Kelle Wood Rich had the good fortune of being introduced to children and adults with Autism at a young age. She went to a private school in Dallas, TX that offered practicum experiences for seniors and was placed at the Autistic Treatment Center where she worked in their pre-school classroom as an aide. The center offered both day treatment and residential services so she had exposure to all ages in the school setting, the vocational setting and the group home settings. Kelle absolutely fell in love with these children and the adults. She had always loved children, growing up babysitting, but had not had the opportunity to meet any children with special needs up to that point. She felt a connection to this population and enjoyed being with them. She intuitively responded to their needs and liked feeling helpful and useful to them. She had found her calling.
Kelle entered college at Texas Christian University as a psychology major but learned that was not the field where one actually works with this population as much as in the field of special education. She switched majors and completed her BS degree in the Studies of Exceptional Students.
After undergrad, Kelle Wood Rich taught special education for several years. She then went back to graduate school and earned a Master’s degree in Behavior Interventions from the University of North Texas. This degree allowed her to take coursework in Applied Behavior Analysis. These courses changed the trajectory of her career. They provided her the explanation as to why some of her skills as a teacher were effective and why some were not.
Kelle returned to the same school district she had taught in as a Crisis Interventionist. The district brought in Dr. Vince Carbone from Florida as a consultant in 1997 to revamp this position to be more proactive instead of reactive. The title changed to Behavior Resource Specialists and focused on teacher training, conducting FBA’s (which were new to IDEA that year) and teaching children social skills and replacement behaviors. It was a much more effective model. That year, the district asked her to be their Autism Specialist. Dr. Carbone mentored Kelle in this position and also consulted with the district on a potentially litigious case. As a result of that case, the district was introduced to using the ABLLS assessment and curriculum on a particular student. That tool and the specific training around that tool incorporated what would later be known as “The Verbal Behavior Approach” a specific approach to ABA therapy that utilizes Skinner’s Analysis of Verbal Behavior as the framework. That student made so much progress in such a short time, that the district took that data to the school board and requested that they utilize this programming in creating new classrooms in the district for children that fit the profile of having significant deficits in language, behavior and social skills. Kelle worked all summer training and developing these classrooms and was then the Specialist assigned to these programs. She continued her training with Dr. Carbone several days each month. Through this supervision, she was able to sit with her graduate school professors for the first Texas Certified Behavior Analysis exam. The following year, the BCBA certification was created making Kelle in the first group of BCBA’s in the country.
How did you get started in this business? What inspired you to start this business?
With the BCBA certification and the growing popularity of Dr. Carbone’s lectures and services, he began to form a group of professionals that he had trained to be his Associates. He referred us out to supervise, train and consult on in-home programs, school district programs, etc. across the country and internationally. I eventually left the school district to do this work with him full time. We developed a 3-day workshop titled “Verbal Behavior in the Classroom” with another associate, Gina Zecchin Tirri. Gina and I spent close to the next decade travelling the world presenting this workshop about once a month. Over the course of that decade, both Gina and I married, became step-mother’s and mothers and it became increasingly more difficult to travel. In addition, a constant concern in supervising in-home programs in particular was quality control. In those days, there were not many BCBA’s around and families were often forced to hire high school to college-aged students to be trained as therapists. This resulted in high turn over rates that negatively impacted our student’s progress. CTAC was born out of both of these desires, to be home more often for my own family, to be able to serve more families and provide them with quality ABA therapy delivered by career professionals.
How long ago did you come up with it?
The idea came around 2002 and we opened in 2003.
What were you doing at the time? What was your life like?
I was working with Dr. Carbone travelling the world conducting workshops that trained others how to set up Verbal Behavior programming in the classroom setting. I was also seeing clients around Texas and California, consulting with local school districts and starting my Ph.D. program at the University of Texas. Life was 24/7 work, study and travel.
How do you make money?
Unfortunately, there is a growing need for our services. When I first started working in the field in 1988, the prevalence rate of autism was 1 in 10,000 births. Now the CDC is reporting a rate of 1 in 68 births. We are also a highly specialized service. There are not many professionals certified to do what we do, especially with our specialization in Verbal Behavior. We are in-network with all major insurance companies and run like a medical office with CPT codes and billing for therapy hours conducted. We also have several training and consulting contracts with school districts. We are also sometimes an option for school districts to place students that may need specialized services.
