Implementing the Group-Based Early Start Denver Model for Preschoolers with Autism (eBook)

Giacomo Vivanti, Ph.D., is Assistant Professor in the Early Detection and Intervention research program at the A.J. Drexel Autism Institute, Drexel University, Philadelphia. His previous experience includes a visiting fellowship at the Yale Child Study Center and a postdoctoral fellowship at the University of California Davis MIND Institute under the mentorship of Dr. Sally Rogers. During 2010, he became Research Fellow at the Olga Tennison Autism Research Centre in Melbourne, Australia, where he worked on a federally funded five-year project on the implementation of the Early Start Denver Model (ESDM) in a group-based early intervention setting. Dr. Vivanti serves on the editorial board of the Journal of Autism and Developmental Disorders and the Encyclopedia of Autism Spectrum Disorders. He is also a member of the Department of the Health Committee to establish evidence-based guidelines for autism treatment in Italy, a certified therapist and trainer in the Early Start Denver Model autism intervention program, and a member of the Early Start Denver Model Training Advisory Group. He is author of approximately 50 peer-reviewed journal articles and book chapters about autism spectrum disorder. Ed Duncan, B.S., M.B.A, is Clinical Director of the Autism Specific Early Learning and Care Centre (ASELCC) at La Trobe University, Melbourne, Australia. Ed has worked at this federally funded service on the implementation of the Early Start Denver Model in a group-based early intervention program since it began in 2010. His previous experiences include working as a manager and speech pathologist in several nonprofit organisations, specializing in working with young children with autism who are minimally verbal. He has held representative positions with AGOSCI (an organisation supporting the needs of people with complex communication needs) and more recently joined the Australian National Disability Insurance Agency. Mr. Duncan has contributed scientific articles to the Journal of Autism and Developmental Disorders and entries within the Encyclopedia of Autism Spectrum Disorders.Geraldine Dawson, Ph.D., is Professor, Departments of Psychiatry, Pediatrics, and Psychology and Neuroscience, Duke University. She is the Director of the Duke Center for Autism and Brain Development, where she oversees interdisciplinary autism research and clinical services for individuals with autism spectrum disorder.  She has published extensively on early detection, brain development, and treatment of autism. Dawson is President of the International Society for Autism Research (2015-2017) and serves on the NIH Interagency Autism Coordinating Committee, which develops the federal strategic plan for autism research. Dawson received a Ph.D. in Developmental and Child Clinical Psychology from University of Washington and completed a clinical internship at UCLA.Sally J. Rogers, Ph.D., is a developmental psychologist, clinician, Professor of Psychiatry and Behavioral Sciences, and Director of Training and Mentoring at the MIND Institute, University of California Davis. She has been the principal investigator of several NIH funded multi-site autism research projects, including a ten year CPEA program project and two funded Autism Centers of Excellence (ACE) network projects. She has served as president of the International Society for Autism Research, associate editor of the journal Autism Research, a member of the Autism Speaks Global Autism Public Health Initiative, a fellow of the American Psychological Association, Division 33, and a member of the Autism, PDD, and other Developmental Disorders workgroup for the DSM 5. The Early Start Denver Model that she developed with Geri Dawson and other colleagues at University of Colorado Health Sciences Center, University of Washington, and University of California Davis is internationally known and recognized by Time.com and Autism Speaks as one of the 10 most important scientific findings of 2012.

Foreword 5
Acknowledgments 7
Contents 8
Authors and Contributors 13
1 Early Learning in Autism 15
Early Development and Learning 15
Learning from Peers 17
Brain and Cognitive Foundations of Early Learning 18
Summary of Early Learning in Typical Development 20
Learning in Autism Spectrum Disorder 20
What Causes Autism? 21
How Does Autism Disrupt Learning? 22
Autism and Learning: What Is the Role for Education? 24
Conclusions 24
References 25
2 The Group-Based Early Start Denver Model: Origins, Principles, and Strategies 27
Why Treat Autism? 28
Why Early and Intensive Treatment? 29
Why the Early Start Denver Model? 30
Principles of the ESDM 30
Developmental Sequences 31
Joint Activity Routines 32
Use of Child-Preferred Activities for Meaning, Motivation, and Reward 33
Embedded Learning Within Joint Activity Routines 35
From ESDM to G-ESDM 37
Potential Concerns About Group Interventions for Autism 38
Individualization Is not Incompatible with Group Implementation 39
