ESDM (Early Start Denver Model) in Ontario

What ESDM therapy is, its evidence base, how to find certified Ontario providers, and whether OAP funds Early Start Denver Model intervention.

Direct answer

The Early Start Denver Model (ESDM) is a naturalistic, play-based early intervention for autistic children aged 12 to 48 months. ESDM combines ABA learning principles with a child-centred, relationship-based approach. Supported by a randomized trial (Dawson et al., 2010, Pediatrics). ESDM can be paid for with OAP core clinical funding as an ABA service when a qualified provider delivers it as part of your child's treatment plan. Find certified providers through the UC Davis MIND Institute registry.

Page updated · Sources

The numbers behind the answer

Age range
12 - 48 months
OAP eligible
As an ABA service
Evidence
RCT support; partly replicated
Dawson et al., 2010

What is ESDM?

The Early Start Denver Model (ESDM) was developed by Dr. Sally Rogers and Dr. Geraldine Dawson. Its official training program is at the UC Davis MIND Institute. It is designed for children from 12 to 48 months and blends Applied Behaviour Analysis learning principles with a child-centred, relationship-based framework.

Sessions happen in natural settings - your home, a daycare, a park - rather than a clinical table setup. The therapist follows the child's lead in play while embedding communication, cognitive, and motor learning targets into enjoyable interactions.

Intensity: trials have given ESDM at about 15 to 25 hours per week, and results on whether more hours help are mixed. Parent coaching extends learning into everyday routines.

Evidence base

ESDM is the most studied naturalistic developmental-behavioural approach in autism research. Dawson et al. (2010), Pediatrics: randomized controlled trial showing significant gains in IQ, language, and adaptive behaviour versus community intervention after 2 years. A larger 2019 trial partly repeated the language gains.

Most rigorous evidence applies to children under 5. Evidence for older children is more limited - other approaches may be better suited once a child is school-aged.

OAP funding and finding a provider

OAP core clinical funding can pay for ABA services. ESDM uses ABA principles, so it can be an eligible ABA service when a registered behaviour analyst, psychologist or psychological associate delivers or supervises it as part of your child's treatment plan. Confirm details with your AccessOAP care coordinator. For private ESDM, ask each provider for a written rate sheet.

ESDM certification is issued by the UC Davis MIND Institute or their licensed trainers. Certification levels: Therapist, Parent Coach, and Trainer. The official certified-provider directory is kept by the UC Davis MIND Institute.

When evaluating a provider, ask: What level of ESDM certification do you hold? How many hours per week do you recommend for my child's age and profile? How do you involve parents in the program?

Why Timing Matters

A wait spans childhood.

Early support can help autistic children develop skills. Age six is not a clinical cutoff, and support can be beneficial at any age. Illustrative arithmetic only: registration at age three plus a five-year wait reaches age eight. Age six is a reference marker, not a clinical cutoff. This is not a prediction of funding, service access or developmental outcomes.

Illustrative example · not a population estimate

Example: an illustrative child's journey through the Ontario Autism Program

An assumed five-year wait from registration at age 3 reaches age 8. This is an example, not a typical or predicted service date.

Illustrative age referenceAge six is not a clinical cutoff
Example childRegistered at 3, example wait ends at 8
5 years waiting
Age 6
Past age 6at the end of this illustrative wait
Registeredage 3
Example wait endsage 8
012345678
Child's age (years)
Example: age reference and assumed wait
MeasureAge range
Illustrative age referenceBirth to age 6
Example wait using the OAC-reported minimum (registered age 3)Age 3 to age 8 (5 years)
Age at the end of this illustrative waitPast age 6

Toddler treatment study

Dawson et al. (2010) randomly assigned 48 autistic toddlers aged 18–30 months to the Early Start Denver Model (ESDM) or community intervention for two years. The ESDM group had greater improvements in cognitive and adaptive outcomes. This study compared treatments for toddlers; it did not compare intervention before versus after age six or establish a universal multiplier for gains.

Support across ages

NIH notes that treatment can help at any age. Support should reflect the person’s needs; a wait does not determine an individual child’s future outcomes.

Ontario does not publish an age-at-registration breakdown for registrations without an active Core Funding Agreement. This example does not describe the age distribution of that group.

