Starting and scaling a company is no easy task. Whether you’re launching a tech startup, a healthcare company, or a consumer product, the journey can be filled with hurdles. However, when the industry you’re entering has its own unique set of challenges—especially one as complex as autism therapy—the difficulty level increases significantly. Entrepreneurship within autism therapy is one such example. This field comes with a distinct set of obstacles that require constant attention, innovation, and strategic thinking in order to overcome them. Despite the overwhelming demand for autism therapy services, many of these challenges remain unsolved.
The autism therapy industry—specifically in the realm of Applied Behavior Analysis (ABA) therapy—is still very much in its infancy. This means that the entrepreneurial landscape within the sector is constantly shifting, with no playbook for success. In fact, as David Iklodi, vice president of strategy and corporate development at Behavioral Framework, pointed out, “Given where the industry is — it’s a very young industry — I’m not sure that [autism therapy] fits into any of the boxes that a lot of investors have seen, and therefore, the playbook operationally is just entirely different.”
Despite the growing demand for services, the industry’s complexity presents a major obstacle. Companies attempting to scale in this space often find themselves in uncharted waters, trying to balance business goals with clinical needs. This is why understanding the nuances of Autism Therapy Business Growth is essential for success in this field.
Defining Early Priorities in Autism Therapy Startups
Like any other startup, setting the right priorities early on is crucial for the long-term success of an autism therapy business. The earliest days of a new company are pivotal; these early decisions will shape the direction of the business for years to come. For companies in this sector, identifying these priorities requires a deep understanding of both the clinical and business sides of the operation.
For example, Behavioral Framework, an ABA and autism diagnostics provider headquartered in Rockville, Maryland, learned early on that securing contracts with payers and streamlining the provider credentialing process were essential steps for getting their business off the ground. As the company began to grow, their focus expanded to building operational density—ensuring that they had enough clients and qualified providers in place to meet the increasing demand for services. These foundational elements are often the first challenges that need to be tackled. Once those are sorted, the next set of priorities emerges: How can the company meet market demand while maintaining high standards of care? This is one of the core pillars of successful Autism Therapy Business Growth.
Angela West, founder and chief medical officer of Behavioral Framework, laid out a clear vision when she founded the company in 2017. Now, serving nearly 800 families, primarily through in-home services, Behavioral Framework serves as an example of how defining and pursuing the right priorities can pave the way for sustainable growth. The company’s recent investment by Renovus Capital Partners in January underscores the increasing interest in the autism therapy space and the opportunity for growth within the Autism Therapy Business Growth sector.
Lessons from the Field: Scaling with Purpose
Scaling a business in the autism therapy sector isn’t simply about building clinics or expanding geographic presence. In fact, one of the most important lessons learned by those in the field is that the infrastructure—the clinics and physical locations—are just the beginning. Once the clinics are up and running, the real challenge begins. The focus shifts toward recruiting and retaining high-quality clinicians, particularly Board Certified Behavior Analysts (BCBAs), and ensuring that the services provided meet the needs of the families they serve. These are the professionals who deliver the ABA services, and they are in high demand, making them a key asset for any autism therapy provider.
Kyle Seco, president of Apara Autism Centers in Dallas, recalls how the company quickly learned that opening a clinic was only one piece of the puzzle. “Looking back on it, I think opening a clinic is probably one of the easier things we do,” Seco reflects. “We’re now recruiting BCBAs, finding the families that are looking for services and making sure that we’re providing that high-quality service is our No. 1 objective.”
Seco’s comment highlights a central truth about scaling in the autism therapy market: the work is never done. Recruitment, retention, and maintaining quality service delivery are ongoing challenges. As the demand for ABA therapy continues to grow, securing enough BCBAs to meet that demand becomes a priority. However, finding and retaining these highly skilled professionals isn’t simple. They’re in short supply, and burnout is a serious concern.
Seco also points out that it’s a mistake to assume that clinicians’ passion for helping children with autism will prevent burnout. “They want to just make sure what they’re doing is right, and they want to feel comfortable with what the company is trying to accomplish,” Seco says. For this reason, Apara Autism Centers places a significant emphasis on work-life balance and offering flexible working options, such as work-from-home days, in order to mitigate burnout and improve job satisfaction. These principles are central to Autism Therapy Business Growth.
