Early Start Denver Model vs. ABA: What's the Difference?

The Early Start Denver Model, or ESDM, is a play-based early intervention for autistic toddlers and preschoolers that blends ABA teaching strategies with developmental science. Most clinicians, including me, place it under the ABA umbrella as a naturalistic, relationship-first form of therapy. The two share core tools such as reinforcement, prompting, and data collection, and they differ mainly in who leads, how play is structured, and which skills come first.

At Blue Jay ABA, we provide play-based, naturalistic ABA for toddlers and preschoolers across Colorado. Below, I explain how ESDM and ABA compare, what the research shows, and what to ask any provider before you commit.

Where the Early Start Denver Model Came From in Colorado

The model carries the city's name for a reason, and its history explains why it looks so different from a table-and-flashcards version of therapy. Knowing the background also makes it easier to see how it connects to ABA.

From a Denver classroom to a toddler model

Researchers Sally Rogers and Geraldine Dawson built ESDM in stages. According to CU Anschutz's JFK Partners, the model evolved from the original Denver model at the University of Colorado Health Sciences Center in Denver. Rogers and her colleagues now continue the work at the MIND Institute at UC Davis.

The same source describes ESDM as a comprehensive approach for children 12 to 60 months old. It includes assessment, objective writing, data collection, and progress monitoring, so there is more structure behind the scenes than you see in the room.

Why ESDM sits under the ABA umbrella

In 2015, the developers of several early intervention programs, including Dawson and Rogers, published a consensus statement that grouped these approaches as Naturalistic Developmental Behavioral Interventions, or NDBIs. NDBIs take place in natural settings, share control between child and therapist, use natural rewards, and teach developmental skills with behavioral strategies.

CU Anschutz describes ESDM as a naturalistic approach with some ABA teaching components. UC Davis says it starts with the science of human development and weaves in ABA strategies as a child needs them. Both descriptions are fair, and I tell families that ESDM is ABA delivered through a developmental lens.

Our own sessions use that lens too, and our post on child-led ABA shows what it looks like at home.

What the Early Start Denver Model Looks Like in a Real Session

Watching an ESDM session often surprises parents. UC Davis clinicians say observers frequently remark that the child and therapist just look like they are playing.

A play routine from start to finish

The therapist follows what interests the child, then builds a short routine around it with a clear beginning, middle, and end. Teaching targets such as a look, a gesture, a sound, or a word are woven into the routine. The reward comes from the activity itself, so the child gets the next turn because they communicated.

I once supported a two-year-old who spent early sessions dropping wooden balls down a ramp and ignoring every adult in the room. We sat at the bottom, held each ball for a beat, and returned it only after he looked at us or reached. Within a few weeks he looked up during the pause, then reached, then made a sound that meant "more." The ramp never changed, and the routine around it did.

The parent's role

Parent coaching sits at the center of the model. CU Anschutz notes that parents play a key role, and UC Davis describes both therapists and parents delivering the strategies during play and daily routines.

In practice, a coach shows you a technique in your own living room, you try it while they watch, and you get feedback on the spot. Our ABA parent training follows the same pattern of instruction, modeling, rehearsal, and feedback.

Intensity and who delivers it

The research programs were intensive. In the original randomized trial, 48 toddlers diagnosed between 18 and 30 months received two years of ESDM from therapists and parents or were referred to community providers. A later multisite trial of 118 toddlers described about 15 hours a week of one-to-one treatment on average from supervised therapy assistants, plus monthly parent coaching from a certified ESDM therapist.

Those are research settings. Your child's real schedule will depend on needs, family capacity, and insurance authorization.

ESDM vs. ABA: Side-by-Side Differences

The two approaches overlap so much that a feature-by-feature view is the clearest way to compare them. The table also shows how our own play-based sessions line up.

Teaching style: who leads and who sets the pace

In structured ABA, the adult picks a target, such as touching a nose or matching a card, and presents short teaching trials. In ESDM and other naturalistic approaches, the child picks the activity and the adult creates chances to practice inside it.

