Stepping stones learning center.

Smith (2013) tells the story of Stepping Stones Learning Center. The clinic has run high-quality ABA since 1996.

The paper is a case study. It describes how the agency keeps quality high year after year, not a one-shot outcome trial.

The center stays strong because three things never stop: a leader who guards quality, outside experts who visit and coach, and tight links with local schools and funders.

No graphs or effect sizes are given. The message is simple: keep the guardrails in place and the program survives.

Bustos et al. (2021) extends this tale. They asked 100 community EIBI staff what implementation tricks they actually like. Staff loved the same tactics Tristram used: outside consultation and clear leadership. The 2021 study adds a free survey tool (ISSS) so you can copy the check-up at your own site.

Gadow et al. (2006) is the warning shot. Therapists doing home EIBI told researchers that child problem behavior and feeling alone killed their fidelity. Tristrum’s clinic beats that trap by keeping expert coaches on speed dial—exactly the fix D et al. said was missing.

Vivanti et al. (2014) show the idea works in group care too. They ran ESDM in 1:3 community childcare and saw bigger language gains than standard programs. Same recipe: outside training plus on-site leaders who protect quality.

You can clone Stepping Stones. Pick a quality champion, book a monthly outside BCBA to watch sessions and give feedback, and sign a memo of understanding with your local school. Do those three things and your program can still be strong in 2033, not just next month.