Why We Prioritize Full-Time Services (And How It’s Sustainable)

Disclaimer: Throughout this article we refer to comprehensive ABA services (typically 25-40 hours per week) as “full-time” to ensure clarity to families, business owners, and practitioners alike.

At Essential Speech and ABA Therapy, we’ve built our entire model around full-time (comprehensive), medically necessary therapy services. This choice isn’t arbitrary; it’s a purposeful decision driven by our clinical ethics and rooted in our mission and core values.

Even still, we understand this approach can raise some questions, especially from potential franchisees.

Many ask:

• “Why can’t we offer part-time services to increase revenue?”

• “Wouldn’t we serve more kids and maximize profits by allowing a hybrid or flexible model?”

Our commitment to full-time, comprehensive services does not just reflect our commitment to delivering meaningful, evidence-based practices –it is also sustainable, profitable, and deeply aligned with our mission.

Let’s walk through why.

Full-Time Therapy Leads to Better Clinical Outcomes

ABA therapy is most effective when it’s intensive and consistent, especially for early learners between 18 months and 6 years old. These early years are the most critical window for brain development. Studies show that early intensive behavioral intervention (EIBI) delivered at 25–40 hours per week produces the most meaningful gains in communication, behavior, and developmental progress.

One of the most widely cited studies in the field found that 47% of children who received 40 hours per week of intensive ABA therapy achieved average-range intellectual functioning, compared to just 2% of children in the control group receiving less than 10 hours per week (Lovaas, 1987). Another meta-analysis concluded that EIBI produces moderate to large effects across cognitive, communication, and adaptive functioning domains, particularly when started before the age of 5 and delivered at a high intensity (Reichow et al., 2012).

The National Research Council (2001) recommends a minimum of 25 hours per week of structured intervention, stating that children with autism need high-intensity, year-round instruction to make meaningful progress. And more recent research supports this view: treatment intensity is one of the strongest predictors of success in ABA therapy (Granpeesheh et al., 2009; Harris & Handleman, 2000).

This is why we primarily serve clients who require comprehensive services. This does not mean that every child who comes into our centers for an assessment gets assigned 25-40 hours. If a child receives an assessment for ABA services that determines a lower medically necessary clinical recommendation, that child is generally referred to an in-home or community-based provider. We recognize that this decision may raise an eyebrow from a business perspective, but we make this decision due to the clinical impact, which is what every business decision should consider.

Our intention here is to ensure children who do not need intensive services are able to receive services in their natural environment instead of being placed into a more intrusive setting like an ABA clinic. Our clinics are set up to systematically address barriers for children who need intensive services, not just take in every child with a diagnosis.

Offering both full-time and part-time options might seem like a reasonable compromise—but in practice, it dilutes the clinical integrity of the program, overcomplicates operations, and sends mixed messages to families about what’s truly necessary for meaningful progress.

When a child is recommended for full-time ABA, anything less isn't just a lighter version—it’s a clinically insufficient version. Providing part-time as an option when a child requires comprehensive services implies it is equally effective, which it’s not, according to the research. And when families opt for fewer hours due to convenience, insurance limitations, or misconceptions, the child is the one who suffers.

We’ve made a deliberate decision not to offer a menu of therapy “packages” because this isn’t retail. It’s healthcare.

Just as you wouldn’t expect a cardiologist to offer a 30-minute-a-week heart treatment when 10 hours is the minimum needed—we don’t offer part-time care when full-time is what’s medically necessary.

We owe that level of honesty and integrity to the families we serve.

Providing part-time therapy solely for convenience or profit undermines the needs of the children we serve. Our approach is grounded in doing what is clinically appropriate—not what is most convenient.

Ethical Care Means Putting Kids First. 

Too many clinics offer part-time sessions just to increase volume or fill staffing gaps. But ABA isn’t a daycare, and we’re not here to provide short bursts of babysitting. We’re here to provide intensive medical intervention, backed by data, supervision, and measurable goals.

That means:

• Only accepting children for whom full-time ABA therapy is medically necessary.

• Creating individualized plans that truly move the needle.

• Titrating down hours only after a child meets meaningful milestones—not before.

Ethical care requires restraint. It requires saying “no” to part-time services when we know it won’t produce meaningful outcomes. It requires holding our ground when others compromise.

Full-Time Services Actually Simplify Operations

Franchisees often assume part-time services would bring in more clients. But in reality, offering part-time care can create complexity, instability, and staff burnout.

Here’s why:

1. Scheduling Becomes a Nightmare

Trying to juggle morning-only, afternoon-only, or M/W/F clients creates massive inefficiencies in your clinic’s schedule. You can’t build a stable routine, and your RBTs end up with scattered hours and unpredictable shifts.

Full-time clients = full-time RBTs = a sustainable staffing model.

