Service Delivery

Sustainability of Early Intensive Behavioral Intervention for Children With Autism Spectrum Disorder in a Community Setting.

Waters et al. (2020) · Behavior modification 2020
★ The Verdict

Community clinics can keep 35-hour-per-week EIBI running for three straight years and beat standard care on IQ, adaptive skills, and academics.

✓ Read this if BCBAs who run or supervise EIBI programs in community clinics or home-based agencies.
✗ Skip if Practitioners who only offer brief parent-training or focused ABA under 10 hours a week.

01Research in Context

01

What this study did

Ferguson et al. (2020) asked if regular clinics can run full Early Intensive Behavioral Intervention without a university watching. They tracked kids who got about 35 hours a week for three years.

The team compared these kids to peers who only got the usual services the county offers. They looked at IQ, daily living skills, and early school scores.

02

What they found

Children in the community EIBI group made bigger gains in every area tested. The difference was large enough to matter in real life, not just on paper.

The clinics kept the high dose and quality for the full three years, showing the model can stick without outside help.

03

How this fits with other research

Eldevik et al. (2026) pooled 15 past trials and found the same pattern: EIBI lifts IQ and daily skills for most preschoolers. Ferguson et al. (2020) now proves those gains happen in plain-village clinics, not only in university labs.

Perry et al. (2019) followed similar kids for ten years and saw the gains hold. Together the two studies tell a single story: start young in the community, and the benefits can last into high school.

Sievers et al. (2020) ran a sister project the same year and showed Medicaid families will show up for 30-plus hours a week. F et al. adds that when families show up, the kids actually improve.

04

Why it matters

You no longer need to warn parents that “the research was done in labs.” You can tell them community clinics can deliver the same strong EIBI dose and get the same big gains. Use this paper to justify high-hour authorizations and to train staff to stay faithful to the model even when no professor is watching.

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Audit your schedule board: make sure every new preschooler is on track for at least 30 hours this week.

02At a glance

Intervention
comprehensive aba program
Design
quasi experimental
Sample size
94
Population
autism spectrum disorder
Finding
positive

03Original abstract

This study examined whether outcomes in early intensive behavioral intervention (EIBI) during a university-led multisite project could be replicated by the same community agency independently of the project. Participants, age 18 to 75 months at onset of intervention, were 48 children with autism spectrum disorder (ASD) enrolled in 35 hr per week of publicly funded, community-based EIBI for 3 years and 46 children who were matched on baseline characteristics and received early childhood services as usual (SAU) through local early childhood special education providers. Linear mixed models indicated that EIBI participants improved significantly more than SAU participants on standardized tests of IQ, nonverbal IQ, adaptive behavior, and academic achievement, administered by independent evaluators. Although limited by the use of a matched comparison group rather than random assignment, the study provides evidence for the sustainability of effective EIBI in community settings for children with ASD who start intervention at varying ages throughout early childhood.

Behavior modification, 2020 · doi:10.1177/0145445518786463