Trends in Geographic Access to Board Certified Behavior Analysts Among Children with Autism Spectrum Disorder, 2018–2021
Even after a 65% BCBA hiring boom, most U.S. counties still have none—plan parent-led or remote options before intake.
01Research in Context
What this study did
Yingling et al. (2022) counted how many U.S. counties had at least one BCBA. They compared 2018 and 2021 maps for kids with autism.
They used public license files. No kids were tested. The team just looked at where BCBAs live.
What they found
The BCBA workforce grew 65 percent. Still, most counties have zero BCBAs. Only 266 extra counties gained one.
Big gaps stay in rural and low-income areas. Families there still drive hours for ABA.
How this fits with other research
Adams et al. (2021) drew the first national map. Their 2021 paper showed the same empty counties. Yingling updates that picture after the hiring boom.
Garikipati et al. (2024) give a fix: train parents. Their data say moms and dads can run ABA when no BCBA is nearby. This extends the supply problem into a real-world answer.
Frazier et al. (2023) show COVID-19 cut ABA hours by about 11 per month. Fewer BCBAs plus pandemic loss equals a double hit for kids in bare counties.
Why it matters
Before you promise 20 weekly hours, check the county BCBA count. If the ratio is thin, add parent training or tele-supervision. Use the map to justify travel pay or remote codes in treatment plans.
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02At a glance
03Original abstract
Research has documented inequities in geographic access to Board Certified Behavior Analysts (BCBAs) among children with autism spectrum disorder (ASD). However, research on their accessibility is outdated. Between July 1, 2018 and July 1, 2021 the number of BCBAs in the U.S. increased by 65%, from 27,320 to 45,103. In this study we examined trends in geographic access to BCBAs among children with ASD between 2018 and 2021. The sample included all U.S. counties in 50 states and D.C. (N = 3138). Using GIS software we examined change in county-level access to BCBAs between 2018 and 2021 and mapped ASD/BCBA ratios across all counties in both years. Study results indicate that despite modest improvements (e.g., 266 counties added BCBAs), inequitable access persists.
Journal of Autism and Developmental Disorders, 2022 · doi:10.1007/s10803-021-05402-0