SourceDawson et al. (2010) · NIH: autism and support across ages. The illustrative wait uses the community report: 5+ years for families registered in August 2021 (community-reported, Ontario Autism Coalition, July 2026). This is not a provincial average.

ESDM at a glance

Age range
12 - 48 months
OAP eligible
As an ABA service
Evidence
RCT support; partly replicated

Questions to ask a provider

Sources: UC Davis MIND Institute; Pediatrics; Cochrane. Verified 2026-04-30.
TopicDetailsSource
CertificationESDM certification is issued by the UC Davis MIND Institute or their licensed trainers. Certification levels: Therapist, Senior Therapist, Supervisor, and Trainer.UC Davis MIND Institute
Provider registryThe official certified-provider directory is at earlystart.ucdavis.edu/esdm.html.UC Davis MIND Institute
  1. What level of ESDM certification do you hold?
  2. How many hours per week do you recommend for my child's age and profile?
  3. How do you involve parents in the program?

Frequently asked questions

The Early Start Denver Model (ESDM) is a naturalistic, play-based early intervention for autistic children aged 12 to 48 months. Developed by Dr. Sally Rogers and Dr. Geraldine Dawson, it combines the learning principles of Applied Behaviour Analysis (ABA) with a child-centred, relationship-based approach focused on social communication. Sessions occur in natural settings rather than a clinical table-and-chair setup.

ESDM is one of the most studied early autism interventions. A 2010 randomized controlled trial published in Pediatrics (Dawson et al.) showed significant gains in IQ, language, and adaptive behaviour compared to a community-comparison group. Most of the strongest evidence applies to children under 5.

It can. OAP core clinical funding can pay for ABA services, and ESDM uses ABA principles, so it can qualify when a registered behaviour analyst, psychologist or psychological associate delivers or supervises it. If a child's individualized funded service plan includes ESDM delivery, it can be paid for with core clinical services funding. Confirm the specific service structure with your AccessOAP care coordinator, as funding is tied to the individualized plan rather than to therapy names directly.

ESDM requires specific training and certification through the UC Davis MIND Institute or their licensed trainers. Certification levels are: Therapist, Parent Coach, and Trainer. The official provider registry is kept by the UC Davis MIND Institute. End The Wait Ontario does not endorse specific providers - use the UC Davis registry to find certified practitioners in your region.

Both use ABA learning principles, but ESDM differs in delivery. Traditional ABA (particularly Discrete Trial Training) uses structured, table-based trials with explicit prompting and reinforcement. ESDM embeds learning in natural play and daily routines, prioritizes emotional engagement and imitation, and builds on the child's own interests and motivation. Many clinicians describe ESDM as a naturalistic or developmental ABA approach.

Sources

  1. UC Davis MIND Institute

    Early Start Denver Model - certification and provider registry

    Checked

  2. Pediatrics

    Dawson G, Rogers S, et al. (2010). Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics 125(1):e17-e23

While you wait for OAP funding

Free Foundational Family Services are available immediately, no waitlist.

Evidence for this answer

Watchdog Reports

  • [2024]
    Ministry of Children, Community and Social Services: Spending Plan Review
    Financial Accountability Office of Ontario (FAO) • Watchdog report • 2024-06-05

FOI Records

  • [2026]
    Ontario Autism Program figures as of May 13, 2026 (MCCSS, released under Freedom of Information to the Ontario Autism Coalition; published in the OAC "OAP At A Glance" update, July 2026)
    Ministry of Children, Community and Social Services (Ontario), obtained by the Ontario Autism Coalition • FOI record • 2026-05-13

Source context: Check each claim’s scope, dates and limitations against its linked record. A reference list is not blanket verification of every statement. Recorded review date: April 30, 2026.

Claims and sources from this page(1)

How many children are on the Ontario autism waitlist in 2026?

As of May 13, 2026, 91,974 children are registered with the Ontario Autism Program. However, only 20,711 (22.5%) have an active Core Funding Agreement. This represents ~300% growth in registrations since 2019, with 71,263 children still waiting for essential funding.

Source: MCCSS FOI via OAC · May 2026 · Open source record

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