Jen Wirt remembers when her daughter struggled to meet developmental milestones.

“When my daughter was a baby,” she says, “we noticed she wasn’t moving the way she should.

“We set out to find help,” Wirt explains, “only to be met with wait-lists, dead ends, and overwhelming costs.”

Wirt’s experience led her to found Coral Care, a network of therapists delivering early childhood intervention services.

According to the federal Child and Adolescent Health Measurement Initiative, childhood developmental delays and behavioral disorders have increased substantially over the past 20 years. Consider the following:

• Developmental delay affected 3.20 percent of children in 2007, 6.34 percent in 2016, and 7.60 percent in 2022.

• Speech disorder was diagnosed in 3.70 percent of children in 2007, 7.31 percent in 2016, and 9.10 percent in 2022.

• Attention deficit/attention deficit-hyperactivity disorder (ADD/ADHD) affected 6.40 percent of children in 2007, 9.44 percent in 2016 and 10.20 percent in 2022.

The figures for autism spectrum disorder (ASD), which can include the above-noted problems, as well as a host of other whole-body medical issues, have climbed so rapidly over the past 50 years that “skyrocket” has become a cliché in articles about the topic. The U.S. Center for Disease Control runs a tracking program known as the Autism and Developmental Disabilities Monitoring Network, using data from surveillance sites in different states to estimate the national prevalence of autism. The figures released in any given year indicate the percentage of 8-year-olds who were diagnosed with ASD three years earlier. (This means that the figures are already outdated when they are released. Adding to the confusion is that the sampling sites participating in ADDM have changed over the years.)

According to the 2025 report, the prevalence of ASD was 1 in 150 8-year-olds in 2000, 1 in 44 in 2018, and 1 in 31 in 2022.

Skyrocketing prevalence,

skyrocketing costs

With 10 percent of children coping with ADD/ADHD and nearly 10 percent of children struggling with speech disorder, many Americans know an affected family, even if they are not directly affected themselves.

Aside from compassion, there is a pragmatic reason to care about this growing problem. Simply put, we are all paying for it.

A true accounting of the costs of child developmental and behavioral disorders is the proper domain of academic researchers, so this article will provide just a sample of some of the costs, summarized from a paper published in 2023 in IPAK Public Health Policy Initiative by Harvard MBA Mark Blaxill; political economist Toby Rogers, PhD; and University of Colorado research scientist Cynthia Nevison, PhD.

In their paper, “Autism Tsunami,” Blaxill et al break down the different types of services that children with ASD receive.

For example, children with autism receive an education that costs $12,243 more per year ($18,139 in 2018 dollars) than their neurotypical peers. This cost is borne by property taxpayers, who contribute to the public education systems in their communities. Although students diagnosed only with ADD/ADHD likely do not require as much educational support as some students with ASD, this figure is an appropriate benchmark for the 1 in 31 8-year-olds on the autism spectrum in 2022, for their education from age 5 through age 21.

Blaxill uses a variety of sources to estimate the cost of early intervention/behavioral intervention (EIBI) services. The annual cost of an EIBI program is $63,500; the average utilization per young child is 30 percent of the available hours, yielding a price tag of roughly $19,000 per early childhood year, funded by families, who may have some coverage through insurance. (Insurance payouts are funded by everyone who pays into a plan.) The report estimates a utilization drop after early childhood, with families paying roughly $2,800 per year from ages 7 through 21.

Providers

harder to find

With more children every year requiring EIBI and related services, families struggle to find providers. Coral Care, the national pediatric therapy company founded by Jen Wirt, performed its own survey of parents seeking services.

From the end of 2024 through the beginning of 2025, Coral Care collected responses from families using its online developmental prescreening tool. Fifteen hundred families participated, yielding insights into a growing, underserved population:

• One in three families using the Coral Care online tool had a child with a feeding issue, from “extreme pickiness” to children actually gagging on food.

• Thirty-seven percent of participants reported emotional regulation issues, such as “intense meltdowns.”

• Fifty-eight percent of screened children ages 2.5 through 3.5 were not yet combining two words, e.g., “want cookie” or “more juice.”

• Just over half of screener participants had any services in place for their children when they completed the survey.

Tempting as it may be to dismiss parental concerns, the quotations from families seeking help indicate that the problem is real. “He’s almost four,” one parent wrote, “and still can’t speak in full sentences.” Another parent bemoaned treatments delays: “Our EI [early intervention] evaluation took five months. By the time we were seen, our son had already aged out.”

Coral Care aims to help parents who are not financially needy enough to qualify for public services, yet not wealthy enough to pay out-of-pocket for needed services. The company employs licensed occupational therapists, speech-language pathologists and physical therapists who deliver therapy in the affected child’s home. The company’s services are in-network with major insurance plans in Pennsylvania (Independence Blue Cross, Highmark, Capital Blue and Curative), and therapy can start within two weeks, even if a child does not yet have a diagnosis in place.

Coral Care is available to residents of Illinois, Massachusetts, New Hampshire, Pennsylvania, Texas and Virginia. The company plans to offer its services in additional states next year.

More information on Coral Care is available online (JoinCoralCare.com). The Blaxill, Rogers and Nevison paper is available for download (publichealthpolicyjournal.com/autism-tsunami-the-impact-of-rising-prevalence-on-the-societal-cost-of-autism-in-the-united-states/). The CDC report referenced in this article is available here (cdc.gov/mmwr/volumes/74/ss/ss7402a1.htm). Data collected by the Child and Adolescent Health Measurement Initiative is available for download (childhealthdata.org).