September 8th 2026
Dear Larisa Miles,
Thank you for the time and care you invested in your recent article, Accelerating autism care. On behalf of the Association for Science in Autism Treatment (ASAT), we appreciate your focus on the critical issue of access to autism services.
We wanted to take this opportunity to thank you for highlighting the challenges of long waitlists, limited specialist availability, and geographic barriers, and how these factors can prevent children from receiving timely, autism-specific care. As you noted, some children may never receive treatment due to a lack of nearby services, while others might wait months or even years. In such cases, innovative service-delivery models, such as telehealth, hold real promise for reducing these inequities by bringing support directly to underserved families.
In your article, you also noted that “providing quicker access to intervention means more effective care and ultimately better outcomes for kids and families affected by autism.” We fully agree that reducing delays is vital, and we share your commitment to better outcomes for autistic children and their families. At the same time, we believe that, as practitioners, we must also carefully evaluate the effectiveness of any treatment model. Quicker access does not always translate into better care, particularly if an approach has not been robustly supported by scientific evidence.
As telehealth continues to expand, it will be important for future research to examine how improved access relates to treatment effectiveness and client outcomes. While timely access to care is an important consideration, additional evidence regarding treatment response, diagnostic accuracy, family satisfaction, and other outcome measures can help strengthen our understanding of the overall impact of telehealth services.
At ASAT, like you, we believe that autistic children and their parents, regardless of where they live, should be afforded access to the same high standard of evidence-based treatment and support. Telehealth can be a powerful tool to extend reach, especially in regions with limited practitioner availability, but the priority must remain ensuring that what is delivered through telehealth is genuinely high-quality, evidence-based care.
The TeleOutreach Hub mentioned in your article appears well positioned to expand research, collaboration, and access to services for geographically dispersed and underserved populations. To strengthen the platform, it would be helpful to include more information on how outcomes are evaluated, how barriers such as technology access and digital literacy are addressed, and what evidence demonstrates the initiative’s impact.
Thank you again for drawing attention to these important issues.
Sincerely,
Joalis De La Cruz, MS, BCBA, ASAT Extern
Reva Mathieu, EdD, BCBA
