It is no secret that there have been significant increases in the development of autism among children in the U.S. over the past three decades. The U.S. Centers for Disease Control and Prevention (CDC) acknowledges that, today, at least one in 44 eight-year-old children have been diagnosed with Autism Spectrum Disorder (ASD)1 and some autism prevalence estimates are higher.2 In addition to the high costs to families raising children with autism,3 the autism epidemic is becoming a big business opportunity for corporations.
About 10 years ago, states began mandating that insurance companies pay for Applied Behavioral Analysis (ABA) therapy for children diagnosed with ASD. This led to a boom in ABA service across the country,4 and insurance companies were forced to cover the cost of ABA therapy because it is the only treatment option that is government approved for doctors to prescribe and treat children with autism.5 For some families, ABA therapy is the only way their autistic children will receive any type of treatment.6
ABA focuses on behavior modification by rewarding certain “good” behaviors and punishing “bad” behaviors with the hope that behaviors will change over time. This type of behavioral modification can only be taught by professionals trained in the ABA technique.
The Demand for Applied Behavioral Analysis Therapy is Growing
The profit to be made in the ABA therapy market has been realized by private equity firms as they began investing in and buying up ABA centers across the country in recent years. In 2017, Coker Capital Advisors projected that community-based ABA providers could earn $10 billion and school-based providers could earn $7 billion in annual revenue.7 In 2018, the Center for Autism and Related Disorders was acquired by Blackstone for approximately $700 million and, in 2019, Rothschild acquired New England ABA.
In 2019, Patrick Krause, co-head of health care services for MHT Partners, a private equity firm in Dallas, said:
The market is incredibly robust. You have an expanding [autism] demographic population, you have commercial insurance lined up to cover it and there are not a lot of [providers] doing it on a large scale. It checks all the boxes you would expect for private equity being interested in it.8
Michael Maloney, president and CEO of Learn Behavioral, an ABA provider purchased by the private equity group LLR Partners in 2016, estimated that ABA therapy generates between $15 and $80 billion dollars each year based on estimated by the CDC.9
In 2019, TPG Capital, a Fort Worth- and San Francisco-based private equity firm committed $300 million of equity capital to Kadiant, a company offering ABA and related therapy to children with ASD.10 Katherine Wood of TPG Capital said:
Despite growing awareness of the need for autism services, many living with ASD still do not have easy access to high-quality, specialized care. With Kadiant, we hope to positively impact this imbalance by building an organization focused on providing clinical and operational excellence at scale.11
Does Private Equity Funding Help or Hurt Children with ASD?
Many parents find fault with the ABA model of therapy, especially after so many private equity firms have heavily invested in the field. Complaints about private equity backed ABA therapy point to the poor quality of treatment, including therapists using cookie-cutter templates to treat all children regardless of ability; demanding children engage in more and more hours of therapy; high turn-over rate of therapists, and ABA provider shortages.12
Some ABA providers disagree with the critics claiming that they personally make decisions about how many hours of therapy a child needs, not private equity firms, and that each child’s care is individualized.13
ABA therapy is supposed to conduct an assessment before the start of therapy to determine each individual child’s needs, abilities and goals. However, whistleblowers in the industry argue that the therapy centers funded by private equity firms skip these assessments and use the same treatment plans and goals with multiple children, regardless of a individual child’s ability. The maximum number of hours are being pushed on these children by private equity firm owners without considering other aspects of the child’s life, such as other types of therapy, school and family life. ABA providers have been caught submitting more treatment hours than there are in a day—in one case logging in 65 hours in a day—which prompted a federal watchdog agency to take notice.14
Eric Larsson, executive director of clinical services for Lovaas Institute Midwest, an ABA center that is not funded by private equity, emphasized the importance of individualized care when he said:
You can’t just walk in and hand people a book and say, ‘This is what we’re doing this week,’ because you’re going to totally miss the point of what this individual child and the parents need.15
As the private equity industry takes over the ABA market, the industry has seen a high ABA provider turn-over rate, which has a negative effect on children with ASD who depend upon and thrive with consistency. ABA therapists are not required to have extensive schooling or training. The only requirement is that they be at least 18 years old, have a high school diploma, undergo 40 hours of training and pass a test in order to administer ABA therapy.16
