Understanding the Role of ESDM in Supporting Children with Co-Occurring ADHD and Autism

In recent years, conversations around neurodevelopmental conditions have gained momentum. Attention Deficit Hyperactivity Disorder (ADHD) and Autism frequently co-occur, presenting unique challenges for autistic children and their families. Many parents seek effective intervention strategies to help their children thrive. One approach that stands out is the Early Start Denver Model (ESDM). This blog explores how ESDM supports autistic children with co-occurring ADHD, offering practical insights for families navigating this complex landscape.

The Early Start Denver Model approach aims not only to address the characteristics of autism but also to strengthen developmental skills, including communication, social interaction and play. As ADHD shares overlapping traits with autism, the strategies within ESDM can also be highly beneficial for children managing both conditions.

To fully understand the benefits of ESDM, it’s important to recognise the co-occurrence of ADHD and autism. While each condition is distinct, they share common features such as impulsivity, difficulties with focus, and social communication challenges.

Research suggests that around 30 to 50% of autistic children also show signs of ADHD. This highlights the need for a holistic intervention approach that addresses both sets of behaviours. By taking a dual-focus lens, caregivers can create more comprehensive support plans that cater to the full spectrum of the child’s developmental needs.

While ESDM was developed for autism intervention, many of its techniques are effective in addressing ADHD symptoms. Below are several ways ESDM supports autistic children who also have ADHD:

• Naturalistic Teaching

  ESDM integrates learning into everyday routines and environments. This naturalistic approach allows children to remain engaged in meaningful interactions, which can help increase their attention spans over time.

  
  

  For example, during mealtimes, children might be encouraged to help set the table or pass items to others. By keeping activities functional and engaging, children are less likely to exhibit inattentive or hyperactive behaviours.

  
  

• Enhancing Social Interactions

  Autistic children with ADHD often struggle with social skills. ESDM places strong emphasis on building social communication through structured play and peer interactions.

  
  

  Therapy sessions support children in practising skills like turn-taking, sharing, and interpreting facial expressions and tone of voice. Evidence shows that structured play can improve social skills by up to 40% in children with co-occurring diagnoses. These social opportunities can help bridge the gap between ADHD-related impulsivity and autistic traits.

  
  

• Parent Involvement and Training

  Parental involvement is a cornerstone of ESDM. Parents are supported to implement strategies in everyday interactions, empowering them to reinforce learning outside of therapy sessions.

  
  

  When parents are equipped with tools to manage both ADHD and autism-related behaviours, they’re able to create a supportive, consistent environment at home. This continuity greatly enhances the outcomes of therapy and promotes family connection.

  
  

• Individualised Approach

  Each child is unique, and this is particularly true for those with dual diagnoses. ESDM is designed to be flexible and adaptable to meet individual developmental profiles.

  
  

  Therapists work closely with families to set personalised goals and monitor progress. This tailored approach ensures that both ADHD and autism traits are acknowledged and addressed in therapy planning, increasing the likelihood of positive outcomes.

Early intervention is critical for improving long-term outcomes for autistic children and those with ADHD. Research shows that beginning support before the age of three can significantly boost the development of core skills and reduce the severity of symptoms.

Because ESDM focuses on children under four years of age, it allows families to access intervention during a key period of brain development. This early access can lead to substantial gains in communication, play, and social engagement.

While ESDM has many strengths, it’s not without challenges. The structured nature of the intervention requires consistent commitment from families, and progress may vary from child to child. Additionally, access to certified ESDM practitioners may be limited in regional or remote areas. Families will need to weigh the potential benefits against the logistics of delivery and access when considering whether ESDM is the right fit.

The Early Start Denver Model offers a strong, evidence-based framework for supporting autistic children with co-occurring ADHD. Through naturalistic teaching, social communication development, and active parent involvement, ESDM addresses the complex and overlapping needs of these children in a holistic and developmentally appropriate way.

Navigating dual diagnoses can feel overwhelming, but effective early intervention can make a significant difference. With the right guidance and a team-based approach involving families and professionals, children can achieve meaningful developmental progress.

As research continues to grow and access to personalised supports expands, the future looks promising for families exploring ESDM. Understanding the model—and how it can fit into your child’s unique journey—is an empowering first step towards creating lasting and positive outcomes.