The autism therapy industry is undergoing a significant shift—one that promises to redefine how services are delivered to children with autism spectrum disorder (ASD) and their families. This transformation marks the next chapter in an industry that has already experienced a substantial evolution: from obscure, mom-and-pop operations to a mainstream, private-equity-backed field. But as the industry matures and the needs of children and families grow more complex, providers must adapt to address more than just autism. They must take a holistic, whole-child approach that integrates care across disciplines and services.
The next chapter of the autism therapy industry will look very different from previous ones. The forces driving change are pushing the industry to move beyond its core therapy, applied behavior analysis (ABA), and to embrace a more comprehensive, multidisciplinary approach to care. The emphasis will shift from simply treating autism to supporting the overall health and well-being of the child through holistic autism care models.
A Shift Toward Whole-Child, Integrated Care Models
One of the most significant changes in the autism therapy space is the transition from fragmented, siloed care to a holistic, integrated approach. This shift is aimed at addressing the child’s full range of needs, rather than focusing solely on autism as a singular condition. The current model, in which a child might visit multiple clinics to receive various therapies, is increasingly seen as inadequate. Families are looking for comprehensive solutions that offer a more coordinated approach to treatment, which is where multispecialty providers are stepping in.
Neil Hattangadi, CEO of Cortica, a multispecialty autism therapy provider based in San Diego, highlighted the importance of this shift during a panel at the BHB Autism & Addiction Treatment Forum in Chicago. “We’re trying to transition the field from being fragmented and siloed to being whole-child and integrated,” Hattangadi explained. The focus, he noted, is on delivering care that encompasses all aspects of a child’s development—medical, behavioral, and social. This approach ensures that the child’s needs are met across various domains, rather than just addressing autism in isolation. This holistic autism care model is essential for providing a comprehensive treatment experience.
Mark Shalvarjian, CEO of Gracent, another multispecialty provider, echoed Hattangadi’s vision, emphasizing the goal of becoming a “pediatric therapy company” that provides comprehensive care. While ABA still generates the majority of Gracent’s revenue, the company is working to integrate services like speech therapy, occupational therapy, neuropsychology, and mental health support. The aim is to provide families with a one-stop solution for the diverse needs of their children, reflecting a growing industry-wide shift towards holistic autism care.
This shift is particularly important because the majority of children with autism have comorbid conditions, such as developmental coordination disorder, gastrointestinal issues, sleep-wake problems, and ADHD. Research indicates that approximately 74% of children with autism also have one or more comorbidities. These conditions can complicate treatment and require a multifaceted care approach. By integrating therapies and collaborating across disciplines, providers can deliver more effective care that accounts for the whole child. In this context, holistic autism care is becoming a vital part of the industry’s evolution.
Shalvarjian highlighted the importance of listening to parents and caregivers to create individualized care plans that meet the unique needs of each child. “We work very hard to listen to the parents of the children that we take care of and meet them where they are and meet their needs,” he said. This personalized, family-centered approach is central to the future of autism therapy and reflects the broader trend toward patient-centered care across the healthcare industry, especially within the framework of holistic autism care.
Improving Care Quality and Outcomes
As the autism therapy industry expands, there is a growing emphasis on improving care quality. The influx of capital into the sector has resulted in more providers entering the market, leading to increased competition. With more options available, consumers—whether families or payers—want assurances that the services they receive are not only effective but also provide value.
Gracent is leading the charge in prioritizing care quality through strategic investments in clinical training and quality assurance. Shalvarjian noted that Gracent has appointed a senior director of training and clinical quality to oversee the daily management of clinical quality. This role ensures that services are delivered consistently across clinics and that the therapy provided is tailored to each child’s specific needs. By focusing on quality upfront, the company believes it can provide more efficient, effective care in the long run, leading to better outcomes for children and families.
At Cortica, a similar approach is being taken. The company has developed a “whole-child scorecard” that spans ten different domains, including medical, behavioral, and developmental measures. This tool is designed to help care providers assess the effectiveness of their services and ensure that care is coordinated across specialties. By using this scorecard, Cortica can track progress across multiple areas of a child’s development and make adjustments to care plans as needed.
This emphasis on coordinated, holistic care is gaining traction with payers as well. “All payers are talking about whole-person care,” Hattangadi explained. Payers are increasingly recognizing the value of models that integrate medical, behavioral, and developmental care, as they can lead to better overall outcomes and potentially lower healthcare costs. Payers are also looking for evidence of value-based care, which focuses on outcomes rather than volume. Cortica’s embrace of holistic autism care and value-based care principles sets it apart from other providers in the industry and positions it to succeed in an increasingly competitive market.
Addressing Workforce Challenges
One of the most significant challenges facing the autism therapy industry is workforce retention. According to data from CentralReach, the autism and intellectual and developmental disability (IDD) industry software provider, employee turnover rates remain alarmingly high. In 2024, companies with more than $30 million in revenue are projected to experience a turnover rate of 104%, while smaller companies will see turnover rates ranging from 78% to 90%. This high turnover is especially prevalent among registered behavior technicians (RBTs), who provide frontline care under the supervision of board-certified behavior analysts (BCBAs).
The high turnover rate among RBTs is a direct result of several factors, including low wages, long hours, and burnout. Hattangadi pointed out that ABA is unique in that it often relies on undertrained practitioners who are quickly overwhelmed by the demands of the job. “ABA is the only field of medicine I’ve experienced where the main caregiving practitioner is often undertrained relative to the need and leaves the field within six to 12 months,” he said. Addressing this issue is critical to ensuring a sustainable workforce in the long term.
Both Cortica and Gracent are working to address these workforce challenges by investing in staff training, retention strategies, and organizational support. At Cortica, BCBAs and RBTs work in collaboration with other clinicians, which helps to reduce individual workloads and ensures that care is provided in a more coordinated and manageable way. By embracing a multidisciplinary care model, the company helps prevent burnout and ensures that RBTs and BCBAs have the support they need to succeed, all within the broader context of holistic autism care.
Gracent, on the other hand, is making significant investments in leadership development and training for both clinicians and business leaders. Many clinicians who transition into leadership roles lack experience in managing teams or running a business. To address this, Gracent is equipping its leadership team with the skills necessary to manage a multidisciplinary organization, fostering a culture of collaboration and effective decision-making throughout the company. This support helps create a sustainable workforce, which is essential for providing holistic autism care at scale.
The Road Ahead: Embracing Change and Innovation
The future of the autism therapy industry is one of transformation, with a clear shift toward holistic, integrated care. As private equity-backed companies and larger providers drive industry consolidation, the focus will no longer be solely on ABA therapy. Instead, it will encompass a more comprehensive, multidisciplinary approach to treating the whole child. This evolution is necessary to meet the diverse and complex needs of children with autism and their families.
In addition to embracing holistic autism care models, the industry will also need to focus on improving care quality and ensuring that services provide value to both families and payers. The increasing emphasis on value-based care and the collaboration between providers and payers will help shape the future of autism therapy.
Finally, addressing workforce challenges will be crucial to the long-term sustainability of the industry. By investing in training, leadership development, and staff retention, autism therapy providers can ensure that they have the right people in place to deliver high-quality care and support the growing demand for services.
The autism therapy industry is entering an exciting new phase, one that promises better care, better outcomes, and a brighter future for children with autism and their families. Those companies that can adapt to these changes and implement holistic autism care will be well-positioned to lead the way in the next chapter of autism therapy.
