Brightline seeks to be the first digital pediatric behavioral health provider to serve the entire family, in part by establishing Autism Spectrum Disorder services in early 2022.
Executives with the Palo Alto, California-based startup tell Behavioral Health Business that the inspiration for the new line of business came from the parents of children seeking other behavioral health services not related to their children’s Autism Spectrum Disorder diagnosis.
The coronavirus epidemic placed massive pressure on parents as they shouldered all educational and caretaking responsibilities — on top of all other responsibilities — as schools and daycares all over the United States shuttered. This drove huge demand for all behavioral health services as the mental health distress of children reached crisis levels.
Most children and families come to Brightline, legally known as Brightline Medical Associates PA, for clinical services for comorbidities like anxiety, ADHD or other disruptive disorders, Brightline Chief Psychiatric Officer Dr. David Grodberg told Behavioral Health Business.
The to-be-launched Autism Spectrum Disorder services program will focus on early intervention, structured coaching programs delivered by video visits with parents and caregivers, and on-demand resources to support families between sessions.
“The need is so vast and we can’t ignore it,” Grodberg said. “It’s one of the most commonly requested services that parents or employees are asking for — in addition to pediatric behavioral in general.”
In 2019, CEO Naomi Allen and Dr. Giovanni Colella founded the company, which provides self-guided, coaching and clinical provider services for children with behavioral health needs.
Brightline which closed on a $72m series B round of financing in June 2021 to expand nationwide, provides support for parents and other family members and sells to insurance plans and employers who give access to employees and beneficiaries.
Brightline is younger than many of the children that it serves. And the company didn’t start off seeking to provide Autism Spectrum Disorder services.
But since its founding just before the pandemic, the company witnessed first-hand the massive impact of the pandemic on the mental health of youth.
In December, U.S. Surgeon General Dr. Vivek Murthy released an advisory detailing the mental health crisis American youth face and its dire trajectory, going so far as to say, “The future wellbeing of our country depends on how we support and invest in the next generation.”
The surgeon general noted that youth with intellectual and developmental disabilities (I/DD) were at higher risk of critically worsening health because of their reliance on school-based care or other in-person therapies, especially children requiring Autism Spectrum Disorder services.
Even before discourse around the mental health struggles of American children reached the heights of federal health officials, the market jumped at the chance to serve children and families needing behavioral health services.
One estimate posits that investment in youth mental health companies increased 671% in the first half of 2021 compared to the whole of 2020.
The ABA puzzle
Grodberg said that children and families who get access to therapies closer to the time of a child being identified as at-risk of autism have better outcomes because it allows them to make adjustments to the child’s care.
This drives down the stress in the family, as measured by a clinical assessment, and that, in turn, allows for greater productivity for the companies whose employees have children with Autism Spectrum Disorder.
Brightline faces a big opportunity and a big challenge at this point. Nationwide state advocacy, especially in statehouses, has created a market where applied behavioral analysis (ABA), a key part of Autism Spectrum Disorder services, is “covered in a robust way,” Grodberg said.
“But outcomes are not very good,” Grodberg added. “I think we’re still early days in measuring outcomes in ABA systems and trying to understand why there are sub-optimal responders.”
Many children have additional complex behavioral health needs that act as complicating factors in their care and development. But Grodberg contends that earlier interventions through easier access to care through a family-oriented digital behavioral health platform like Brightline could enhance ABA and improve outcomes.
Earlier autism interventions through tech
The average age diagnosis for Autism Spectrum Disorder is four years old. But children can be identified as being at risk at 18 months old.
“There’s a really long period where parents are in an incredibly stressful holding pattern where they can’t really get access to services because they don’t have the diagnosis,” Grodberg said. “For some parents, it’s devastating.”
Brightline seeks to address this by implementing in-home, parent-mediated interventions for Autism Spectrum Disorder. Parents can be trained in these interventions that happen naturally throughout the day. But the problem of these types of programs, as they are currently practiced in the academic health centers where they were developed, is that they are not scalable. Brightline’s remote coaching service makes parent-mediated interventions scalable, Grodberg said.
“Brightline gives the perfect environment to teach these critical skills and strategies in bite-size, digestible packets … and [parents] can start learning them the same day that their child is screened for autism at 18 months rather than having to wait two years to get referred to a system.
“That’s what I think is so exciting about what we’re launching — that we’re going to take the latest in what we know works and improves outcomes in children, improves their symptoms and improves service utilization down the road — we’re going to get that into the hands of parents years earlier than they have access to now.”