Soar Autism Center

The second edition of the Early Start Denver Model for Young Autistic Children offers new research, additional clinical guidance, and approach refinements for both experienced and newly trained ESDM practitioners alike. These changes are based on decades of ESDM implementation across settings, cultures, and provider disciplines. For clinicians already familiar with ESDM, the core framework will remain familiar. For new practitioners, the second edition manual offers a clear starting point for ESDM implementation and training.

Below are the most important updates in the second edition, with a focus on what they mean for clinical implementation.

A strengthened link between learning science and intervention structure

One of the most visible changes in the second edition is the expanded explanation of how autistic children learn, grounded in current research in the field of child development. The second edition clearly links ESDM strategies to research on attention, and shared engagement.  This clarity helps the reader understand the “why” behind ESDM’s developmental grounding, and why learning through interaction matters. 

For providers, this shift can reframe intervention decisions as reading and responding to the child’s cues in the moment.  Clinicians are encouraged to observe whether specific techniques or strategies are supporting attention, engagement, and shared interaction. This supports a more flexible, responsive teaching style across activities, which is core to effective ESDM implementation.

An expanded and updated approach to language development

Language development is one of the most substantially revised areas of the manual. In the second edition, language is defined broadly and includes information about multiple modalities, like spoken language, augmentative and alternative communication (AAC) systems, gestures, and other ways children can communicate. The manual places a greater emphasis on supporting multimodal communication early in the intervention process to ensure therapists are responsive to each child’s unique needs and developmental profile

For clinicians, this affects how goals are selected and how communication progress is evaluated. The focus remains on reading and responding to communicative intent with flexibility across communication systems.

Revisions to the ESDM Curriculum Checklist

The second edition also includes an updated version of the ESDM Curriculum Checklist, which includes detailed item descriptions, and new assessment items to consider across developmental domains. The second edition checklist has been expanded to include skills that typically emerge around six months of age, to ensure providers are building a complete picture of each child’s unique developmental strengths and needs. 

The second edition checklist builds on the strengths of the first edition, and remains focused on assessing all developmental domains for young children. The checklist is designed to be completed through shared interaction and engagement rather than a discrete list of items to evaluate. This focus reminds practitioners that ESDM is all about learning through shared engagement.

An emphasis of a neurodiversity affirming practice

The second edition adopts a clearly stated neurodiversity affirming perspective. Intervention goals are framed around learning, participation, communication, and quality of life rather than symptom reduction or normalization. Characteristics historically viewed as deficits are discussed as differences in learning and processing that require thoughtful support rather than elimination.

For clinicians, this has implications for goal writing, progress monitoring, and communication with families. Outcomes are defined by growth in agency, relationships, and engagement.

Updates to fidelity measurement

The revised fidelity system reinforces that ESDM fidelity is primarily about adult behavior within interaction, and reading and responding to the child and their cues. Fidelity ratings focus on how providers support attention, motivation, emotional regulation, and reciprocal engagement during joint activities. The fidelity system is positioned as a reflection and coaching tool to guide professional growth and consistency across teams.

In summary

The second edition of the ESDM manual clarifies how the model is intended to be used and expands on key information from the first edition. The updates provide more explicit guidance around learning processes, communication pathways, and values-driven practice. For providers, the second edition offers clearer support for making informed, responsive decisions that align intervention with each child’s unique learning profile.