Service Delivery

Geographic Access to Registered Behavior Technicians among Children with Autism Spectrum Disorder

Yingling et al. (2023) · Behavior Analysis in Practice 2023
★ The Verdict

Kids with autism outnumber RBTs in most U.S. counties, so check local ratios before you grow.

✓ Read this if BCBAs who hire or place RBTs in rural, suburban, or expanding clinics.
✗ Skip if City-center BCBAs with full staff and no plans to expand.

01Research in Context

01

What this study did

Yingling et al. (2023) counted how many Registered Behavior Technicians (RBTs) live in every U.S. county.

They compared those counts to the number of children with autism in the same counties.

The team used public BACB files and census data to build a national map of RBT supply.

02

What they found

In most counties, kids with ASD greatly outnumber RBTs.

RBT shortages look a little better than BCBA shortages, but gaps are still large.

Rural and low-income areas show the biggest worker-to-child gaps.

03

How this fits with other research

Deochand et al. (2024) already showed that BCBA supervisors cluster in a few regions. Yingling’s numbers now prove the same problem hits RBTs at the county level.

Shawler et al. (2021) found two-thirds of parents can’t find dentists for their autistic kids. Yingling’s map adds ABA to the list of everyday services that are hard to reach.

Thompson et al. (2025) give a checklist that helped three states raise Medicaid rates and add telehealth. Their wins show policy action can shrink the very gaps Yingling measured.

04

Why it matters

Before you add clients or open a new site, check the county RBT-to-child ratio. If the number is low, plan for longer travel, higher wages, or tele-supervision. Share the ratio with funders and state reps—hard counts turn budget requests into proof.

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Look up your county’s RBT-to-child ratio on the BACB certificant map and write the number at the top of your staffing plan.

02At a glance

Intervention
not applicable
Design
other
Sample size
3138
Population
autism spectrum disorder
Finding
not reported

03Original abstract

Research has documented inequities in geographic access to board certified behavior analysts (BCBAs) among children with autism spectrum disorder (ASD). Unexplored is geographic access to registered behavior technicians (RBTs), the frontline ABA providers BCBAs supervise. In this study we examined county-level geographic access to RBTs in the United States, including change in their geographic distribution over time, the current distribution of RBTs related to the distribution of BCBAs, and the current distribution of RBTs as a function of children with ASD. The sample included all U.S. counties in all 50 states and the District of Columbia (N = 3,138). County-level ASD/RBT ratios indicate that the number of children with ASD far exceed RBTs, and the geographic accessibility of RBTs appears to be superior to that of BCBAs.

Behavior Analysis in Practice, 2023 · doi:10.1007/s40617-022-00729-1