2. Staff Retention Improves with Full-Time

RBTs thrive on consistency. When they know they’ll work 30–40 hours a week with the same few children, they stay longer, perform better, and feel more connected to their work.

Part-time clients lead to piecemeal shifts, lower hours, and higher turnover.

3. Supervision and Quality Are Easier to Manage

BCBAs are responsible for ongoing case supervision which includes protocol modification, treatment planning, family guidance meetings, and treatment fidelity checks. It’s far easier to maintain high clinical standards with full-time clients whose data and behavior they review daily rather than a rotating door of part-time children who attend only a few hours a week.

Full-Time Services Are More Financially Sustainable Than You Think

Disclaimer: The information below discusses financial considerations; however, we want to emphasize that the primary and most important question in any decision should always be: Does this benefit the child receiving services? While financial sustainability is necessary to ensure continued access to care, it should never come at the expense of clinical quality. The following considerations are shared to support business owners in maintaining operations so that children can continue to receive the therapeutic support they need. 

Let’s bust a myth: more clients does not equal more profit.

In fact, fewer full-time clients can produce more consistent, predictable revenue with lower administrative overhead.

Here’s how our full-time model supports profitability:

1. Each Client Fills a Full Schedule

Instead of needing 3–4 part-time clients to fill one RBT’s week, one full-time client covers the entire position. This means:

• Fewer assessments and treatment plans for your BCBA to write

• Lower intake and onboarding costs

• Fewer parent training/family guidance sessions to coordinate

• Reduced insurance claims and billing issues

2. Insurance Reimbursement is Stronger for Medically Necessary Full-Time Care

Our model aligns with insurance best practices—including early intensive behavior intervention (EIBI). When services are medically justified and appropriately documented, insurers are more likely to approve full-time hours and pay reliably.

Part-time clients often come with requests for shorter plans, more reauthorizations, and greater scrutiny.

3. Titration Provides a Natural Off-Ramp

We do not keep children in full-time ABA services indefinitely. As they progress, our clinical teams titrate hours down, easing children into part-time care and eventually graduation.

This allows your clinic to gradually bring in new full-time clients as others step down—creating a pipeline of continuity and sustainability.

Parents Choose Us Because of This Model

One of the most powerful marketing messages we have is simple: We only take clients we can truly help.

Parents trust us because they know we won’t just “add them to a list.” We tell the truth, set clear expectations, and work with only the children we believe we can support to meaningful success.

This transparency builds long-term trust, loyalty, and word-of-mouth referrals that drive clinic growth without costly marketing gimmicks.

How This Model Supports Our Franchisees

We get it –this approach feels bold. It takes courage to say “no” to a family seeking part-time care. It takes patience to fill full-time slots before opening your doors.

But we don’t leave you to figure it out alone. Our franchise model was built around full-time services and includes:

• Robust training and mentorship on how to explain our model to parents

• Clinical support to justify full-time hours through clear assessments

• Administrative templates and scripts for onboarding and schedulingMarketing materials that position you as the gold standard

• Ongoing KPI reviews to track and adjust your clinic’s growth strategy

We don’t just say full-time is better. We prove it—with tools, training, and a proven path to sustainable success.

In Summary: Full-Time Is the Ethical, Clinical, and Financial Gold Standard

Our choice to offer only full-time services isn’t limiting, it’s liberating.

It ensures:

• Kids get the best possible chance at long-term success

• Staff are supported and retained through stable schedules

• Franchisees build businesses rooted in integrity and sustainability

We’re not interested in running high-volume, low-quality clinics. We’re here to create a lasting impact for children, families, and the owners who take this mission to heart.

If you’re ready to join a network that puts quality over shortcuts, and lives changed over numbers on a spreadsheet, we’d love to welcome you to Essential Speech and ABA Therapy.

Let’s grow the right way –together.

References

Granpeesheh, D., Tarbox, J., Dixon, D. R., Peters-Scheffer, N., & Kornack, J. (2009). Evidence-based practices and treatment for children with autism. Journal of Clinical Psychology, 65(8), 825–838. https://doi.org/10.1002/jclp.20692

Harris, S. L., & Handleman, J. S. (2000). Age and IQ at intake as predictors of placement for young children with autism: A four- to six-year follow-up. Journal of Autism and Developmental Disorders, 30(2), 137–142.

Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55(1), 3–9. https://doi.org/10.1037/0022-006X.55.1.3

National Research Council. (2001). Educating children with autism. Washington, DC: National Academy Press.

Reichow, B., Barton, E. E., Boyd, B. A., & Hume, K. (2012). Early intensive behavioral intervention (EIBI) for young children with autism spectrum disorders (ASD). Cochrane Database of Systematic Reviews, 2012(10). https://doi.org/10.1002/14651858.CD009260.pub2