The Group Delivery of the ESDM Is not a Diluted Version of the 1:1 Delivery 39
Receiving Therapy in a Group Setting Is not Incompatible with Mainstream Inclusion 40
Children with Autism Do not Copy Each Other’s Maladaptive Behaviors in Group Settings 40
Delivering Therapy in a Group Setting Does not Mean that the Caregivers Are not Involved 41
Conclusions 41
References 42
3 Creating Treatment Objectives in the G-ESDM 45
Individual Learning Objectives in G-ESDM 45
Constructing Learning Objectives 47
Identifying the Criterion that Defines Mastery of the Objective and Steps 49
Environmental Considerations—Not All Settings Provide the Same Opportunities to Target Individual Goals 51
What Gets Measured Get Improved: Collecting Data in the G-ESDM 52
When to Take Data 52
How to Take Data 53
Data at the End of the Day 53
Data Tracking in G-ESDM—Some Practical Considerations 54
Conclusions 55
References 56
4 Setting up the G-ESDM Team and Learning Environment 57
Designing the G-ESDM Team 57
Transdisciplinary Team Approach 58
Transdisciplinary Practice in Action—Going Beyond the ‘Specialist Role’ 59
Designing the G-ESDM Classroom 60
Organizing Physical Spaces Around Clear Purposes and Motivation 62
Decreasing the Competition for Attention 63
The Different Learning Areas in the G-ESDM Playroom 63
Play-Activity Centers 64
Small Circle and Large Group Areas 66
Other Areas 68
Transitions Between Areas 69
Questions that Can Help Arranging the Physical Space 70
Conclusions 70
References 71
5 Development of the G-ESDM Classroom Curriculum 72
Curricular Activities in the G-ESDM—Incorporating Individual Child Objectives Within Group Routines 72
Embedding Direct Teaching for Children with Autism Within Daily Routines 74
How to Make This Happen: Team Cooperation and Daily ‘Symphony’ 77
Supporting Transitions 78
Roles and Responsibilities in the G-ESDM 79
Lead 79
Invisible Support 79
Float 80
Is the Intervention Being Delivered as Planned? Fidelity Measures Within the G-ESDM 80
G-ESDM Classroom Implementation Fidelity Tool 81
G-ESDM Small Group Activity Fidelity Tool 81
G-ESDM Management and Team Approach Fidelity Tool 82
Conclusions 82
References 83
6 G-ESDM Treatment Strategies 84
The Context for Intervention 84
Intervention Strategies Used in the G-ESDM 85
Management of Children’s Attention 85
Quality of Behavioral Teaching 86
Instructional Techniques Application 87
Managing Children’s Affect and Arousal 89
Management of Challenging Behavior 90
Peer Interaction 91
Children’s Motivation Optimized 91
Adult Use of Positive Affect 93
Sensitivity and Responsivity 93
Multiple and Varied Communicative Opportunities 94
Adult Language 95
Joint Activity Structure and Elaboration 96
Transition Between Activities 97
Conclusions 98
References 98
7 Facilitating Learning Through Peer Interactions and Social Participation 100
The Role of Peers in Early Learning 100
Creating Social Participation in Inclusive Settings 101
Creating the Right Climate—Philosophical Adherence and Practical Support to Inclusion 102
Are We All on the Same Page? 102
Bringing Caregivers on Board 103
Do We Have the Resources to Do It? 104
Individualization of Objectives in Inclusive Settings 105
Teaching Strategies that Involve Peers 106
Example of a Peer Interaction in a Small Group Activity 108
Conclusions 110
References 111
8 What if the Child Does not Make Progress? 113
Why Do Some Children Fail to Respond Readily to the Intervention Program? 113
When Do We Have to Change Our Teaching Approach? 114
What Can We Do if the Child Does not Learn? 115
What if the Child Is Still not Learning? 118
Specialist Input in the G-ESDM Decision Process 123
What if the Child Is not Showing Progress in the Ability to Speak and Use Language? Contributions from the Speech and Language Pathologist 124
What if the Child Has Challenging Behaviors that Interfere with the Program? Contributions from Behavior Analysis 125
Conclusions 127
References 128
9 Frequently Asked Questions 131
Is the G-ESDM Appropriate for All Children with Autism? 131
Is the ESDM Appropriate for Children with Diagnoses Other Than Autism? 132
What Is the Scientific Evidence Supporting the Effectiveness of the ESDM and the G-ESDM? 132
What Qualification Is Necessary to Deliver the G-ESDM? 133
What Roles Do Caretakers Play a Role in the G-ESDM? 134
What Is the Role of Visual Supports in the G-ESDM? 134
Many Activities in This Book Requires Children to Sit at the Table. What if They Only Sit for a Few Seconds or not at All? 136
How Does the ESDM Address Sensory Reactivity or Responsivity? 137
Are IPads and/or Other Mobile Technology Tools Used to Facilitate Learning in G-ESDM? 138
What Are the Planning and Meeting Requirements in a G-ESDM Program? 139
ESDM Specialist Review Meetings 139
Individual Classroom Meetings 140
Caretaker Meeting 140
Team Meeting 140
How Can a Transdisciplinary Team Culture Be Established? 140
As the Manager of a G-ESDM Program, are There Any Resources Available that can Assist in Delivering the G-ESDM? 141
References 141
Appendix: G-ESDM Fidelity Tools 143
Index 154