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Wednesday, July 5, 2023

CARD Developments

 The Politics of Autism includes an extensive discussion of autism service providersPrivate equity firms now own many of themThere are critics.

At Forbes, Phoebe Liu reports on the Center for Autism and Related Disorders:

By the time Blackstone took over, the company had already been struggling with employee turnover, especially that of entry-level therapists, due to a combination of low wages, the emotionally taxing work and frequent cancellations that led to an unstable income and schedule. [Doreen] Granpeesheh says CARD’s wages were “competitive” and emphasizes that its 24% turnover rate at that time among therapists was fairly standard in the autism treatment industry—not CARD-specific issues. Granpeesheh stayed on as CEO until the end of 2019. She wrote in a LinkedIn post in January this year that she stepped down because she was “tired and wanted time with [her] family … 40 years was long enough.”

Things got worse during the pandemic. Closures followed.

On June 11, 2023, CARD filed for Chapter 11 bankruptcy with just $2 million of cash in the bank and more than $240 million in debt, according to court filings, which also show that Granpeesheh now has a 21% stake in the bankrupt CARD. (Employees who reinvested some of their shares have 9% and Blackstone has the remaining 70%.)

Two days prior, as part of the bankruptcy proceedings, Granpeesheh and her business partner Sangam Pant—a managing partner at CARD from 2014 to 2019—entered an agreement to purchase the company for just $25 million, on top of assuming some of CARD’s liabilities. Granpeesheh says she can’t disclose the exact breakdown of the deal but that she is the majority owner; court filings say she will be responsible for 60% of guaranteed debts.


But she will have to face an environment that isn’t as friendly to ABA as it was in CARD’s fastest-growing days. Although punitive measures in ABA like using electric skin shock to correct behavior are mostly phased out, the therapy still has its critics, who say it prevents autistic children from engaging in self-stimulatory behavior like repeated motions or noises that can bring them relief. The University of Stirling’s Botha says the therapy is based on a “cruel” premise of making autistic people “appear normal.” The American Medical Association voted to remove its explicit endorsement of ABA at its annual meeting in mid-June, citing a need for more research on ABA’s potential negative effects and on treatment alternatives.