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Effectiveness of individual versus group Early Start Denver Model interventions in children with autism spectrum disorder

Pediatric Research (2025)Cite this article

Abstract

Background

We investigated the effectiveness of individual-Early Start Denver Model (I-ESDM) and group-ESDM (G-ESDM) intervention in children with autism spectrum disorder (ASD) at varying ability levels.

Methods

A total of 404 children were divided into I-ESDM (n = 237) and G-ESDM (n = 167) groups, receiving 3-month of intervention. The I-ESDM group had a staff-to-child ratio of 1:1, while the G-ESDM group had a ratio of 2:6. Clinical symptoms, neurodevelopment, and parenting stress were evaluated both pre- and post-treatment.

Results

After 3 months, both interventions significantly improved clinical symptoms, neurodevelopment, and reduced parenting stress in children with ASD. In the language age group under 2 years, the I-ESDM subgroup showed greater improvements in clinical symptoms compared to the G-ESDM subgroup. In the ≥2-year language age group and the general quotient (GQ) ≥ 70 group, the G-ESDM subgroup demonstrated greater improvements in clinical symptoms and neurodevelopment compared to the I-ESDM subgroup.

Conclusion

Both I-ESDM and G-ESDM effectively improve clinical symptoms, neurodevelopment, and reduce parenting stress in children with ASD. I-ESDM was more effective for children with a language age <2 years, while G-ESDM showed better outcomes for those with a language age ≥2 years or GQ ≥ 70.

Impact

  • After 3 months, both individual-Early Start Denver Model (I-ESDM) and group-ESDM (G-ESDM) significantly improved clinical symptoms, neurodevelopment, and reduced parenting stress in children with ASD.

  • The I-ESDM subgroup showed greater improvements in clinical symptoms in children under 2 years of age.

  • The G-ESDM subgroup demonstrated superior improvements in clinical symptoms and neurodevelopment in children aged ≥2 years or those with GQ ≥ 70.

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Fig. 1: Schematic figure of the study procedure.

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Data availability

The data utilized in this study were obtained from clinical sources. Due to concerns regarding personal privacy, raw data cannot be publicly shared. However, requests for access to the data can be made to the corresponding author of the article. The data supporting this study’s findings are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors are deeply thankful to all the families who contributed their time to this study in order to better understand autism spectrum disorder. This study was supported by the Health Science and Technology Capacity Improvement Project of Jilin Province (Grant Number: 2022LC104).

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Authors and Affiliations

  1. Department of Developmental and Behavioral Pediatrics, Children’s Medical Center, The First Hospital of Jilin University, Changchun, China

    Jun-yan Feng, Miao-shui Bai, Han-yu Dong, Yang Xue, Yu-mo Liu, Huan Ma, Zakaria Ahmed Mohamed, Ling Shan & Fei-Yong Jia

  2. The Child Health Clinical Research Center of Jilin Province, Changchun, China

    Jun-yan Feng, Miao-shui Bai, Han-yu Dong, Yang Xue, Yu-mo Liu, Huan Ma, Zakaria Ahmed Mohamed, Ling Shan & Fei-Yong Jia

  3. Jilin University, Changchun, China

    Jun-yan Feng, Miao-shui Bai, Han-yu Dong, Yang Xue, Yu-mo Liu, Huan Ma, Zakaria Ahmed Mohamed, Ling Shan & Fei-Yong Jia

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  1. Jun-yan Feng
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  2. Miao-shui Bai
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  9. Fei-Yong Jia
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Contributions

J.-Y.F. conceptualized and designed the study and drafted the initial manuscript. M.-S.B., H.-Y.D., Y.X., Y.-M.L., H.M., Z.A.M. and L.S. collected data, data analysis and interpretation. F.-Y.J. conceptualized and designed the study, and coordinated and supervised the whole research process. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Fei-Yong Jia.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethics statement

The study protocol was approved by the Ethics Committee of the First Hospital of Jilin University (approval no. 2017-307) and registered with the Chinese Clinical Trial Register Center on November 02, 2017 (registration no.: ChiCTR-IOR-17013217). Informed consent was obtained from the parents of the study participants before enrollment.

Consent statement

The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Ethics Committee of First Hospital of Jilin University. Informed consent was obtained from all subjects involved in the study.

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Feng, Jy., Bai, Ms., Dong, Hy. et al. Effectiveness of individual versus group Early Start Denver Model interventions in children with autism spectrum disorder. Pediatr Res (2025). https://doi.org/10.1038/s41390-025-04375-5

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  • DOI: https://doi.org/10.1038/s41390-025-04375-5

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