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What Policymakers Should Know About Access to ABA Therapy

Applied behavior analysis (ABA therapy) has been used as an effective treatment method for supporting children with autism spectrum disorder (ASD) for decades now. In fact, it’s considered the gold standard treatment option for children on the autism spectrum.

Yet, despite its widely-recognized benefits, access to ABA therapy is unequal throughout the country. Due to a variety of factors, not every family with a child with autism has access to ABA therapy.

That’s why it’s important for policymakers to do all they can to improve access to this much-needed therapy, so all children with ASD can be supported equally, regardless of where they live or their income level.

In this article, we’ll discuss some things policymakers should know about access to ABA therapy.

Key Takeaways
ABA therapy access is strongest in urban and affluent regions.
Rural and underserved communities face major access issues.
There is a national shortage of BCBAs, limiting availability.
Insurance mandates vary by state and often fall short.
Telehealth and policy reform can help bridge the access gap.

Table Of Contents

Access is Strongest in Metropolitan and Affluent Areas

Access to ABA therapy is strongest in both metropolitan counties and those that are on the more affluent end of the financial spectrum. One study found that there are many reasons for this, but it’s fueled in large part by the fact that that is where Board Certified Behavior Analysts (BCBAs) can be found in the largest concentration.

What this means is that families who live in close proximity to a major city, and who live in an affluent area, are much more likely to have ready access to ABA therapy services for their child.

Another study pointed out that more than half of counties throughout the country don’t even have one BCBA located in their county.

There has been a major shortage of BCBAs for years now, as the demand for services has outpaced the number of people who can provide those services.

In 2023, for example, there were 65,300 job postings looking to hire a BCBA. That same year, there were only 66,300 individuals who had BCBA credentials throughout the country.

This data shows that if every BCBA wanted to switch their job that year, they could’ve done so — and there still would be significant gaps.

Policymakers need to recognize this huge demand for BCBAs and ABA therapy clinics, and do everything they can to raise awareness about it as well as incentivize more people to get into the field.

Section Details
Introduction ABA therapy is recognized as the gold standard for treating children with autism, but access is inconsistent across the country.
Access Disparity Access is best in metropolitan and affluent areas due to the higher concentration of BCBAs. Rural and lower-income areas are underserved.
BCBA Shortage There is a national shortage of BCBAs, with job demand nearly equaling the total number of credentialed professionals in 2023.
Insurance Coverage Though progress has been made, gaps remain in coverage, with many policies exempt and coverage caps limiting access for some families.
Inclusivity Challenges Barriers include geography, finances, and cultural competency. Solutions include telehealth, integrating public and private services, and inclusive BCBA training.
Blue Gems ABA Advocates for increased access and awareness of ABA therapy and autism services across all communities.

Access Depends a Lot on Insurance Coverage

States have done a good job in recent years in mandating insurance coverage for autism-related services. This is extremely important, as ABA therapy services are quite intensive and, as a result, can become expensive to pay out of pocket.

However, more can still be done.

In some states, there are many insurance policies that are exempt from the law. In addition, some states put fairly low caps on coverage amount or hours — leaving many families to either shoulder the financial burden themselves or bypass the services altogether.

Policymakers should seek to address these gaps in coverage across types of insurance as well as increase coverage as much as possible. They should also seek to expand autism-related coverage to adults with ASD, as many of these mandates only cover individuals until they become an adult.

Access isn’t Always Inclusive

There are many barriers to access to ABA therapy, including geographical and financial. This often creates a situation where ABA therapy access isn’t always inclusive.

There are a few ways this can be addressed.

First, telehealth services can be included in insurance coverage for autism-related services, as it would break down the barriers of geographical limitations. This would allow children with ASD to get the services they need, no matter where they are located.

Second, policymakers can help to bridge the divide between ABA services funded by insurance coverage and those provided by public school systems. This would ensure seamless ABA therapy access, no matter where the child is during the day.

The latter would also help to support many underserved communities, where families might not have the means to either stay home with their child all day for in-home ABA therapy services, or transport them back and forth to an ABA therapy clinic.

It’s also vitally important that BCBAs get training on cultural competency, so that the services they provide are inclusive to all patients, regardless of who they are and where they come from.

Blue Gems ABA Advocates for Increased Access to ABA Therapy

ABA therapy has proven to be the best treatment option for children on the autism spectrum. Yet, access to ABA therapy is unequal throughout the country.

At Blue Gems ABA, we are active advocates for increased access to ABA therapy, as well as awareness of and support for autism-related services in general.

To learn more, please contact us today.

FAQs Answers
Why is access to ABA therapy unequal? Access varies due to location, income, BCBA availability, and insurance coverage disparities.
What can policymakers do to improve access? Expand insurance mandates, support BCBA workforce development, promote telehealth, and bridge school-clinic gaps.
How many counties lack a BCBA? More than half of U.S. counties do not have even one Board Certified Behavior Analyst.
Is telehealth a viable solution? Yes, it can reduce geographic barriers and extend ABA services to underserved areas.
How is Blue Gems ABA involved? They advocate for broader access and support policy improvements for equitable ABA therapy availability.