Exploration of a Community-Based Early Intervention for Diverse Children with Autism

Background: Despite the efficacy of early intensive behavioral intervention (EIBI) for children with autism spectrum disorders (ASD), little is known about the feasibility of implementing EIBI services for a broad and diverse community. The present paper describes and explores a model of EIBI that was designed with community dissemination as a primary objective. The Michigan State University Early Learning Institute (ELI) is a community-based EIBI model that provides comprehensive programming for low-income children with ASD and their families. Although affiliated with a university, the ELI is a stand-alone collective of EIBI centers that serves children with ASD within existing early childhood centers (e.g., preschools) near their home communities. The ELI started with a single center serving eight children within an inclusive learning environment, where children with ASD could interact with typically developing peers at a very young age. The ELI quickly expanded services in a manner that maintained the intensive and inclusive qualities of the original program. There are currently three MSU ELI sites in mid-Michigan with XX children served over 3.5 years. The ELI is a unique EIBI program in that it emphasizes services for low-income children and families, is built into communities, maintains consistent services, and emphasizes inclusive therapeutic services in preparation for public school.

Objectives: This exploratory study describes the feasibility of implementing an inclusive EIBI program within community settings, primarily for low-income children with ASD. The specific objectives were to assess the likelihood of low-income families to enroll children in the program, evaluate adherence to treatment by calculating utilization over one year, and compare preliminary outcomes to those observed in prior EIBI literature.

Methods: Observational methods were used to assess the utilization of the ELI program among low-income families. A single group pre-test post-test design was used to assess for changes among children with ASD enrolled in the ELI following one year across several outcome measures including: the Mullen Scales of Early Learning, the Vineland Adaptive Behavior Scales, the Social Responsiveness Scale – 2^nd Edition, and language samples.

Results: There were 31 spaces available for families to enroll their children at the ELI during the study period. Low income children were enrolled into 22 of the 31 spaces. Total utilization among low income children was a mean of 85% (range, 80% to 94%). A dependent samples t-test will be used to test for change on outcome measures.

Conclusions: Preliminary data suggest the ELI has potential as a model for delivering EIBI to low-income children with ASD in community settings. Utilization among low-income families was substantially higher than levels observed in prior research, suggesting the ELI model may be accessible to diverse families. Children demonstrated gains on standardized measures, though these gains were less than those observed in highly controlled research studies. Implications of utilization and outcomes will be presented.