“This is like a full-time job for a young child. It’s shocking to me that without any science, 40 hours per week has become the standard in some places,” said Zoe Gross, director of advocacy for the nonprofit Autistic Self Advocacy Network.17
Other parents have a different view and are grateful that private equity firms have made it possible for ABA programs to be expanded and offered in many more locations. Without the funding, they would not be able to obtain ABA services for their children.18
Thomas Frazier of Autism Speaks offered a more optimistic point of view about private equity firms financially investing in ABA services. He said:
This is not necessarily a bad thing that private equity is getting involved. If we can standardize things, private equity may bring in the financing that allows us to expand. If we do things right, we could actually create a market that serves individuals and families better.19
Abuse Allegations Against Private Equity Backed ABA Center
Hopebridge is one example of an ABA center that was able to expand into other states and open a number of new clinics with a sizable investment from Baird Capital in 2018. Dennis May, chief executive director of Hopebridge, explained that the company is managing its growth responsibility and is keeping its standards consistent using uniform training and technology. He said:
It’s a capital infusion that’s allowed us to grow our staff, our number of clinics and also our clinical expertise. They’ve got a wealth of experience about previous health care companies that have gone through growth. We’re able to draw on their experience and expertise as we think about company infrastructure investments.20
In 2019, Hopebridge was taken over by the private equity firm Arsenol Capital Partners for a reported investment of between $100-500 million, giving the ABA therapy center a valuation reported to be at $255 million.21
In January 2022, Hopebridge had over 100 locations—up from 17 in 2018—and approximately 5,000 employees in 12 states. The corporation plans to expand again and open 40 new clinics nationwide in 2022 fueled by an investment from Arsenal Capital Partners.22 By August, however, the growing ABA provider faced allegations of abusive and unethical behavior. An investigate reporter uncovered allegations from employees, former employees and parents of abuse; high turnover of an ill-trained staff; lack of transparency and accountability ,and putting profit over providing services to autistic children.23
Kim Strunk, founder of Hopebridge denied the recent allegations…
We take all reports seriously and have zero tolerance for any abuse. We understand that every question and concern comes from a place of deep caring. However, we were unable to substantiate any of the [claims] through two independent investigations into the allegations in Athens, Georgia.24
Private equity firm’s investment in ABA therapy over the past decade has proven lucrative with some private equity firms realizing gains of 10-15 times the amount of their initial investment when exiting within five years. As of the 2020, 55 private equity firms had invested in ABA learning centers with 20 ABA companies developed. Of the 23 for profit large ABA companies (1,000-5,000 employees), more than 50 percent are either owned by or received investments from a private equity firm.25
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Click here to view References:
1 U.S. Centers for Disease Control and Prevention. Autism and Developmental Disabilities Monitoring (ADDM) Network. National Center on Birth Defects and Developmental Disabilities Mar. 31, 2022.
2 Cáceres M. Autism Rate Now 1 in 30 Among American Children. The Vaccine Reaction July 10, 2022.
3 Blaxill M, Rogers T, Nevison C. Autism Tsunami: the Impact of Rising Prevalence on the Societal Cost of Autism in the United States. Journal of Autism and Developmental Disorders 2022; 52: 2627-2643.
4 Summers J. As private Equity Comes to Dominate Autism Services… The Nation Apr. 2, 2021.
6 Bannow T. Parents and clinicians say private equity’s profit fixation is short-changing kids with autism. STAT Aug. 15, 2022.
7 Perkes C. As Demand For ABA Therapy Increases, Investors Buy In. Disability Scoop Oct. 23, 2018.
8 Pixabay C. PE Interest in Autism Booms Amid Increased Diagnoses, Insurance Coverage. Behavioral Health Business Dec. 2, 2019.
9 Furfaro H. Optimism greets investors’ sudden interest in autism therapy. Spectrum News July 9, 2018.
10 Fort Worth, SF private equity firm partners for autism therapy organization. Fort Worth Business Feb. 1, 2019.
12 Bannow T. Parents and clinicians say private equity’s profit fixation is short-changing kids with autism. STAT Aug. 15, 2022.
19 Perkes C. As Demand For ABA Therapy Increases, Investors Buy In. Disability Scoop Oct. 23, 2018.
21 Larson C. PE Firms Take Note of Increasing Demand for Autism Services. Behavioral Health Business June 22, 2022.
22 Coward K. Hopebridge Continues to Ramp Up Growth, Plans to Add 40 New Clinics in 2022. Behavioral Health Business Jan. 27, 2022
23 Matthew J. A new investigation throws private equity’s foothold in the autism services industry into question. Fortune Aug. 8, 2022.
24 Smead M. New Survey Questions The Entrenchment Of Private Equity In The Autism Services Industry. Ocupario Aug. 26, 2022.
25 Private Equity in Autism Services: Big Money in Applied Behavior Analysis (ABA) and the Effect on Ethical Practitioners and Client Outcomes. Business Insider Feb. 27, 2020.
Great article and this dovetails well.
