Acceptability and Efficacy of a Culturally Adapted, Low-Frequency Parent-Mediated Early Start Denver Model (ESDM) Versus Standard Care in Young Children With Autism

• Compare the changes in scores on the Early Start Denver Model (ESDM) curriculum checklist from the baseline to the final review (Week 26) between the children receive the ESDM therapy and children who attend in-house routine-based therapy program to determine the effectiveness of the ESDM program. 2) For ESDM group, compare the change in the number of therapeutic strategies demonstrated by the parent in the parent-child play interactions as measured by the parent skill acquisition checklist at the baseline, mid-point through the intervention, and end of the intervention. 3) Compare changes in the adaptive scores measured with the Vineland Adaptive Behavior Scales- Third Edition (VABS-III) from baseline to assessment at the end of the intervention between these two groups. 4) Survey parent satisfaction of both treatments and perceptions on the feasibility of the parent-implemented interventions at the end of the intervention for both groups. 5) For both groups, compare changes in the quality of parent-child engagement as measured with the Joint Engagement Rating Inventory (JERI) from the baseline to progress review at the end of the intervention. 6) For both groups, determine the feasibility of the parent implemented intervention framework by assessing parent satisfaction data, clinic attendance rate throughout the intervention, and therapy take-up rate

Inclusion criteria

• Children between 12 to 36 months old
• met cut off for the 'moderate-risk' for autism on the M-CHAT-R/F (i.e. post-interview score of 2 - 7, Robins et al., 2014) and had a clinical diagnosis of autism based on DSM-5 criteria following clinical eva and had a luation
• were not receiving any concurrent autism-targeted intervention

Exclusion criteria

• children with known genetic disorders, very marked delays in gross motor skills, hearing or vision impairments, uncontrolled seizure disorders, as well as significant anxiety or behaviour problems that prevented rapport-building or entry into therapy spaces.
• parents unable to commit to session frequency or their caregivers could not speak or understand the languages spoken by the therapists (i.e., English or Mandarin Chinese)