The Early Start Denver Model (ESDM) is an early intervention approach for autistic children under age 5. While it uses principles from traditional ABA like positive reinforcement and teaching skills in small steps, it is more child-led and embedded into everyday play and routines.
If you’re exploring ABA therapy but worried about highly structured sessions, ESDM may offer a different picture. ESDM therapists use proven ABA strategies in your child’s natural world — following their interests, joining their play, and using what motivates them to learn.
The Core Features of ESDM
Developed by psychologists Sally Rogers and Geraldine Dawson, ESDM is built around how toddlers learn — through play, interaction with others, and preferred activities.
Play-based learning
Traditional ABA may teach a skill through a therapist-chosen activity or repeated practice. In ESDM, the therapist looks for opportunities to teach that same skill within play your child chooses.
If your child reaches for bubbles, for example, the therapist might pause before blowing them and wait for your child to look, gesture, or say “more.” Getting the bubbles becomes the natural reinforcement for communicating.
Relationship-focused
ESDM recognizes that young children are more receptive to learning through positive human connection. Therapists and caregivers build on that connection to encourage communication and social interaction.
Delivered in natural, everyday settings
ESDM isn’t limited to a therapy room. Learning can happen during routines like meals, bath time, getting dressed, or other everyday routines. This type of learning can continue at home, either through in-home ABA therapy or caregiver support. Many early intervention centers offer ABA parent training and parent resources for caregivers to apply techniques at home.
Still built on ABA principles
ESDM may look like play, but there’s a clear teaching strategy behind it. Therapists still use core ABA principles that promote skill development:
- Antecedent-Behavior-Consequence (ABC): looking at what happens before a behavior (antecedent), what your child does (behavior), and what happens afterward (consequence) to understand and encourage learning.
- Natural reinforcement: using positive reinforcement that comes directly from the activity, like getting the toy they asked for or continuing a favorite game.
- Frequent practice: creating many small opportunities to practice skills throughout play.
- Measuring progress: tracking the skills your child is learning and adjusting goals as they progress.
ESDM vs. Traditional ABA: What’s the Difference?
ABA is a broad science of learning and behavior, so there isn’t just one way to practice it. More traditional ABA programs tend to be structured, using techniques like Discrete Trial Training (DTT) to practice skills through repeated trials.
ESDM ABA follows the child’s lead and builds teaching into play and interaction rather than relying primarily on DTT.
Neither approach is automatically better. The right fit depends on your child’s age, needs, goals, and how they learn best.
Is ABA Being Phased Out?
The short answer is no. ABA is not being phased out, but the way it is practiced continues to evolve.
Why the field is evolving
ABA has evolved as we’ve learned more about autism, child development, and the experiences of autistic people and their families. This has encouraged more neurodiversity-affirming care, including:
- More individualized therapy based on each child’s strengths and needs.
- More child-led learning through play, interests, and everyday interactions.
- More attention to the child’s experience, including their comfort and preferences.
Where ESDM fits into that shift
ESDM reflects this shift toward more flexible, child-centered early intervention. It keeps core ABA principles like reinforcement, skill-building, and tracking progress, but applies them through play, relationships, and everyday interactions.
Who Is ESDM For?
ESDM may be worth exploring if your young child:
- Has an autism diagnosis or is showing early signs of autism
- Needs support with communication or interacting with others
- Learns well through play, movement, and activities that capture their interest
Typical age range and what research shows
ESDM is designed for children from about 12 to 48 months of age, and is supported by over a dozen studies showing benefits in language, learning, and everyday skills.
A notable 2012 study found that children receiving ESDM showed patterns of brain activity during social interactions that were more similar to those seen in typically developing children. The research was later recognized by TIME as one of its Top 10 Medical Breakthroughs of the year.
Getting Started With Early Intervention
Early intervention gives young children opportunities to build developmental skills during an important period of learning and growth. ESDM can be one part of early intervention, whether used on its own or alongside traditional ABA therapy.
If your child already has an autism diagnosis, talk with their care team about whether ESDM could be a good fit. If you have concerns about your child’s development but don’t have a diagnosis, your pediatrician can help you pursue an evaluation and connect with early intervention ESDM services near you.
Wherever you are in the process, learning how ABA therapy supports your child can also help you compare your early intervention options.
What insurance typically covers
Insurance may cover ESDM under an ABA or autism therapy benefit, although an autism diagnosis is often required. Some families qualify for ESDM therapy nearby that’s free or low-cost through state early intervention programs.
Early, Play-Based Support That Grows With Your Child
Your child’s diagnosis is just one part of who they are. Their unique preferences, strengths, and personality deserve to be preserved and nourished — which is why it’s so important to find care that meets them where they’re at.
ESDM offers a research-backed way to foster skill development without changing what makes them shine. And because it incorporates many of the same learning principles as ABA, it can blend naturally with more traditional ABA support as your child grows and their needs evolve.
Exploring autism therapies for your young child? We’re here to help! Talk to our team about early intervention options.
FAQs
What is ESDM in ABA therapy?
ESDM stands for Early Start Denver Model. It is an early intervention framework for autistic children under age 5 that combines ABA learning principles with play-based learning.
Is ABA being phased out?
No. ABA remains the most widely researched autism intervention that’s commonly covered by insurance. However, the field is evolving toward more collaborative, child-led, and neurodiversity-affirming care such as ESDM. ESDM is a good example of that evolution rather than a replacement for traditional ABA.
What are the key differences between ESDM therapy and ABA therapy?
ESDM incorporates ABA learning principles but emphasizes child-led play, relationships, and natural learning opportunities.
How much is 1 hour of ABA therapy?
ABA therapy costs vary by provider, location, and insurance plan. Many families pay little to nothing out of pocket when ABA is covered by insurance or Medicaid, while self-pay rates can range widely.
3 References
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Autism Center, Duke University. (2026). Early Start Denver Model (ESDM) Training. Duke Center for Autism and Brain Development. https://autismcenter.duke.edu/education/early-start-denver-model-esdm-training
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Autism Speaks. (n.d.). Early Start Denver Model (ESDM). https://www.autismspeaks.org/early-start-denver-model-esdm
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Vivanti, G., & Stahmer, A. C. (2020). Can the Early Start Denver Model Be Considered ABA Practice? Behavior Analysis in Practice, 14(1), 230. https://doi.org/10.1007/s40617-020-00474-3