Serving Underserved Markets: A Strategic Approach
Another approach to scaling successfully comes from Brett Blevins, founder and CEO of Commonwealth Autism Care. His company focuses on finding clinicians in underserved cities and helping them set up their own clinics, with full support from Commonwealth Autism Care. Blevins, a Board Certified Behavior Analyst (BCBA) himself, returned to the field of autism therapy after selling his majority stake in a youth mental health startup in 2019. His goal was to address the historic operational mistakes made by incumbent autism therapy providers while also providing clinicians with a better workplace experience.
Commonwealth Autism Care now operates 13 centers across Georgia, Indiana, Kentucky, and Virginia, with a particular emphasis on underserved rural markets. By focusing on rural areas, Blevins has been able to provide much-needed access to autism therapy services while also empowering clinicians to start their own clinics. His model of “intrapreneurship”—where clinicians have the opportunity to take ownership of their own clinics with support from the company—is central to the company’s success.
“I’d talk with [clinicians] and say, ‘Well, why don’t you start your own clinic?’ And they would say, ‘We don’t want to do that; we don’t know how to do that,’” Blevins recalls. “So it’s more ‘intrapreneurship’ than entrepreneurship.” By providing these clinicians with the resources they need, such as capital, equipment, and operational support, Commonwealth Autism Care has been able to expand rapidly into underserved regions while maintaining the quality of care that is vital to its mission.
Blevins’ model underscores an important point: successful scaling in autism therapy requires collaboration, creativity, and a commitment to providing clinicians with the tools they need to succeed. For clinicians who want to serve their communities but don’t have the resources or know-how to start their own businesses, this model offers a viable solution and supports long-term Autism Therapy Business Growth.
The Importance of Mission Fidelity During Expansion
As companies scale, maintaining their core values and mission becomes increasingly challenging. As companies expand into new markets and acquire other businesses, it’s easy to lose sight of the principles that initially guided the organization. However, the best autism therapy companies understand that maintaining mission fidelity is critical for success.
Behavioral Framework, for example, ensures that clinical quality remains at the forefront of every decision the company makes. Iklodi explains, “Our clinical team is involved in every strategic decision that we’re making… If something doesn’t make sense clinically, it’s dead on arrival.” This emphasis on clinical input in all strategic decisions helps maintain the company’s high standards while ensuring that clinical staff feel heard and valued.
Similarly, Commonwealth Autism Care uses six core values—quality, integrity, creativity, innovation, growth, and sustainability—to guide every decision the company makes. Blevins adds, “We’re really looking at towns that some of the larger players may steer away from. Those are the things that get us fired up, when we are the first providers in a town.” The company’s commitment to expanding access to care, especially in underserved markets, is a direct reflection of its values and its dedication to improving the lives of children with autism and their families. This strong mission alignment is key to sustained Autism Therapy Business Growth.
The Role of M&A in Autism Therapy
As autism therapy providers look to expand, mergers and acquisitions (M&A) often become a part of the conversation. Some companies, like Commonwealth Autism Care, choose to grow organically, avoiding M&A in favor of slower, more deliberate expansion. Others, like Behavioral Framework and Apara Autism Centers, see M&A as a necessary tool for scaling rapidly and gaining a foothold in new markets.
For instance, Apara Autism Centers recently acquired Autism Learning Collaborative (ALC) and Early Autism Services’ Missouri operations in 2023, while Behavioral Framework acquired Behavior Consultation & Psychological Services (BCPS) in North Carolina in mid-2024. Both companies see M&A as a way to accelerate growth, acquire payer contracts, and enter new states more efficiently.
However, Iklodi emphasizes that successful acquisitions go beyond geography. “We need to see significant differentiation and something more special than geography,” he says. Companies looking to acquire other businesses should seek out targets that offer unique features, such as client experience, patient and provider retention, or specialized training programs that align with their core mission. These differentiating factors help ensure that the acquisition enhances the company’s overall strategy and doesn’t compromise its values.
Conclusion: Navigating an Evolving Industry
The autism therapy industry, while still young, presents significant opportunities for entrepreneurs. However, these opportunities come with unique challenges that require creative solutions, strategic thinking, and an unwavering commitment to clinical quality. By focusing on the right priorities, maintaining mission fidelity, and being open to innovative growth strategies—whether through organic scaling or strategic M&A—businesses can pave the way for long-term success and continued Autism Therapy Business Growth.
