The autism therapy industry is at a crossroads — facing challenges that, while daunting, are pushing the field toward a higher standard of quality and client-centered care. As organizations adapt to stagnant reimbursement rates, workforce shortages, and evolving public discourse, the future of autism therapy is set to look dramatically different — and better — than ever before.
One of the most significant shifts impacting the future of autism therapy is the growing conversation around Applied Behavior Analysis (ABA), the industry’s primary mode of treatment. While ABA has helped many individuals on the spectrum, a small but vocal movement has criticized its methods, pushing the industry to rethink and refine its practices. Today, greater sensitivity to the perspectives of autistic individuals and their families is becoming the norm rather than the exception.
Mark Shalvarjian, CEO of Gracent, sees this shift as a major positive force. “I think it’s going to be the big theme of 2024,” he told Autism Business News. “It’s something we’re all going to start focusing on a lot more intently than we have over the past decade or more.” According to Shalvarjian, the future of autism therapy will be rooted in listening to clients and building services around their real, lived experiences — not just around clinical models.
Listening and Evolving
Gracent itself exemplifies the new wave of care emerging in the future of autism therapy. Spun out of a defunct behavioral health asset in 2022, Gracent today provides ABA, speech therapy, occupational therapy, and neuropsychology services through its Pine Cone Therapies clinics in Texas and North Shore Pediatric Therapy locations in Chicagoland. With steady organic growth and new clinics opening this summer, Gracent is positioning itself for long-term success — by putting children and families first.
As Shalvarjian notes, “There was a real rush into the sector to meet unmet demand. Now, there’s a shift toward quality — how we measure it and how we ensure real outcomes for kids.” This growing emphasis on quality over quantity will define the future of autism therapy, demanding that providers not only deliver services but also continually improve them based on feedback and results.
Industry Headwinds and Opportunities
Despite optimism, the road ahead is not without obstacles. Flat reimbursement rates, soaring labor costs, and fierce competition for Board Certified Behavior Analysts (BCBAs) continue to make the business of autism therapy difficult. The labor market remains “intensely competitive,” Shalvarjian said, and it may take several years for supply and demand to balance out.
Still, these structural challenges could accelerate positive changes. Dealmaking in 2024 is expected to be slow, but consolidation among smaller providers might create stronger, more sustainable networks. In this way, even financial pressures could help usher in a better, more resilient future of autism therapy.
Importantly, Gracent is approaching growth with a partnership mindset — aiming to join forces with clinicians rather than simply absorbing their practices. Clinicians who partner with Gracent retain ownership stakes and have a true voice in shaping the organization’s future. It’s a model Shalvarjian has successfully used for decades in healthcare and believes is sorely needed as part of the future of autism therapy.
Moving Beyond ABA Alone
Another major development shaping the future of autism therapy is the broadening of service offerings beyond just ABA. Gracent, for example, views itself not as an ABA company, but as a pediatric therapy provider that supports children with a wide range of services — from speech-language therapy to mental health care.
This holistic approach reflects the reality that autism is complex and multifaceted; one-size-fits-all solutions are no longer acceptable. As more organizations follow this lead, the future of autism therapy will likely be more interdisciplinary, coordinated, and genuinely responsive to each child’s unique needs.
Toward Value-Based Care
Conversations around value-based care are also gaining traction. While there is no industry-wide consensus yet on how to define “value” in autism therapy, one promising indicator is the focus on parent training and support. Helping families better understand and assist their children may soon become a standard metric of quality, further solidifying the client-centered shift in the future of autism therapy.
Shalvarjian remains optimistic that, eventually, insurance payers will reward higher-quality providers with better reimbursement rates, encouraging best practices across the board. “Over time, we’re going to see an increasing level of quality across the sector,” he said. “There’s probably some variability now, but I think some of that variability is going to come out of the system.”
A Long-Term View
Ultimately, real change won’t happen overnight. “If you’re in it for two years, forget about it,” Shalvarjian cautions. The future of autism therapy will reward organizations that are committed to a long-term vision of excellence — companies willing to invest in better training, better services, and better outcomes for their clients.
By tuning in to the voices of autistic people and their families, adapting to financial realities, and focusing relentlessly on quality, today’s providers have a unique opportunity to reshape the future of autism therapy for the better. And while the path ahead may not be easy, it is certainly full of promise.
