Effectiveness of early behavioral intervention in public and mainstream settings: The case of preschool-age children with autism spectrum disorders

• A public EBI service delivered in integrated day care settings was assessed.
• Children's intellectual and adaptive functioning improved significantly.
• Children's socioaffective competencies improved significantly.
• A parental coaching pre-program did not influence children's outcomes.

Despite the demonstrated positive outcomes of early intensive behavioral intervention (EIBI) among children with autism spectrum disorders (ASD), several challenges to its implementation on a large scale and in community settings remain. In order to maximize the accessibility and cost-effectiveness of its services, a regional public agency serving children with ASD implemented two consecutive programs: a 1 year pre-program for parents (intensive sessions followed by 1 hour per week of individual coaching) and an early behavioral intervention (EBI) program with less than optimal weekly intensity (16–20 hours) delivered in mainstream day care settings. The outcomes of these programs were assessed among 93 children. Their IQ, adaptive behavior, and socioaffective competencies were found to have improved after 12 months in the EBI program. Their autism symptoms had also decreased marginally. Although the pre-program did not have observable effects on children's outcomes, their parents reported positive impact on their well-being and family life. These results demonstrate the feasibility and sustainability of offering EBI to large, unselected populations. However, the pre-program may need to be offered more intensively in order to yield positive outcomes for children. Delivering EBI services in mainstream settings may foster the development of skills linked to social integration.