A Program Evaluation of Home and Center-Based Treatment for Autism Spectrum Disorder

Dixon and his team looked back at one agency’s records. They compared how fast kids with autism learned new skills at home versus in a center.

They counted how many teaching examples each child mastered per hour. The same kids often had hours in both places.

Center hours doubled the learning speed. Kids mastered twice as many examples per hour in the clinic as they did at home.

When families used both settings, the center still carried the heavier load.

Perera et al. (2016) seems to disagree. Their home-based program in Sri Lanka created big social-communication gains in just three months. The key difference: Perera measured social skills, while Dixon measured how many new tasks a child could master per hour. Different yardsticks, different winners.

Eskow et al. (2015) and Ferguson et al. (2018) line up on Dixon’s side. Goldrich showed Medicaid-funded home ABA helps daily-living skills, but the gains were modest. Ferguson’s review found tele-home programs work, yet most studies were weak and progress was slow.

Anonymous (2023) moves the story forward. They blended home and center hours and added digital tracking. The hybrid lifted goal success by about ten percent, showing the debate is no longer either-or.

If your client plateaus at home, don’t just add more home hours. Shift some sessions to a center room, even a shared one. Track exemplars per hour, not just broad goals. Use the faster center rate to build core skills, then practice them at home for generalization.