Joshua Feder, MD, explains how AACAP’s revised policy aims to improve access, insurance coverage, and family-centered decision-making for autism care.
In October 2025, the American Academy of Child and Adolescent Psychiatry (AACAP) released a new policy statement urging broader access to
Joshua Feder, MD, editor in chief of The Carlat Child Psychiatry Report and executive medical director at Positive Development, said the policy reflects years of careful review.
“The headline is that the American Academy of Child and Adolescent Psychiatry, after a very long deliberative process—8 years, actually—decided to join the American Academy of Pediatrics and the American Medical Association and actually go beyond those statements to specifically include developmental, relationship-based approaches and naturalistic developmental behavioral approaches as part of the care offerings for autistic people and their families," he said.
ABA remains the most familiar modality for many clinicians, particularly pediatricians. “You take a person’s behavior, and you try to shape it—rewarding what you want to see more of…. So there’s often a focus on compliance.” Although acknowledging ABA’s role, he said many individuals with autism and their families are seeking approaches aligned more closely with strengths, agency, and neurodiversity-affirming philosophies.
DRBI approaches—including DIRFloortime, the Positive Development model, the Play and Language for Autistic Youngsters Project, and the Pediatric Autism Communication Therapy model—focus on reading a child’s cues and building communication through reciprocal interaction. “Basically, it’s helping caregivers…respond to them in a way that builds communication and ideas together,” Feder said, adding that research supporting these approaches has been accumulating for years.
NDBIs blend behavioral and developmental principles, providing children with more choices and often anchoring learning in their interests. Feder explained that NDBIs differ from purely developmental models in that the goals are typically selected externally rather than emerging from the child’s intrinsic motivations.
AACAP’s statement also underscores the need for expanded training, improved workforce capacity, increased telehealth support, and insurance coverage across the full range of evidence-based interventions. Without such changes, Feder said, “families don’t get the choices that they need…so kids can do better and we can use resources more wisely.”
By encouraging payers and policy makers to adopt broader coverage standards, AACAP aims to address longstanding access gaps and help families secure timely, individualized care that best fits their child’s developmental needs.
Reference
Policy statement of expanding access to care for the autism community. American Academy of Child & Adolescent Psychiatry. October 2025. Accessed December 2, 2025. https://www.aacap.org/AACAP/Policy_Statements/2025/Expanding_Access_Care_for_Autism.aspx
