Therapy Guide
$60–$100/hour (therapist-delivered); $120–$180/hour (BCBA-led)
Typical Cost
15–25 hours per week recommended for optimal outcomes
Frequency
12–48 months
Age Range
4
Provider Types
ESDM is eligible under OAP core clinical services when delivered by a BACB-certified behaviour analyst or supervised therapist. Funding is allocated through the childhood budget.
ESDM uses play-based activities embedded in natural routines to teach cognitive, language, social, and motor skills. Therapists follow the child's interests and motivation while systematically targeting developmental objectives from a curriculum checklist covering receptive communication, expressive communication, social skills, fine and gross motor skills, and personal independence.
Unlike traditional discrete trial training, ESDM sessions look like play. The therapist creates engaging interactions where learning opportunities emerge naturally. Each session targets multiple developmental domains simultaneously, reflecting how young children actually learn — through relationships and exploration rather than isolated drills.
In Ontario, ESDM is typically delivered in a combination of clinic-based and home-based sessions. Parents receive coaching to implement strategies throughout daily routines, which research shows amplifies therapy gains and supports generalization of skills across settings.
The landmark 2010 randomized controlled trial by Dawson et al., published in Pediatrics, found that children receiving ESDM for two years showed significantly greater improvements in IQ (averaging 17.6 points), adaptive behaviour, and autism diagnostic scores compared to the community-intervention control group. Brain imaging studies also showed normalized patterns of neural activation in response to social stimuli.
A 2012 follow-up study (Dawson et al., Journal of the American Academy of Child & Adolescent Psychiatry) demonstrated that gains were maintained two years post-intervention. Additional RCTs conducted in Australia and Canada have replicated core findings, establishing ESDM as one of the most evidence-supported early interventions for autism worldwide.
Dawson et al. (2010)
Randomized, controlled trial of an intervention for toddlers with autism: The Early Start Denver Model. Pediatrics, 125(1), e17-e23.
Dawson et al. (2012)
Early behavioral intervention is associated with normalized brain activity in young children with autism. Journal of the American Academy of Child & Adolescent Psychiatry, 51(11), 1150-1159.
Rogers et al. (2012)
Effects of a brief Early Start Denver Model (ESDM)-based parent intervention on toddlers at risk for autism. Journal of Autism and Developmental Disorders, 42(12), 2476-2485.
Commitment to Accuracy: Our data is verified against official government reports (FAO, MCCSS), peer-reviewed scientific literature, and accessible public records. Last updated: March 24, 2026.
Verified Facts
Early Start Denver Model (ESDM) delivered to children aged 18–30 months produced significant gains in IQ, adaptive behaviour, and autism severity — some children no longer met diagnostic criteria at follow-up
Cochrane systematic review finds evidence that early intensive behavioural intervention (EIBI) may produce positive effects on adaptive behaviour and communication for young children with ASD (low certainty of evidence)
WHO recommends accessible, community-based early interventions for children with autism — timely evidence-based psychosocial interventions improve communication and social engagement
88,175, children are registered in the Ontario Autism Program
23.4%, Only 20,666 children have active funding agreements () — less than one in four