Christopher Weaver, Tom McGinty and Anna Wilde Mathews:
Autism diagnoses among 8-year-olds climbed to one in 31 by 2022, from one in 150 in 2000, driving rapid growth in the therapy industry. In 2023, state Medicaid programs paid an average of $61 an hour for therapy services, according to the Journal’s analysis. Those services are often provided by high-school-educated workers earning less than $20 an hour, employees say.
While individual treatment varies, the therapy can include teaching young children to follow directions, practicing chores like folding laundry or learning communication skills, and is mostly administered by registered behavior technicians, the lower-wage workers. More highly trained behavior analysts, typically with master’s degrees, oversee the therapy.
The Journal’s analysis examined providers’ payments per patient as well as the overall number of hours billed per patient. Many providers nationwide billed a high number of hours of therapy for nearly every patient, the Journal found. Experts say that therapy plans should be tailored to individual children’s needs, and thus the number of hours should vary.
Mendy Minjarez, a University of Washington psychologist who oversees an autism treatment program for Medicaid patients at Seattle Children’s Hospital, said she never recommends 40-hour weeks, the most many states will cover. “It’s a very, very rare situation” where a child needs full-time therapy in a clinic, she said.