Applied Behavior Analysis (ABA) therapy is a widely used behavioral intervention for children with autism spectrum disorder (ASD). Autism diagnoses are on the rise, with current estimates indicating that 1 in 44 children are diagnosed with ASD. As more children are diagnosed, the demand for ABA therapy has dramatically increased as well.
ABA therapy uses techniques based on the science of learning and behavior to build behaviors and skills in children with ASD. ABA therapy is considered the gold standard treatment for autism and is endorsed by the American Academy of Pediatrics. Numerous studies have demonstrated that ABA therapy can improve communication, social skills, attention, behavior, play skills, and more in children with autism.
The rising demand for ABA therapy for autism has led many parents to ask: how much does ABA therapy cost? Unfortunately, there is no one simple answer, as ABA therapy costs can vary significantly based on several factors. This article will break down the costs of ABA therapy and provide tips for obtaining insurance coverage and government assistance to reduce out-of-pocket expenses.
What is ABA Therapy?
Applied Behavior Analysis (ABA) therapy is a scientifically proven intervention for improving behavior and skills in individuals with autism spectrum disorder (ASD). ABA therapy uses principles of learning and motivation to bring about positive changes in behaviors related to communication, social skills, academics, self-care, and more.
The main goal of ABA therapy is to teach new skills and reduce challenging behaviors by systematically reinforcing desired behaviors and discouraging unwanted behaviors. ABA programs are highly customized to each child’s needs, strengths, challenges, interests, and family situations.
ABA therapy sessions involve working directly with the child in a variety of settings to teach and reinforce target skills through structured activities and natural play.
Lessons and techniques are continually adjusted based on data collected on the child’s progress. ABA therapists use strategies like prompting, shaping, modeling, chaining, reinforcement, and task analysis to improve behaviors and teach new repertoire.
While traditional ABA therapy involves up to 40 hours per week of direct, intensive teaching, many providers today offer services ranging from comprehensive to focused/targeted programs. Overall, ABA aims to equip children with skills critical to success in school, relationships, self-care, and beyond.
Proven Benefits of ABA
Applied Behavior Analysis (ABA) therapy is one of the most extensively researched and effective treatments for autism spectrum disorder.
Over the past 50+ years, a substantial body of scientific evidence has demonstrated that ABA can produce meaningful improvements in communication, social skills, behavior challenges, play and leisure skills, school performance, self-care, and more for individuals with autism.
Some key research findings on the benefits of ABA therapy include:
- Multiple independent scientific reviews have concluded that ABA is the gold standard treatment for autism, with proven effectiveness in improving outcomes. For example, the U.S. Surgeon General stated in 1999 that “30 years of research demonstrated the efficacy of applied behavioral methods in reducing inappropriate behavior and in increasing communication, learning, and appropriate social behavior.”
- In a 1987 study published in the journal Behavioral Interventions, 47% of young children with autism who received 40 hours per week of ABA therapy for 2 years acquired normal functioning levels compared to just 2% of the control group.
- A 2009 review of one ABA program by SRI International found that ABA participants demonstrated statistically significant improvements in IQ, communication, daily living skills, social skills, and behavior problems compared to a control group. These gains were maintained at a follow-up assessment.
- Multiple studies have shown ABA to be effective in improving speech and language skills in children with autism. Some double-blind, controlled studies reported up to 50% of nonverbal children developing functional speech after receiving ABA.
- Research supports the use of ABA strategies to reduce disruptive behaviors like tantrums, aggression, and self-injury in individuals with autism. Interventions based on ABA principles have been shown to reduce problem behaviors by 80-90% in some cases.
- There is substantial scientific evidence that early intensive ABA intervention leads to better long-term outcomes for children with autism. The earlier therapy begins and the more intensive it is, the greater the improvements tend to be. Overall, ABA therapy is a highly data-driven and customizable treatment approach that has decades of research demonstrating its effectiveness for individuals with autism. When delivered intensively and early in life, ABA gives children with autism the best chance to reach their full potential.