Modern ABA already includes natural environment teaching, so the gap is narrower than reputations suggest. Our overview of autism therapy types maps where each approach fits.

Evidence: what the studies show and where they stop

In the original trial, children who received ESDM gained about 17.6 standard score points on an IQ measure over two years, compared with 7.0 points in the community comparison group. They also kept pace with typical growth in adaptive behavior and were more likely to see a change in their autism diagnosis.

A larger multisite trial published in 2019 found a language advantage for ESDM in the pooled analysis, though one of three sites showed no difference. It found no significant group differences in developmental quotient, autism severity, or adaptive behavior.

A 2021 meta-analysis from Project AIM concluded that NDBIs may improve language, social communication, play, and cognition, with the largest gains in skills the intervention directly targeted. The U.S. Preventive Services Task Force reported in 2016 that among behavioral interventions, those based on ABA have the highest-quality data on cognitive and language outcomes.

No approach can promise a specific result for your child. What the research supports is early, individualized, parent-involved intervention.

Credentials and availability in Colorado

ESDM training runs through UC Davis, including workshops offered by the MIND Institute's Collaborative Start Lab. Ask providers directly whether anyone on the team has completed that training and at what level.

Which Approach Fits Your Child?

Most families do not need to pick a camp. They need a plan that matches their child's age, interests, and daily routines.

Signs a play-based, relationship-first approach may suit your toddler

• Your child was flagged or diagnosed before age 4.
• Your child engages more with objects than with people, and you want social connection to come first.
• You want a strong coaching role during bath, meals, and car rides.
• Sessions that look like play fit your child's tolerance better than table work.

When more structured teaching helps

• A specific skill needs repeated, explicit practice, such as toileting steps or safety routines.
• Challenging behavior needs a function-based plan alongside skill-building.
• Your child is older than the usual ESDM age range and needs school-readiness goals.

Most toddlers I work with do best with a blend: play-based sessions with short, structured moments for skills that need extra practice. Our post on ABA for 2-year-olds shows what that mix can look like.

Questions to Ask Any Colorado Provider About ESDM and ABA

Ask the same questions of every provider you interview, whether they use the ESDM name or not. The answers will tell you more than the label does.

• Does anyone on the team hold ESDM training, and who would work with my child?
• Who delivers sessions, and how often does a BCBA observe?
• How will you coach me, and how soon will I start using strategies?
• What goals will you write, and how will you show me progress data?
• How will you plan for the move to preschool or kindergarten?
• What happens if my child's needs change?

Coverage deserves its own question, and it depends on your plan and the service being billed. Some ABA agencies train their behavior analysts in ESDM and deliver it within an insurance-funded ABA program, which a recent NIMH-funded study at UC Davis is testing across community agencies. Our team verifies benefits and handles authorizations, and you can see the plans we work with on our insurance coverage page.

Not sure which of these questions fit your child's age and goals? Talk with a Blue Jay ABA clinician and bring whatever your pediatrician or evaluation team has shared.

How Blue Jay ABA Supports Toddlers and Preschoolers in Colorado

Our Colorado team works with young children in the places where they spend their day. I also want to be clear about one distinction.

ESDM is a specific, manualized model with its own training pathway. Our sessions draw on the naturalistic teaching principles that ESDM and other NDBIs share: following the child's lead, building routines around play, and teaching communication in the moment.

Home-based ABA and assessment

Home-based ABA puts sessions in your living room, backyard, and kitchen, where skills need to work. Every plan begins with an ABA assessment that looks at how your child learns, communicates, and plays. If your child has not been evaluated yet, our autism evaluation services can help you get answers.

School and telehealth support

For preschoolers, school-based ABA therapy brings strategies into the classroom. Telehealth ABA lets us coach you between visits.

Where we work

We serve Colorado families in communities including Denver, Aurora, Lakewood, Boulder, Littleton, Highlands Ranch, Colorado Springs, and Fort Collins. You can see every community on our ABA therapy in Colorado page.

