# How Profit-Seeking Autism Clinics Can Harm Kids
The autism therapy industry is growing rapidly, but financial incentives are driving treatment decisions in ways that can hurt children. Health reporter Sarah Kliff and economist Margot Sanger-Katz investigated this trend for the New York Times, uncovering how profit motives shape clinical practices at expanding therapy centers.
Applied Behavior Analysis, or ABA, dominates autism treatment. ABA clinics provide intensive therapy designed to modify behavior, often requiring 20 to 40 hours weekly. The problem emerges when centers prioritize revenue over individual child needs. Clinicians may recommend more intensive hours than clinically justified, extending treatment length beyond what evidence supports, simply because longer treatment generates more billable hours.
Insurance coverage for autism services has expanded, creating a lucrative market. This draws new providers with limited expertise into the field. Some operate high-volume clinics where children receive care from undertrained staff rather than experienced behavior analysts. Turnover runs high, disrupting the continuity children need.
The research highlights how payment structures incentivize quantity over quality. Centers earning per-hour fees have built-in motivation to increase hours rather than focus on measurable progress toward independence. Some families report their children made limited gains despite years of intensive therapy at high cost.
The investigation found that children sometimes receive excessive therapy without clear clinical justification. Others never receive the formal assessment needed to determine whether ABA fits their specific profile and needs. Vulnerable families, desperate for help and trusting clinical recommendations, often cannot evaluate whether the proposed treatment plan serves their child's actual interests.
Experienced practitioners emphasize that effective ABA requires individualized assessment, qualified staff, and periodic review of whether intensive hours remain necessary. As the field expands, quality control becomes harder. Parents face pressure to accept recommendations from profit-driven centers without independent verification of what