Factors Affecting ABA Costs
Several key factors impact the overall cost of ABA therapy:
Number of Therapy Hours
The number of therapy hours per week is the biggest driver of overall ABA costs. Most ABA programs recommend 25-40 hours of therapy per week, but some children may start with fewer hours and work up to higher levels. More therapy hours mean higher overall costs, but also faster progress for the child.
Location
ABA therapy costs more in areas with a higher cost of living like major cities. Urban and suburban areas also tend to have more ABA providers, allowing for greater competition and potentially lower rates. In rural areas, there are fewer providers so costs may be higher.
Provider Credentials
The credentials of the ABA therapist impact costs. Board Certified Behavior Analysts (BCBAs) have the highest level of training and can charge more. Registered Behavior Technicians (RBTs) have less training and tend to have lower hourly rates. Some ABA agencies employ therapists with diverse credentials at different rates.
Individual Provider Rates
Within any given geographic area, specific ABA providers will charge different hourly rates based on their credentials, experience, demand, and business overhead costs. Comparing rates between several potential providers is wise to find the best value.
Range of Services
Some ABA providers offer comprehensive programs with therapy, assessments, treatment planning, and progress monitoring. Others provide mainly direct 1-on-1 therapy. More extensive services typically cost more but may be worthwhile for thorough treatment.
Average National Costs
ABA therapy costs can vary widely across the United States. However, national averages provide a general benchmark for comparison. According to the most recent data, the average hourly rate for ABA therapy is $50-150 per hour.
This can translate to $1,000-$3,000 per week if a child receives 25-40 hours of therapy. Over a year, total ABA costs often range from $40,000-$60,000 on average.
Some key factors influencing national averages include:
- Where the therapy is provided – clinic, home, school, etc. In-home ABA is typically more expensive than clinic-based.
- The credentials of the therapist – Board Certified Behavior Analysts (BCBAs) tend to charge higher rates than RBTs.
- Geographic location – ABA costs are higher in major metro areas relative to rural regions.
- The child’s therapy needs – More intensive ABA regimens cost more overall. While national averages provide a useful benchmark, the actual cost for any individual child depends on their specific situation. Working with a provider to understand expected hours, duration and other factors is important for budgeting ABA therapy.
Costs by State
ABA therapy costs can vary significantly depending on which state or region you live in. Here’s a breakdown of average ABA therapy costs by state and region:
Northeast
- New York – $50,000-$80,000 per year
- Massachusetts – $55,000-$85,000 per year
- New Jersey – $40,000-$75,000 per year
- Connecticut – $45,000-$70,000 per year The Northeast region tends to have some of the highest ABA therapy costs in the country due to the high cost of living and demand for ABA services.
Midwest
- Illinois – $30,000-$60,000 per year
- Ohio – $25,000-$50,000 per year
- Michigan – $35,000-$65,000 per year
- Wisconsin – $30,000-$50,000 per year The Midwest region tends to have more affordable ABA therapy costs compared to coastal states. However, costs can still be high in major metropolitan areas.
South
- Florida – $30,000-$50,000 per year
- Texas – $25,000-$45,000 per year
- Georgia – $30,000-$50,000 per year
- North Carolina – $30,000-$55,000 per year The South has relatively affordable ABA therapy costs, although higher demand in states like Florida can increase prices.
West
- California – $40,000-$75,000 per year
- Washington – $35,000-$65,000 per year
- Arizona – $30,000-$60,000 per year
- Colorado – $35,000-$60,000 per year Western states like California tend to have higher ABA therapy costs due to the high cost of living and demand. However, prices vary within states. Where you live is a major factor in ABA therapy costs for autism. Comparing average costs by state and region can help families budget and plan for services.
Insurance Coverage for ABA Therapy
Insurance coverage for ABA therapy can significantly reduce out-of-pocket costs for families. Many private insurance plans and Medicaid now cover ABA due to increased awareness of its benefits and state mandates requiring coverage. Coverage varies widely depending on the state and individual insurance plan.
