Autism Therapy Is the Next Roll-Up Industry Facing a Backlash
Private equity has bought more than 500 autism therapy centers over the past decade. Lawsuits and a new Illinois ownership law are now testing that model. Vet clinics and dental chains faced the same test before it.
NEW YORK, September 1, 2026. Private equity has acquired more than 500 autism therapy centers over the past decade. That's according to a review published in PMC. The centers offer Applied Behavior Analysis, or ABA, the standard treatment for children on the autism spectrum. The pattern now looks familiar. It's the same roll-up playbook that reshaped veterinary clinics, dental practices and physician staffing groups. And it's drawing the same complaints. Understaffing, rushed care and clinical decisions made by people without a clinical license.
Action Behavior Centers is the clearest case study. NexPhase Capital recapitalized the company in 2018. It grew into a chain of more than 200 clinics. Locations span Texas, Colorado, Arizona, Illinois, North Carolina and Minnesota. Charlesbank Capital Partners bought it in a deal worth roughly $840M, announced in August 2022. Since then, multiple families have filed lawsuits alleging physical abuse, improper restraint and emotional harm. The suits point to undertrained and undersupervised staff. State investigations opened in 2025, and litigation is still active this year.
Illinois passed a direct response this year. SB 712, signed in 2026, restricts corporate practice of ABA. Clinical decisions must now be made by a licensed behavior analyst, not a business owner or investor. Violations carry penalties of up to $10,000 each. That's according to alerts from Ropes & Gray and Nixon Peabody. A separate 2022 Illinois licensing law goes further. Under Section 150, anyone who owns an ABA business in Illinois must hold a state behavior-analyst license. The deadline is January 15, 2027, or they must sell. That's a direct challenge to private equity ownership, which by definition doesn't come with a clinical license attached.
Not every large ABA provider fits the roll-up story. ABA Centers of America was founded by Chris Barnett's ICBD Holdings. It grew mostly by building new clinics rather than buying existing ones. It isn't private-equity owned, and it only recently began seeking a capital partner. Publix filed a federal RICO suit against the company in August 2025. That dispute is unrelated to sponsor ownership and shouldn't be read as part of the same pattern.
The Illinois law is the more telling development. Vet and dental roll-ups drew complaints for years before regulators moved. In ABA, a state legislature has already acted. The deadline for owners to comply lands in January 2027. Sponsors that built ABA platforms on the same multi-state consolidation model now have about 16 months to adapt. They need a structure that survives the law, or a buyer who already holds the license.