Two-year outcomes for children with autism after the cessation of early intensive behavioral intervention.
EIBI gains can vanish in two years without a clear maintenance plan, but kids whose parents keep services lose less—and longer studies show skills can rebound.
01Research in Context
What this study did
Hanna and colleagues tracked kids with autism who finished two years of early intensive behavioral intervention. They checked in again two years after the program stopped to see which skills stuck around.
Some families kept services they chose and paid for. Others had ended the university-run program completely. The team compared how each group fared on cognitive and daily-living scores.
What they found
Most early gains slipped away once formal EIBI ended. The children looked about the same as before the program started.
One bright spot: kids whose parents lined up their own services kept more skills than those with no follow-up care. Still, even the parent-commissioned group lost ground.
How this fits with other research
de Korte et al. (2021) looked at the same question and saw the opposite. Their group held onto IQ and adaptive gains for ten full years after EIBI ended. The key difference is time: Hanna stopped watching after two years, while P kept tracking. Skills may dip then climb again if you stay in touch.
Rodgers et al. (2021) pooled nearly 500 children and found small but real boosts after two years of EIBI. Their data say the program works on average, yet they warn that results vary. Hanna’s fade-out fits the low end of that wide range.
Bigham et al. (2013) add a clue: when parents are trained to run parts of therapy during treatment, outcomes improve. Hanna saw the same pattern after treatment—parent-led services slowed the slide.
Why it matters
For BCBAs, the message is simple: plan the hand-off before you discharge. Build parent skills while the child is still on your caseload. Schedule booster sessions or brief consults for the next two years. A short follow-up may look like failure, but later checks might show recovery—so keep measuring and stay involved.
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02At a glance
03Original abstract
Evidence from recent meta-analytic and narrative review suggests that early intensive behavioral intervention (EIBI) may improve life chances of preschool children with autism. Unfortunately, there are few data indicating whether early gains are maintained after intervention ceases. The purpose of the present study was to establish the 2-year follow-up outcome for children with autism (N = 41) who had participated in an earlier 2-year controlled comparison of EIBI. Twenty-three children in the intervention group (100% of original sample) and 18 in the treatment-as-usual comparison group (86% of original sample) were located and retested. Group differences favoring intervention substantially diluted in this period but varied significantly between subgroups who had received university-supervised and parent-commissioned interventions, favoring the latter. These groups differed in terms of their baseline characteristics and intensity of intervention. Results strongly suggest a need for better characterization of those children who would benefit from more active maintenance programs.
Behavior modification, 2011 · doi:10.1177/0145445511405513