AUGUST 21, 2020 Autism—The Most Glaring Aspect of the Deterioration of Health Among Our Kids?
The numbers: We’ve watched the numbers explode with no end in sight. Over the last 20 years the Centers for Disease Control and Prevention have routinely updated the autism rate: 2001: one in 250
2004: one in 166
2007: one in 150
2009: one in 110
2012: one in 88
2014: one in 68
2018: one in 59
2020: one in 54
What an absolute nightmare.
This shift for Human Capital Markets has been a powerful undercurrent gaining momentum for decades, as explained by Alison McDowell on her YT channel and blog wrenchinthegears dot com.
First US HCM was Riker’s Island in 2012 (Goldman Sachs). Prisoners first guinea pigs for radical behavioral HCM re-training via continuous monitoring and “geofencing”. Then some inner city schools. Next is health care. Involves expanding privatization (P3). Tied to your energy credits, rationing, and a China-style social credit system on steroids.
Money hungry vultures profiting from invented diseases. That is now the standard medical system ruse funded by the greedy and arrogant haters of humanity.
Excerpt these are Not imaginary disorders….we have a child created with autism from experimental vax given to him as a newborn..in 1996…which caused the brain damage that became known as Autism..only because it was the closest malady the medical world had seen to compare it too…by behaviors of the child affected …and…they had no idea that they played a part in this by trusting the drug organizations and the Federal health control agents who payed them or the nurses to coerce new Moms into getting their babies vaxed before they left hospital. This brain damage by experimental vax has been going on since 1988 and mostly buried by the CDC. I’ve also been to many huge gatherings of parents and other relatives of children who were also afflicted.,to try to hear some hope news in therapies for their children. It’s Real and is Still going on. Our bkessed governmental health agencies have been doing live experiments with new vax for decades..in foreign nations too…paying those governments huge sums of money for letting Our medical system Use their poor peoples children and women for those experiments. Wake up and smell the rot in this system…and it didn’t just begin in todays time. Regards, Grandma Peg.
I appreciate the NVIC as a source for credible information on vaccine safety. However, I’m embarrassed to refer friends and relatives to your site because the comment section is full of MAGA extremists spreading preposterous mischaracterizations and conspiracy theories. Please disable comments or at least filter out the crazies. Thank you.
Please..do read the above comment from me Grandma Peg. It’s not crazies posting…it’s crazies who refuse to find and see the truth…and I’ve been there, done that since my grandson was afflicted as a newborn given experimental vax that was meant for sexually active adults …and they are from All political,parties nit just the MAGA of today…..don’t be blind to this sci fi kind of scenario going on to reduce our population of available males for future military by brain damage and abortion…to reduce populations needed for your future….
I have had the same concern about those who post on this platform with a political agenda in mind, and have replied to a few to leave their political views and rants for their private social media, not this forum. I thank you for reiterating the message.
The autism treatment industry has legs, it’s walking on it’s own now, in a well dressed suit. While a substantial portion of the people whom honestly care are instead drawn to activist groups whom highlight there is no such thing as a safe vaccine, advocating for informed consent and far far better product safety standards. Sadly, our group will now also have to contend with private equity firms whom have a financial stake in silencing our messages and diminishing our impact. Irregardless, we will never stop advocating for informed consent, never.
I recently pointed new parents to be towards informed consent. I think the main issue was that their baby was only a few weeks from delivery. I think new parents need a good year to digest all the information and really feel comfortable making the decision to vaccinate or not. After about a year and a half of reading and discussing, I’m comfortable with my decision to never vaccinate for anything, my child included, ever again…
I haven’t had much luck with ABA in Eastern NC. I can’t see doing a minimum of 20 hours a week when my son spends all day in school. I would rather work with someone with lots of knowledge in the GAPS diet. I’m hoping he will respond to an improvement to his immune health through diet. Why isn’t this type of treatment approved? I have the book by Dr. Natasha Camble-McBride, Gut and Physiology Sybdrome. Does anyone have any other recommendations? … Thanks
We found a nutritionist that was not only a GAPS certified practitioner but also certified in Nutrition Response Testing. She took out the guess work of what foods to introduce when. She was also key in detoxing from a vaccine like reaction. The combination totally worked for us. Love the GAPS diet for healing gut and body. Best of luck!
Hi Mark, I have asperger’s and lifelong intestinal problems (I had oral thrush at birth and my mom had Crohnes and IBD). I finally found the diet that helped me; a combination of GAPS, FODMAP, and the anti-histamine diet. Meat, saturated fats, and a cross-referenced list of carbohydrates. They’re very restrictive but foods can be tolerance tested and added as the diets allow. It would have saved me years of searching and experimentation if I knew about these three diets sooner.
