Sibling-Mediated Early Start Denver Model Support for Young Autistic Children

Young autistic children and their siblings often need support to play and engage with each other. The inclusion of older siblings in the provision of support may improve outcomes for autistic children and strengthen the sibling relationship. This study evaluated the inclusion of older siblings in the delivery of Early Start Denver Model (ESDM) support to autistic children aged between 3 and 4 years. It used a non-concurrent multiple baseline across participants design to evaluate the effects of sibling-mediated ESDM for four young autistic children and their older, non-autistic siblings. For most dyads, there were improvements in autistic child engagement and in sibling initiations during the sibling-mediated ESDM, which were generally maintained at follow-up. There was some improvement in sibling responses and minimal improvement in autistic child imitation and functional utterances. Sibling initiations and responses were generally positively correlated with autistic child engagement, functional utterances, and imitation. The parents of children in all four dyads found the sibling-mediated ESDM to be acceptable. These preliminary results suggest that sibling-mediated ESDM may be beneficial for improving the interaction between autistic children and their non-autistic siblings while benefits for teaching additional child skills might be more limited. Young autistic children and their older siblings could benefit from structured support during play.We examined sibling-mediated ESDM for four young autistic children and their older, non-autistic siblings.The sibling-mediated support led to improvements in autistic child engagement and in sibling initiations.There were some improvements in sibling responses to the autistic child.There were minimal improvements in autistic child functional utterances and imitation of their sibling.