“There’s been exponential growth in the field along with awareness of ABA therapy because there’s just simply a rise in the [autism] prevalence rate,” Juma said. “Our growth has been guided by where families live, work and attend school—especially elementary schools—since we specialize in pediatric therapies.”
ABA is a goal-driven, data-based therapy that uses positive reinforcement, gaining popularity for its personalized, one-on-one approach—especially for children with autism, said David Wahlquist, behavioral analyst and center director for BlueSprig Katy-South.
Despite there being nearly 40 centers in the Katy-Fulshear area, providers say demand for these centers still exceeds capacity. Juma said staffing shortages and high insurance-related costs remain major barriers to families who live in areas with these centers.
What's happening
In 2000, approximately 1 in 150 children had autism nationwide, according to the U.S. Centers for Disease Control and Prevention.
Since then, CDC data shows the prevalence has grown to 1 in 31 children nationwide in 2022. Texas has higher rates, with an estimated 1 in 28 children receiving the diagnosis.
At the local level, Texas Education Agency data shows a rise in the number and percentage of Katy and Lamar CISD students receiving behavioral health services, with the number of students receiving autism services doubling from 2016-17 to 2023-24 school years.
How it works
Digging deeper
Registered behavioral technicians, or RBTs, provide individualized attention in one-on-one or two-on-one settings with clients, making it hard to meet the demand without compromising quality, Juma said.
Requirements to become an RBT include a high school diploma or equivalent, 40 hours of training, a background check and receiving ongoing supervision from a board-certified behavioral analyst.
With a 65% retention rate of registered behavior technicians—among the lowest for entry-level health care roles—staffing shortages are limiting service availability, according to a 2022 Behavioral Health Center of Excellence report.
Ashly Joys, senior marketing director for Behavioral Innovations, said these struggles are reflective of “broader industry limitations,” where diagnoses are outpacing available clinicians.
Out-of-pocket costs tied to private insurance remain a barrier, with some families covering up to 44% of ABA therapy costs, according to a 2019 report from the American Academy of Pediatrics.
As demand for autism support rises across diverse populations, nonprofits such as Hope For Three financial aid and free programs. BI also connects families to resources such as F.A.C.E.S Autism, Masonic Children & Family Services of Texas and UnitedHealthcare Children's Foundation, Joys said.
Moving forward
To combat the staffing shortage, the University of Houston will host all six courses for the ABA minor this fall as well as a master’s degree in special populations with an ABA specialization, said Charlotte L. Carp, University of Houston clinical assistant professor in special populations. These programs provide the coursework needed for a behavioral analyst certification.
Carp said, through increased exposure through the field and the evidence-based practices that sustain the industry, professionals would be more encouraged to see a long-term career in ABA.
“I think if [professionals] understand why they’re implementing these strategies on the theory side ... they’re more likely to stay in the field,” she said.
