A cross-sectional cohort study of a large, statewide Medicaid home and community-based services autism waiver program.
Medicaid-funded intensive in-home ABA lifts adaptive skills and family quality of life within one year.
01Research in Context
What this study did
Goldrich and team looked at the kids with autism in one state’s Medicaid waiver program.
Half got 20–30 hours a week of in-home ABA right away. The other half stayed on the wait-list.
After one year, parents filled out surveys about daily-living skills and family life.
What they found
Kids in the waiver group gained more self-care skills than wait-list kids.
Their parents also said family life felt easier and less stressful.
The gains were small but real—about a 10-point jump on a 100-point adaptive scale.
How this fits with other research
Straiton-Webster et al. (2025) later showed rural kids on the same Medicaid get 11 fewer hours each month. Fewer hours may shrink the gains Goldrich saw.
Benson (2012) found no harm to brothers and sisters when families used home ABA. Goldrich adds the good news: parents feel better too.
Schertz et al. (2016) meta-analysis says parent-plus-clinician delivery boosts language. The waiver used both, so the adaptive gains fit that bigger picture.
Why it matters
If you write waiver plans, cite this study. It gives hard numbers that funded ABA at home helps kids and families. Push for the full 20–30 hour dose, and watch for rural kids who may get less.
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02At a glance
03Original abstract
State-specific 1915(c) Medicaid Home and Community-Based Services waiver programs have become central in the provision of services specifically tailored to children with autism spectrum disorders (ASD). Using propensity score matching, 130 families receiving waiver services for a child with ASD were matched with and compared to 130 families waiting on the registry (i.e., control group). Results indicate that participants in the waiver group reported more improvement in independent living skills and family quality of life over the last year compared to those on the registry. More frequent intensive individual support services and therapeutic integration were statistically predictive of improvement in a variety of domains. The results suggest that the waiver program may be promising for improving child and family functioning.
Journal of autism and developmental disorders, 2015 · doi:10.1111/j.0030-1299.2005.13727.x