Implementing early intensive behavioral intervention in community settings.

Sievers et al. (2020) opened a community clinic that gives full-day Early Intensive Behavioral Intervention to preschoolers with autism. All families were on Medicaid, so care was free.

The team simply tracked how often the kids showed up. They wanted to know if a real-world clinic could keep the most vulnerable families engaged.

Children kept coming. Attendance stayed high for the whole study period, even though families paid nothing and the site sat in a regular neighborhood, not a university lab.

The authors call this 'feasibility': a community agency can run EIBI and Medicaid families will use it.

Ferguson et al. (2020) ran the same model one year later, after the university walked away. Kids still gained IQ, language, and daily-living skills, proving the clinic could live on its own.

Barton et al. (2019) looked at hundreds of Medicaid preschoolers across a state and saw the opposite picture: most kids received less than half of the EIBI hours written on their plan. The difference is setting. B et al. ran a single, tightly-run clinic, while E et al. counted every child with a waiver, no matter where or how messy the service was.

Dimian et al. (2021) followed the same Medicaid group and showed that shorter wait times lead to better school scores years later. High attendance only helps if you start early.

You can copy this clinic. One room, one BCBA, and a bus route can keep Medicaid kids in 30-plus hours of EIBI. Fight the wait list, track daily attendance, and add parent training like Strauss et al. (2012) to stretch the gains even further.