Military families raising children with autism often face unique barriers to accessing care, including frequent relocations and complex administrative requirements. Applied behavior analysis (ABA) is widely recognized as an effective intervention for many autistic individuals, yet military families report barriers that delay or restrict their access to these services.

The Department of Defense’s Comprehensive Autism Care Demonstration, established in 2014 and extended to 2028, provides ABA to TRICARE-eligible beneficiaries diagnosed with autism while it evaluates the appropriateness of the ABA tiered delivery model under TRICARE.

In 2023, two members of the UNC Frank Porter Graham Child Development Institute, Director Brian Boyd, PhD, and Senior Research Scientist Sam Odom, PhD, were appointed to a 15-person committee of the National Academies of Sciences, Engineering, and Medicine (NASEM), that would conduct an independent analysis of the Department of Defense’s Comprehensive Autism Care Demonstration (ACD).

The committee was charged with examining utilization of the demonstration by TRICARE beneficiaries and providing an assessment of methods used under the demonstration, particularly in relation to assessing autism domains, measuring effectiveness of ABA, and adhering to guidelines and industry standards of care.

Drawing on a careful review of the scientific literature, the NASEM committee produced a new report that evaluates the Department of Defense’s Comprehensive ACD and whether ABA should be covered as a TRICARE Basic benefit.

The report finds that ABA meets the Department’s own standards for reliable medical evidence and that current ACD policies place unnecessary burdens on families and ABA providers. The report calls for greater flexibility in how care is delivered to help ensure that military-connected families receive continuous, high-quality services aligned with best clinical practices. The report—and several supporting materials including an interactive webpage and a summary of the report—is now available to download.  

As follow-on engagement with the topic of person- and family-centered care in applied behavior analysis, the National Academies will host a public stakeholder event on October 8, 2025, from 1:00 pm to 5:00 pm EDT, to further explore the findings of the report. This event will bring together experts in autism diagnosis, and ABA delivery and assessment, representatives from families receiving ABA, ABA providers, and policy makers to discuss current best practices for person- and family-centered care.

During the event, Boyd will discuss the state of the ABA evidence and Odom’s presentation will focus on intensity of ABA interventions. Participants can register to join the event online or in person at the National Academy of Sciences building in Washington, DC.