Interstate Professional Licensing Compacts

What it is: Beyond nursing, interstate compacts now exist or are launching for many of the professions autistic people depend on most: occupational therapy (OT Compact), speech-language pathology and audiology (ASLP-IC), psychology (PSYPACT, which enables interstate telepsychology), and professional counseling (the Counseling Compact, which became operational in late 2025 and has been enacted in more than 35 states). Each compact lets a licensed professional in good standing practice across member states without redundant applications, fees, and waiting periods.

Why it matters to our community: The single biggest barrier to autism services isn’t insurance — it’s workforce. Waitlists for speech therapy, OT, and diagnostic evaluations routinely run six months to two years. Licensing compacts attack that bottleneck directly: they let providers serve patients across state lines (especially via telehealth), let specialists in underserved disciplines reach rural families, and keep practitioners working when they move. Notably, there is no compact yet for behavior analysts (BCBAs) — one of the most in-demand autism professions — which represents a clear advocacy opportunity.

Our position: Americans for Autism Advocacy supports interstate licensing compacts for all professions serving the neurodivergent community, urges every state to join the OT, speech-language, psychology, and counseling compacts, and supports developing a behavior analyst licensure compact to extend the same portability to ABA providers.