Journal of Autism and Developmental Disorders

, Volume 48, Issue 2, pp 561–571 | Cite as

Time-Lag Between Diagnosis of Autism Spectrum Disorder and Onset of Publicly-Funded Early Intensive Behavioral Intervention: Do Race–Ethnicity and Neighborhood Matter?

  • Marissa E. Yingling
  • Robert M. Hock
  • Bethany A. Bell
Original Paper


Health coverage of early intensive behavioral intervention (EIBI) for children with autism spectrum disorder (ASD) is rapidly expanding across the United States. Yet we know little about the time-lag between diagnosis and treatment onset. We integrated administrative, Medicaid claims, and Census data for children in an EIBI Medicaid waiver (n = 473) to examine the relationship between time-lag and (a) child race–ethnicity and (b) neighborhood racial composition, poverty, affluence, and urbanicity. We explored whether the relationship between child race–ethnicity and time-lag varies by neighborhood characteristics. Average time-lag between diagnosis and treatment onset was nearly 3 years. Child race–ethnicity and neighborhood characteristics did not predict time-lag. Reducing time-lag is critical to ensuring that children with ASD receive treatment as early as possible.


Autism spectrum disorder Early intensive behavioral intervention Medicaid Time-lag Disparities 



We acknowledge the South Carolina Department of Disabilities and Special Needs and the University of South Carolina’s Institute for African American Research for their support of this work. The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the South Carolina Department of Disabilities and Special Needs.


This study was funded in part by the Institute for African American Research at the University of South Carolina.

Author Contributions

MY conceived of the study, led its design and coordination, and drafted the manuscript; RH advised MY on conceptualization and data collection and provided feedback on subsequent manuscript drafts; BB advised MY on statistical analyses and interpretation and provided feedback on manuscript drafts; All authors read and approved the final manuscript.

Compliance with Ethical Standards

Conflict of interest

The authors declared that they have no conflict of interest.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Marissa E. Yingling
    • 1
  • Robert M. Hock
    • 2
  • Bethany A. Bell
    • 2
  1. 1.Kent School of Social WorkUniversity of LouisvilleLouisvilleUSA
  2. 2.College of Social Work, Hamilton CollegeUniversity of South CarolinaColumbiaUSA

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