During the last twenty years, there has been a considerable increase in the number of children diagnosed with autism spectrum disorder in the United States, creating additional stress on health care facilities, schools, and behavioral health professionals. Based on the data presented by the Centers for Disease Control and Prevention’s Autism and Developmental Disabilities Monitoring Network in 2025, 1 out of 31 eight-year-old children had an autism spectrum disorder in 2022. The statistics indicate a remarkable difference compared to the CDC estimate in 2000 of 1 in 150 children having this condition.
An increase in autism prevalence has caused a rise in the need for developmental and intervention services. Many medical associations, such as the American Academy of Pediatrics, note the importance of identifying children with the disease and providing interventions, especially during early developmental periods when the treatment is likely to be most effective. Nevertheless, despite the increase in the number of patients, the service’s availability remains rather inconsistent throughout the country.
The disparity in autism diagnoses and treatment has come out clearly in recent times. According to the CDC data on surveillance, autism prevalence varied widely in 2022 among the participating communities, from about 1 child in 103 in the Texas-Laredo surveillance area to 1 in 19 in California surveillance areas. Variations in diagnostic practices, healthcare systems, services, and community screening have been identified as factors that might account for this difference. The information also shows disparities in access to developmental assessment and therapy services across regions.
One of the major problems with autism services in the U.S. is that there are long waitlists for evaluation services and treatment. Many provider agencies, advocacy groups, and healthcare systems have reported wait times for Applied Behavior Analysis services and developmental assessment services ranging from a few months to over a year. In other areas, families have reported that it took years to access services.
Workforce shortages represent another major factor contributing to access limitations. The autism treatment sector relies heavily on specialized professionals, including Board Certified Behavior Analysts, Registered Behavior Technicians, speech-language pathologists, occupational therapists, developmental pediatricians, and psychologists. Industry reports and workforce studies have documented persistent shortages across many of these professions. Staffing instability, employee turnover, geographic concentration of providers, and increasing demand for services have complicated efforts to expand treatment capacity nationwide.
The economic implications of delayed autism intervention have also received increasing attention. Autism Spectrum Disorder (ASD) is a condition that incurs significant expenditure in terms of health care, education, and support. It has been proposed that the late diagnosis of ASD and delayed intervention could be among the factors behind higher costs due to the delay in using interventions aimed at enhancing the child’s ability to communicate, behave normally, learn, and live independently. Despite ongoing discussion about the correlation between early intervention and later outcomes, early intervention remains an important goal of public health policies in the United States.
The growth of autism services has also introduced broader questions regarding healthcare infrastructure and service delivery models. During the 2010s, private equity investment became increasingly prominent within Applied Behavior Analysis and behavioral health services. Consolidation through mergers and acquisitions allowed larger organizations to expand geographically and operationally. At the same time, researchers, advocacy organizations, and policymakers have debated whether consolidation alone can adequately address treatment capacity shortages, particularly in underserved and rural communities where provider availability remains limited.
Against this backdrop, several organizations began experimenting with alternative approaches to service expansion. One such example is Success On The Spectrum, an autism treatment organization founded by Nichole Daher in Houston, Texas, in 2015. The organization initially operated as a provider of Applied Behavior Analysis, speech, and occupational therapy services. According to company records and subsequent media coverage, growing demand for autism services contributed to the organization’s expansion during its early years of operation.
In 2018, Daher established SOS Franchising, introducing what the company and numerous subsequent media reports have described as the first franchise model dedicated to center-based Applied Behavior Analysis services in the United States. Rather than pursuing expansion through the acquisition of existing providers, the franchise model was designed to establish new treatment centers through independently operated locations operating under shared operational and clinical frameworks. The model emerged during a period when policymakers, providers, and researchers were increasingly examining ways to expand autism treatment capacity while maintaining standardized practices.
According to publicly available company information, Success On The Spectrum’s model incorporates standardized operational procedures, internal quality monitoring systems, caregiver training programs, and community outreach initiatives. The organization has also emphasized workforce development strategies, including university partnerships and onsite clinical supervision models. These initiatives reflect broader efforts within the autism treatment industry to address workforce shortages, quality assurance, and access to care.
Success On The Spectrum represents one of several organizational responses to the growing demand for autism services in the United States. Other providers, healthcare systems, nonprofit organizations, and academic institutions have similarly explored approaches involving telehealth services, workforce development programs, regional expansion strategies, and alternative organizational structures. The effectiveness of these various approaches continues to be evaluated as autism prevalence increases and demand for services continues to outpace available capacity in many parts of the country.
The general problem with accessing autism treatments persists. The information from the CDC continues to show a rising number of diagnosed cases, and at the same time, the issues of workforce shortages, regional disparities, the quality and accessibility of services, and the need for facilities to provide ongoing support are not going away. In the midst of these debates, organizations such as Success On The Spectrum join the nationwide dialogue on how to increase access to autism treatments in the U.S.