Some states have robust coverage mandates requiring private insurers and Medicaid to cover ABA. Other states have no mandate or a more limited mandate. Even within states, coverage can vary based on the insurer and individual plan. In general, state employee insurance plans, large employer-based plans, and Medicaid tend to offer the best ABA coverage.
Individual and small group plans offer less consistent coverage, as they are not subject to state mandates in some states. Families will need to research their specific insurance plan’s policies. Look for information on ABA coverage, the number of approved therapy hours, annual caps, co-pays and deductibles required, approved ABA providers, and prior authorization requirements. Getting ABA approved by insurance involves persistence.
Work closely with the treatment team to document medical necessity, submit appeals if denied, and reapply annually. Maintaining detailed treatment records will help in gaining approval. Even with insurance, out-of-pocket costs for deductibles, co-pays, and non-covered services may still be substantial.
However, obtaining the maximum coverage possible through insurance and government assistance can greatly reduce the overall financial burden.
Government Assistance
Government health programs like Medicaid provide coverage for ABA therapy for those who qualify. Medicaid covers medically necessary ABA services for children under 21 with autism spectrum disorder (ASD) in many states. Some states also have Medicaid waivers that can provide additional ABA funding.
Tricare, the health program for military families, covers medically or psychologically necessary ABA therapy for military dependents with ASD. There are some limitations on the number of hours, but active-duty families have the benefit of getting ABA therapy with low or no copays.
Additionally, state disability programs and vocational rehabilitation agencies sometimes cover ABA services. There are also grant programs, scholarships, and nonprofits that help fund ABA therapy for those in need. Partnerships with university ABA graduate programs can also reduce costs.
Connecting with a local autism advocacy organization is a good way to find out about financial assistance options in your state. An experienced ABA agency will also know what funding is available and can help parents access any government programs or other resources to help cover the costs of therapy.
Reducing Out-of-Pocket Costs
There are some ways that families can reduce the out-of-pocket costs associated with ABA therapy:
Scholarships
Many local and national autism organizations offer scholarships to help cover the costs of ABA therapy. Families in need can apply for these scholarships, which are often funded through donations. The amount awarded can vary greatly, from a few hundred to several thousand dollars.
Community Autism Providers
Some nonprofit community providers offer ABA therapy at lower rates, especially for low-income families. These providers may have grants, donations, and other funding that allows them to subsidize costs. Rates are often on a sliding scale based on household income.
DIY Therapy
For families with time and dedication, it’s possible to learn ABA techniques and provide some therapy at home. This requires closely following the treatment plan from your BCBA and regular consultations. Doing a portion of therapy at home can reduce the number of paid hours needed. Some parents train with therapists to learn how to administer therapy themselves. While not ideal for all families, a DIY approach can potentially lower costs.
With some effort and research into scholarships, community resources, and insurance, many families can find ways to make ABA therapy more affordable. The investment into ABA is highly worthwhile given the proven benefits for children with autism.
Conclusion
ABA therapy can be costly, but it is the gold standard treatment for autism spectrum disorder. On average, ABA therapy costs $15,000 to $30,000 per year in the United States. However, costs vary significantly based on your location, provider qualifications, therapy intensity, and other factors. With proper ABA therapy, up to 50% of children can achieve normal functioning. Many studies validate its effectiveness in improving communication, social, academic, and adaptive skills. While expensive, the long-term benefits and independence gained make ABA a worthwhile investment. Several options can reduce your out-of-pocket costs for ABA therapy:
- Most private and government-funded insurance plans cover ABA treatment. On average, insurance pays 50-80% of costs once deductibles are met.
- Many states offer ABA therapy assistance through Medicaid, grant programs, and autism waivers. State and local autism organizations are great resources.
- Seek qualified mid-level therapists instead of higher-cost Ph.D. clinicians when appropriate.
- Advocate for increased ABA coverage with your insurance provider or employer.
- Participate in therapy “boot camps” or intensive sessions to maximize progress per dollar. With proper financial planning and advocacy, ABA’s benefits can be made more accessible for your child. Though costly, its proven effectiveness in treating autism makes it a worthy investment.
