Researchers from Victoria University of Wellington’s School of Education are developing a New Zealand-specific approach to delivering early intervention for children with autism.
Drawing on the Early Start Denver Model (ESDM) that is proving successful internationally, the team is working with the Autism Intervention Trust and Autism New Zealand so children with autism can be identified earlier and then receive support earlier to get a better start in their development and go on to mainstream schools.
An evidence-based therapy developed in the United States for very young children (1-5 years), ESDM uses play and games to build positive and fun relationships in which the children are encouraged to boost language, social and cognitive skills.
“There is a lot of research to show its effectiveness, so we are developing a model based on ESDM that would work within a New Zealand context. Our research is a first in the country and our team are the only people trained in ESDM in New Zealand,” says Dr Larah van der Meer, who together with Dr Hannah Waddington leads the team’s research.
“It’s a naturalistic developmental behavioural model that takes everything we know from the last 20–30 years of autism research around effective practice and what evidence says works.”
Where ESDM differs most from traditional intervention is that behavioural teaching techniques are used within the child’s daily routines and play, “working to help the children reach developmental milestones, especially communication and social interaction”.
“Intervention would previously have been more of a drill-based practice done outside the home and daily routine. This is embedding it into their daily lives,” says van der Meer.
Inspiration for the development of their model has also come from Australia, where ESDM has been adapted into a highly successful group-based approach integrated into pre-schools.
“There is huge progress being made with the Australian programme in key areas of language and social communication. They’ve reported that 90 percent of children going through the programme develop spoken language by school age – compared with typical estimates of 20–30 percent of children that remain non-verbal throughout their lifetime,” says van der Meer.
Training kindergarten teachers to use ESDM strategies is one of the three areas the University’s research team are looking at as part of their model. The other points of focus are one-on-one therapy at a lower intensity (two-three hours a week) than the usual 20 hours a week, and coaching parents to use the same strategies.
“We currently have two main research projects: one training kindergarten teachers in ESDM, led by PhD candidate Jessica Tupou, and another providing parent coaching and then adding on direct therapy, led by Dr Hannah Waddington,” says van der Meer.
“We’re looking at specific measures around communication, imitation – a key early learning skill children with autism typically struggle with – and social interaction and engagement with others.”
Inclusion of ESDM strategies in kindergartens is the “biggest unknown” because there is little teacher training in New Zealand around how to best support children with autism in mainstream settings.
“What we’re doing is taking what we know from overseas around what’s effective and applying it within a New Zealand context using the inclusive philosophy of teaching in New Zealand and the resources we have to see what can work,” says van der Meer.
Currently, most of the support for children with autism in New Zealand is advisory for parents and teachers and there is no funding for one-on-one therapy. Yet for very little funding, says van der Meer, New Zealand could get an early identification programme started by training Plunket nurses.
“It’s very cost-effective, not intensive and research from Australia shows that it doesn’t create any extra work for maternal and child health nurses (equivalent of Plunket). Their research also reports that nurses feel really empowered by this training and it adds to their practice.
“If we can get that identification happening earlier, we can start intervention earlier, which all the research shows creates better outcomes and more progress for the children.”