (2022) extended the idea by adding a group class before 1:1 coaching. Kids still gained engagement and words, showing the basic ESDM parent model can be flexed without losing benefit.
Why it matters
You can offer ESDM parent coaching in short weekly bursts and still see child progress. This fits busy clinic schedules and family life. If a family later moves to higher-intensity services, great; if not, the brief model still carries value. Try starting with 12 one-to-two-hour sessions focused on play, turn-taking, and clear prompts. Measure child engagement and parent fidelity each week to be sure the coaching is sticking.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Schedule a 12-week parent ESDM block: two-hour clinic visit, parent practices with toy set, you give live feedback, track child engagement each session.
02At a glance
03Original abstract
Analysis of the effectiveness of early Parental Coaching in the Autism Spectrum Disorder. Randomized, controlled and blinded clinical trial to analyze parent-child interaction videos. The sample consisted of 18 children being followed up at the Autism Outpatient Clinic of a Neuropediatric Center in southern Brazil diagnosed with Autism Spectrum Disorder, between 29 and 42 months of age, randomly allocated to two groups: the Study Group (SG; n = 9), which received Parental Coaching performed by a professional certified by the Early Start Denver Model; and the Control Group (CG; n = 9), which was in a routine follow-up, without treatment and training of parents by a trained professional. The parents of the SG were willing to attend weekly meetings and to apply the instructional techniques at home with their children. It took 12 weeks and an average of 2 h per meeting. The learning rate for comprehensive development skills in the Early Start Denver Model checklist, such as receptive communication, expressive communication, social capacity, imitation, cognition, games, fine motor skills, gross motor skills, behavior, and personal independence was significantly higher in the SG, as well as the strategies and the quality of interaction between parents and children. Thus, Parental Coaching presents as a possibility of early intervention in children with Autism Spectrum Disorder.
Jornal de Pediatria, 2021 · doi:10.1016/j.jped.2020.09.004