Hidden costs of intensive ABA therapy in Ontario

Direct therapy (RBT hours): $50–$80/hr — approximately $52,000–$83,000/year. The visible number. Not the full picture. BCBA supervision (10–20% of therapy hours): $100–$180/hr — approximately $5,200–$18,700/year. Required for ethical, high-quality programs.

Initial BCBA assessment plus program design: $1,500–$3,000 one-time, before therapy begins. Ask if included. Annual reassessment: $1,000–$2,500/year, every 6–12 months. Parent coaching sessions: $100–$180/hr at BCBA rates — approximately $2,400–$4,320/year (2 hrs/month). Strongly affects outcomes.

Materials, reinforcers, curriculum: $200–$800/year. Visual aids, token boards, edible reinforcers. Clinical reports and written updates: $150–$500/report. Check whether reports are included. Therapist travel time (home-based programs): varies by agency — may add $50–$150/week. Some agencies bill travel at a reduced rate.

ABA providers typically quote an hourly rate for direct therapy. That is the cost of the RBT sitting with your child — the most visible component. It is also the lowest-cost professional in the program. What is rarely in the headline quote: the BCBA supervising the RBT, the assessment and program design that starts before the first therapy session, the parent coaching that makes the program work at home, and the ongoing reporting.

A 30-hour/week program at $60/hr for RBT time looks like $93,600/year. Add BCBA supervision at 15% of those hours at $140/hr, an initial assessment, 2 parent coaching hours per month, annual reassessment, and materials — and the real cost is closer to $110,000–$125,000 per year. This is not unusual. It is normal for high-quality programs.

The Ontario Autism Program funds all of these components within Core Clinical Services for enrolled children. The problem is that 69,166 children are waiting for that enrollment — paying these full costs privately in the meantime.

What is the total monthly cost, all-in? Ask for an itemized estimate covering therapy hours, BCBA supervision, assessments, parent coaching, reports, and any other charges. How are BCBA hours billed? Are they included in the therapy rate or invoiced separately? How many BCBA hours per week are provided?

Is the initial assessment included or additional? When does it happen and what does the cost include? What is your cancellation policy? Is there a charge for cancellations within 24 or 48 hours? What is the policy if the therapist cancels?

Are progress reports included? How often are they produced? Is there a per-report charge? Do you charge travel time? What is the travel billing policy for home-based programs? What happens if my RBT leaves? What is the typical timeline to assign a new therapist? Get the contract reviewed by someone familiar with ABA services before committing.