Kids with autism need to get detoxed. The culprit here is mercury. It was mercury and it still is mercury. People have gotten distracted about aluminum. Aluminum wouldn’t figure unless there was an underlying mercury problem.
The best way to detox mercury is the Andy Cutler ‘half -life” protocol. Every child is different and it takes years of personalized attention and care. Other therapies may be appropriate in order to make up for developmental stages that got missed because of the toxicity.
There is no money to be made detoxing children. It is far too complicated and probably only a parent will have the faith and devotion to do it.
Hi Rebecca. Thank you for the information, Could you post a bit more references for those who would like to learn more about these?
Were you aware of genetic testing? Autism is correlated with MTHFR defects, and those gene defects have to do with metabolizing B12 and B9, which detox the body of the poisons you mentioned. I got my test at MaxGenLabs.
Read Imagine You Are An Aluminum Atom by Dr Christopher Exley for his data on the significant danger of the high-dose aluminum adjuvants in vaxes. It is not all about mercury.
Healthcare of all kinds, done for profit, is a huge and expanding problem, of course.
But an even more fundamental issue is the allopathic medical model of treatment: find and treat the PROXIMATE cause of the disorder (the officially-labeled one). So often, and maybe most often, the ROOT cause of the disorder is not even sought, let alone treated. I’m only peripherally aware of successful treatments for autism, but gut health through establishing or restoring a healthy gut microbiome is one that I’ve seen multiple recommendations for.
But before and above all, emphasize PREVENTION, starting with NO MANDATORY VACCINES.
it is pretty obvious why this is happening. today, children are getting so many shots in the first few years of their lives, it is affecting their bodies in a negative way.
if you look back in time, when you only got measles, mumps and rubella shots, autism
was very rare.
so, not only are these places making money on kids who have been wounded by too many things being pumped into their bodies, doctors and drug companies are to blame as well as they promote and prescribe all this garbage to be shot into babies.
Maybe if we reduced the number of childhood vaccines and banned the use of glyphosate, we would stop the Autism pandemic. Check out Stephanie Seneff PhD’s work.
I’m not sure where you got your stats from Brian James, but if you graph it out, it is right now about 1 in 8 kids have some form of autism. I have been a Dr. for over 40 years and have seen the rise in autism as the number of injections are given.
I think you need to do more research. Not all incidences have been recorded the correct way.
There is so much more information that indicates the damage all these injections are giving children. Allergies are another, ever notice how many children have peanut allergies? Childhood diabetes as well as a number of other health issues.
I’ve seen it happening all along. I do not push shots on any newborns besides the basic ones.
Many of them are not needed and can be dangerous to the child’s health.
This makes me sick to my stomach. First, render the children permanently disabled with vaccines, then come to the rescue with the money-generating “cure”.
Also, I had to laugh when I read that prescribed treatment hours per day for these abused children may exceed 24, and then I laughed harder when reading that this absurdity “prompted a federal watchdog agency to take notice”. I feel so much safer now.
A critical point to consider is Private Equity Firms & Venture Capitalists & investment bankers & all sorts of rich filthies are taking over enough of companies, to control and even redirect them.
… “A group of 19 Republican Attorneys General led by Arizona Attorney General Mark Brnovich and Nebraska Attorney General Doug Peterson have threatened the $10 trillion hedge fund BlackRock with antitrust legal action in an Aug. 4 letter to BlackRock CEO Larry Fink accusing the company of “intentionally restrain[ing] and harm[ing] the competitiveness of the energy markets” with its market dominance of retirement investments. ….”
It’s about Wealth, Never Health.
You can argue it’s capitalism, yet when few hands control massive wealth, it can degrade the very system—notice the immense corruption in government, and certainly mid-manager control of colleges, small providers, doctors’ hospitals, public-school superintendents, etc.
_ Even when many investors have votes on where to go, it’s usually towards the fastest profit & highest returns. Quality and history may be thrown aside. The poor may be re-damned.
_ The government-induced virus panics are always to sell more vaccines. Have YOU had “your” bird-flu? Oh, wait, let’s go back to AIDS, now that they can sell an actual vaccine. (And just who is always front and center, to lie and sell it?)
The few (Exec. Branch unelected) cannot shovel far enough, to get over the many (We The Poor People), fast enough. It’s a race to their banks—and hyperinflation.
Because “our” Gov Regulators totally failed America; We can try to go back to trying unions, until THEY re-corrupt. Will YOU live through the next recycle? It’s the REAL reason USA needed far more jails: the foxes in charge of the chicken coop. Or better, execution by mass injections?