One-fourth of children treated at autism therapy clinics spend nearly eight hours a day in therapy, according to a recent investigation by The New York Times.
Here are five things to know:
- All state Medicaid programs are required to pay for the treatment. Medicaid spending on autism therapy has surged in several states in recent years. In Colorado, Medicaid spent more on autism therapy for children last year than on emergency room care for all patients, according to the Times.
- Applied behavior analysis therapy uses rewards to reinforce desired behaviors. The therapy gained traction after a 1980s study involving 38 preschoolers reported improved behavior and communication skills among children receiving 40 hours of therapy per week. Subsequent research has produced mixed results.
- The investigation found some clinics prescribe 25 or even 40 hours of therapy each week for young children. Average daily appointments also have increased over time, according to Medicaid data analyzed by Trilliant Health.
- Many behavioral health clinics do not require state licensure, exempting them from routine inspections common for daycare facilities. The report cited cases in Texas and North Carolina involving alleged abuse of children at clinics.
- Federal Medicaid rules require coverage of autism therapy, limiting states’ ability to impose restrictions without legal risk. Some states, including North Carolina, have begun implementing policies aimed at controlling spending growth, according to the report. The Trump administration has not provided official guidance on the restrictions it recommends.
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