This increase in the number of autism diagnoses has put immense strain on the US developmental health care system. The latest CDC’s Autism and Developmental Disabilities Monitoring Network data show that there was one case of autism spectrum disorder in 31 children aged eight years in the United States in 2022. Previously, in 2000, the reported prevalence rate of ASD was 1 in 150 children, and it increased to 1 in 44 in 2018. Scientists attribute this phenomenon to the broadening criteria for ASD diagnosis, improvements in screening techniques, and better knowledge of autism spectrum disorders.
An increase in the number of people with autism has resulted in a higher need for therapeutic services. One of the most popular approaches to treating autism, applied behavior analysis (ABA), has played an essential role in the autism market. Market research conducted by Fortune Business Insights suggests that the global market size for autism spectrum disorder reached approximately $8.55 billion in 2025 and will continue to grow in the coming ten years. Communication and behavioral interventions are the largest share of autism treatments’ expenses.
Despite this growth, access to autism services has remained uneven across the United States. Families in many communities continue to face lengthy wait times for diagnostic evaluations and therapy services. Geographic disparities, workforce shortages, and reimbursement differences have contributed to persistent challenges in expanding treatment capacity. These conditions created an environment in which new organizational and operational models began emerging within autism services during the late 2010s.
For much of the previous decade, expansion within the ABA industry largely occurred through consolidation. Private equity investment firms became increasingly active participants in autism services, acquiring existing providers and combining them into larger multi-state organizations. Researchers and policy analysts subsequently examined the effects of consolidation on staffing, service delivery, and access to care. Reports published by organizations, including the Center for Economic and Policy Research, argued that while consolidation increased organizational scale, questions remained regarding whether acquisition-driven growth significantly expanded overall treatment capacity nationwide.
It was against this backdrop that Success On The Spectrum emerged. Founded in Houston, Texas, in 2015 by Nichole Daher, the organization initially operated as an autism treatment provider offering Applied Behavior Analysis, speech therapy, and occupational therapy services. According to company records and subsequent media coverage, the organization’s early growth reflected broader trends in autism treatment demand, with expansion occurring as patient capacity filled rapidly.
In 2018, Daher established SOS Franchising, introducing what has been described by the company and multiple media outlets as the first franchise model dedicated to center-based ABA therapy services in the United States. Rather than pursuing expansion through acquisitions of existing providers, the franchise model sought to create new treatment centers through independently owned operations operating under standardized clinical and operational systems. This represented a departure from prevailing expansion strategies within the autism treatment sector.
The introduction of franchising into autism services reflected a broader question facing healthcare industries: how to expand access while maintaining operational consistency. Franchising had long been established in sectors such as hospitality, retail, and certain healthcare services, including urgent care and home healthcare. However, its application to autism treatment services had been largely unexplored. The Success On The Spectrum model attempted to combine local ownership structures with centralized operational oversight, training systems, and quality assurance procedures.
One distinguishing feature of the model involved ownership structure. According to company information, approximately 25 percent of Success On The Spectrum franchise owners are parents or family members of individuals with autism. The company has argued that local ownership encourages community engagement and long-term operational investment. At the same time, franchise locations operate under standardized clinical policies, quality monitoring systems, and operational procedures established by the franchisor.
In addition, the development of ABA franchises was linked to increased discourse regarding workforce development within autism services. There is an ongoing shortage of Board Certified Behavior Analysts and Registered Behavior Technicians within the sector. Success On The Spectrum implemented policies that placed emphasis on hands-on supervision, university partnerships, practicum training, and workforce pipeline development programs. As per the company’s literature, the organization does not provide for virtual clinical supervision but insists on on-site supervision by Board Certified Behavior Analysts.
Another area in which the franchise model attracted attention involved quality control and parental participation. Success On The Spectrum implemented internal auditing systems designed to evaluate clinical operations, documentation practices, staffing standards, and treatment protocols across franchise locations. The organization also introduced parent viewing rooms, allowing caregivers to observe therapy sessions directly. These initiatives contributed to broader discussions regarding transparency and family involvement in autism treatment services.
Since the establishment of SOS Franchising, additional organizations have entered the ABA franchise market, contributing to the development of a new organizational category within autism services. Industry observers have increasingly discussed franchising as one potential mechanism for expanding treatment capacity, particularly in underserved communities where access remains limited. Fortune Business Insights has identified franchise expansion as one factor influencing growth within the behavioral therapy segment of the autism treatment market.
The overall significance of franchising for autism therapy remains a matter of debate. Proponents have asserted that the system might help open new treatment centers and provide assistance, workforce development, and procedures. However, critics have stated that all models of organizations, whether franchises or not, need continuous scrutiny of their clinical performance, ethics, staffing issues, and patient safety.
With increasing cases of autism and limited facilities, the discussion about organizational structure in autism therapy will probably persist. The emergence of Success On The Spectrum and the subsequent development of ABA franchising introduced a new framework into that discussion, one centered not only on ownership and expansion, but also on the broader question of how healthcare systems can increase access while maintaining accountability, consistency, and quality.
