Autism rates in the U.S. have risen dramatically over the past decade, creating substantial pressures for service providers. According to the CDC, about 1 in 44 children are now identified with autism spectrum disorder (ASD), up from 1 in 69 children in 2012. In addition, there are more than 5.4 million adults living with autism. This surge has highlighted one of the most pressing issues in the field: autism workforce challenges.
Applied Behavioral Analysis (ABA) is the gold standard for autism treatment, providing one-on-one therapy to improve specific behaviors. Yet access to ABA services is limited due to a shortage of skilled professionals. Currently, only 58,345 board-certified behavioral health analysts (BCBAs) exist nationwide, leaving many states far below the recommended per capita supply. As Kathleen Bailey Stengel, CEO of NeurAbilities Healthcare, stated at the Behavioral Health Business INVEST conference: “We don’t have enough skilled clinicians, [or] licensed or certified clinicians. There are just simply not enough currently. So as a workforce, we have to actually develop them within our company. We have to train them up, we have to invest in them.” This statement underscores the reality of autism workforce challenges.
Building the Workforce From Within
To address these shortages, providers are focusing on internal development and training. NeurAbilities Healthcare, based in Voorhees, New Jersey, operates 17 centers across New Jersey and Pennsylvania. They emphasize developing clinicians from within through structured programs and professional development initiatives.
Many providers now offer registered behavioral health technician (RBT) training programs. These programs provide hands-on experience while creating clear pathways for career growth. University partnerships and continuing education opportunities also help staff remain up-to-date on best practices. Doug Moes, chief clinical development officer at The Stepping Stones Group, emphasized the importance of the first 60 days of employment for long-term retention. “During this time, it’s essential to keep employees engaged through training and immerse them in the culture of a practice,” Moes said. These strategies are crucial to tackling autism workforce challenges head-on.
Compensation and Financial Considerations
Financial incentives are another critical factor in addressing autism workforce challenges. Staff members often expect annual raises, but reimbursement rates from payers are slow to match salary growth. To bridge the gap, providers negotiate with payers and leverage outcomes data to justify rate increases.
Private equity investment has further shaped the field. In 2022 alone, there were 46 deals in the autism sub-sector, a 15% increase from the previous year, according to the Braff Group. John Hennegan, a partner at Shore Capital Partners, explained: “More and more investors got into the space and said, ‘Wait, as long as we control the BCBAs, the clients will follow.’ And so we’ve seen rampant wage inflation.” This financial influx helps providers increase salaries and retain skilled staff, mitigating autism workforce challenges caused by the labor shortage.
Technology as a Workforce Solution
Technology is helping providers address autism workforce challenges by optimizing operations and training. Digital platforms can streamline administrative work, such as scheduling or tracking employee performance, freeing clinicians to focus on care delivery.
Doug Moes shared that Stepping Stones built a learning management system to evaluate employee competencies and support career progression. Virtual reality (VR) and AI-powered tools also enhance training, simulate real-life scenarios, and expand access to care. Stengel highlighted that younger employees expect easy-to-use technology: “They grew up on technology…They want things to be easy, so you have to make it easy for them.”
By integrating technology, providers can optimize clinician deployment, matching staff skill sets to client needs, which is key to addressing ongoing autism workforce challenges.
Preparing for the Future
As autism prevalence continues to rise, providers must continue tackling autism workforce challenges with comprehensive strategies. Investing in staff development, competitive compensation, and advanced technology solutions are critical to building a sustainable workforce.
Organizations like NeurAbilities Healthcare and Stepping Stones exemplify best practices, combining training, tech, and strategic financial planning to ensure high-quality care. Addressing autism workforce challenges today is essential for meeting the needs of children and adults with autism tomorrow.