Choosing Between the Early Start Denver Model and ABA for Your Toddler

The Early Start Denver Model grew out of Colorado research, and its best ideas now run through much of modern ABA: follow the child's interests, teach inside play, and bring parents in as partners. Instead of choosing a label, choose a team that can describe a typical session, show you data, and coach you to use what they teach.

Research points to the value of starting early, and you do not need to wait for the perfect program name to begin. If you are weighing ESDM and ABA right now, reach out to Blue Jay ABA and we will help you find a plan that fits your child's day.

Frequently Asked Questions About the Early Start Denver Model and ABA

Is the Early Start Denver Model a type of ABA?

Most clinicians treat it as a naturalistic form of ABA, because it uses behavioral teaching strategies inside a developmental, play-based framework. Its developers also describe it as built on developmental science, so some sources list it as its own category. Either way, ask any provider to describe what happens in a typical session.

What age is the Early Start Denver Model for?

CU Anschutz describes it for children 12 to 60 months old, and UC Davis describes it for ages 1 to 4. Older children can still benefit from play-based, naturalistic ABA strategies.

Is ESDM better than ABA?

Neither approach has been shown to be better for every child. ESDM has randomized trial evidence in toddlers, and the U.S. Preventive Services Task Force found ABA-based interventions had the highest-quality data among behavioral treatments for cognitive and language outcomes in its 2016 review. The better question is which one your child can take part in every day.

How do I find ESDM-trained providers in Colorado?

Start by asking your pediatrician, your early intervention program, or your autism evaluation team for names. Then ask each provider about ESDM training directly. If no one nearby holds it, a BCBA who uses naturalistic teaching can offer a similar play-based style.

Sources

• JFK Partners, University of Colorado Anschutz. (2024). S8 Early Start Denver Model (ESDM): An early intervention approach for young children with autism. https://medschool.cuanschutz.edu/jfk-partners/about-us/archived-news/main-newsroom/s8-early-start-denver-model-(esdm)--an-early-intervention-approach-for-young-children-with-autism
• Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., Donaldson, A., & Varley, J. (2010). Randomized, controlled trial of an intervention for toddlers with autism: The Early Start Denver Model. https://pubmed.ncbi.nlm.nih.gov/19948568/
• Rogers, S. J., Estes, A., Lord, C., Munson, J., Rocha, M., Winter, J., Greenson, J., Colombi, C., Dawson, G., Vismara, L. A., Sugar, C. A., Hellemann, G., Whelan, F., & Talbott, M. (2019). A multisite randomized controlled two-phase trial of the Early Start Denver Model compared to treatment as usual. https://vivo.weill.cornell.edu/display/pubid30768394
• Schreibman, L., Dawson, G., Stahmer, A. C., Landa, R., Rogers, S. J., McGee, G. G., Kasari, C., Ingersoll, B., Kaiser, A. P., Bruinsma, Y., McNerney, E., Wetherby, A., & Halladay, A. (2015). Naturalistic developmental behavioral interventions: Empirically validated treatments for autism spectrum disorder. https://pubmed.ncbi.nlm.nih.gov/25737021/
• Crank, J. E., Sandbank, M., Dunham, K., Crowley, S., Bottema-Beutel, K., Feldman, J. I., & Woynaroski, T. G. (2021). Understanding the effects of naturalistic developmental behavioral interventions: A Project AIM meta-analysis. https://pmc.ncbi.nlm.nih.gov/articles/PMC8862714
• UC Davis Health. (2023). Psychiatry researchers get $4.7 million NIMH grant to test autism intervention in community. https://health.ucdavis.edu/news/headlines/psychiatry-researchers-get-47-million-nimh-grant-to-test-autism-intervention-in-community/2023/09
• UC Davis Extension. (n.d.). Early Start Denver Model. https://extension.ucdavis.edu/subject-areas/early-start-denver-model
• U.S. Preventive Services Task Force. (2016). Autism spectrum disorder in young children: Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/autism-spectrum-disorder-in-young-children-screening