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Mary H. is a mother of three boys living with her family in Georgia. Her middle son, Jack, was diagnosed with autism at age three. Despite getting Jack into an early intervention program, the wait list for behavior therapy — as for most families in Georgia and across the country — stretched to more than a year. With his behavior impeding his speech and occupational therapy, the family had run out of options.

Unfortunately, Mary’s story is all too familiar for the millions of Americans living with autism today. For many, even if they can get through a months-long waitlist, the nearest therapy center might be miles or hours away and then only open between 9am and 5pm — an impossibility for working families. They are all too familiar with the repercussions of our country’s losing battle with autism.

With one in every 36 children being diagnosed with autism, it is the fastest growing developmental disability in the United States. While there is much discussion about the cause of this unwelcome explosion, the often ignored takeaway is that it has caught the healthcare industry flat footed and families and children are stuck looking for support.

An urgent shortage of clinicians to both diagnose autism and deliver applied behavior analysis (ABA) therapy — what some insurers call the “evidence-based gold standard for treatment” — as well as payor uncertainty about how to administer payments for treatment have all resulted in a logjam for access and treatment. And right now, the industry profiting most from this logjam is the same one that is responsible for perpetuating it: private equity.

Inspired by the combination of an urgent need, limited resources, and a chokepoint for diagnosis, private equity has become the dominant player in autism services, having completed 85% of the mergers and acquisitions in the space between 2017 and 2022 — the highest rate in any segment. As evidenced by a scathing new Senate report on private equity’s role in healthcare overall, we know this is an unhealthy equilibrium that seems to be tipping increasingly in the wrong direction. There is no incentive for these investors to dilute their product by making therapy easier and cheaper to obtain for millions more Americans.

Instead, by limiting access to therapy and then staffing centers with minimally trained, usually high school graduate level Registered Behavior Technicians (RBTs), they are locking families into dozens of hours or days of weekly therapy just to eke out de minimis results. Highly trained supervisors are burning out and leaving their jobs in droves. And a standardized treatment model designed by investors to handle large volumes of cases is poorly suited for the individualized needs of autism patients. The fallout has been obvious. An Eastern Michigan University study found that more than 75% of families with autism are waiting five months or longer for their first service, while our own studies show more than 50% of patients wait more than nine months. This lack of support and access is even more pronounced in poor and underserved communities.

We cannot simply accept this status quo and leave an entire generation of children unsupported when more viable options are available. The good news is that the needle is moving. New ABA models are actively proving that virtual therapy can be just as effective — if not more efficient — than traditional, in-person therapy. What took months to achieve in-person can be done in much less time and with overwhelming levels of patient and family satisfaction