Effect of the Parent-Implemented Early Start Denver Model Interventions in Improving Communication Skills and Reducing Severity of Symptoms in Children with Autism: A Case Report of Four Patients

Autism is a neurodevelopmental disorder characterized by deficits in communication skills as one of its most prominent diagnostic criteria, and the initiation of intensive early interventions is a critical determinant in the prognosis of this disorder and the reduction of its severity. This study was conducted to determine the effect of the Parent-Implemented Early Start Denver Model (P-ESDM) interventions in improving communication skills and reducing the severity of symptoms in children with autism. This experimental case report with an A-B design was conducted on 4 children (3 boys and 1 girl) under the age of 60 months diagnosed with autism, who were referred to the Shekoufeha Autism Center in the city of Mahshahr, Iran during 2021. Initially, their parents received training in the P-ESDM interventions through 12 individual, one-hour, weekly sessions. The Autism Treatment Evaluation Checklist (ATEC) was used to assess communication skills, and the Gilliam Autism Rating Scale-Second Edition (GARS-2) was employed to assess autism severity. Assessments were conducted in 7 phases (2 baseline assessments, 3 assessments during the intervention, and 2 follow-up assessments). Data analysis involved descriptive statistics, within-condition and between-condition analyses, and an examination of the percentage of overlapping data (POD) and the percentage of non-overlapping data (PND). The implementation of the P-ESDM training culminated in the decreased mean scores, improved communication challenges, and decreased autism severity scores across all 4 subjects. In the within-condition analysis, the subjects’ communication challenges and autism severity scores exhibited a descending and stable trend. Moreover, in the between-condition analysis, the PND at the baseline and intervention phases was at its maximum (100%), and the POD was at its minimum (0%). The observed changes persisted until the follow-up stage. The findings of this study demonstrated that the implementation of the P-ESDM interventions could significantly reduce communication challenges and the severity of symptoms in children with autism, leading to improvements in their communicative skills.