We invest in hiring the highest quality therapists and keeping them well trained. Recently, we updated the center, the website and acquired an additional 5,000 square feet to open the new Bridges Program for older students with Autism. We are also launching the first annual Verbal Behavior Conference for professionals. This year we are proud to have renown behavior analysts Dr. Vince Carbone, Dr. Mark Sundberg and Dr. Patrick McGreevy.
How long did it take for you to become profitable?
The center was break even for a long time until the insurance reform laws took effect around the 2009 time frame. In general, these laws required that insurance companies cover ABA services for children with Autism. This shifted us from an educational model to a medical model and gave families a secure funding source to receive the services they needed.
When you were starting out, was there ever a time you doubted it would work? If so, how did you handle that?
I never doubted what we were doing therapeutically and we’ve always had success there. The goal has always been to help kids and families; profitability was an afterthought. As I stated earlier, the center was break even for a very long time. I did doubt whether I could continue to support and pay my staff what they deserved to make. As most entrepreneurs have probably experienced, there were times I had to skip paying myself to make payroll and pay the bills. In terms of what didn’t work out the first time we tried it, there was a program that did not take off because of lack of funding sources. It is sometimes recommended that children come for 30-40 hours per week of 1:1 therapy. This is an intense and expensive model that few parents can afford to pay out of pocket. We tried to be creative and offer the program based on tuition or a sliding scale but the timing was just off to be able to make it work. Since securing funding sources, we’ve been able to launch a similar program again with great success.
How did you react to these failures or setbacks?
I held steadfast to the belief in the quality services we were providing to families and the amazing life changing results we saw in our students. I asked for feedback, analyzed what worked and didn’t work and why.
What did this experience teach you going forward? Contingency planning? Better organization? How to ask for help?
I am a practitioner entrepreneur. I had to recognize my own strengths and weaknesses as such. I learned to ask for help especially from the legal, financial and business community. I solicited the help of advisors that were or had been in CEO or CFO positions and could help me develop my business acumen.
How did you get your first customer
Having had a steady stream of clients before I opened CTAC, our first clients just morphed to our new setting. Most clients came through word of mouth or referrals from local parents and parent support organizations.
How did getting this customer affect how you obtained your next customers?
The autism community is very close knit. Quality resources get talked about quickly.
Was there word of mouth? Did it give you more confidence to approach more people?
Yes. We had little need for marketing. We were very lucky that we had an organic stream of clients. We were also the first and only center like this in all of Central Texas and there were very few in the state or in the whole southwest US at that time. My association with Dr. Carbone helped as well of course.
What is one marketing strategy (other than referrals) that you’re using that works really well to generate new business?
Investing in a new website and staying active in the community with presentations, sponsoring resource fairs for autism related events has helped to continue to grow our presence. Also, being viewed as a go to thought leader for local media has been beneficial as well.
Are you active on social media? Do you make and post online videos?
We maintain a facebook page and occasionally post blogs and videos on our website
Have you had success with traditional print or out-of-home advertising?
We do not produce print or out-of-home marketing. Website and email marketing surpasses the effectiveness of that for us.
Or are you doing something completely different?
Keeping an active presence in the community and volunteering our time and services has been effective.
What is the toughest decision you’ve had to make in the last few months?
As we have become in-network for most major insurance providers and 95% of our clients are funded by insurance, it has changed the needs of our front office. Last year we hired our first insurance specialist to handle billing and processing claims. One year later, we made the decision to hire our second insurance specialist. Even though this was an additional cost, we recognized the need to keep our office running efficiently and it has already proven to be a good move for the company.
What do you think it is that makes you successful?
My heart is in the right place, I do this job for the right reasons and that is ultimately for the love of these children and families. I also value education, professionalism and training. Keeping those values at my center, guides me to hire people with the same center and make all business decisions with that love as the focal point. Our field provides the ethical guidelines and the research and science that support everything we do therapeutically. Everything else falls into place around that love and quality.
What does your business offer that others don’t? How are you unique?
We have always maintained our mission to provide quality therapy to our families. We uphold the highest standards for ethical, research based intervention with board certified therapists. We provide training to our team from the most respected BCBA’s in the field. We don’t shy away from taking on difficult cases, for example children that are non-vocal or may engage in self-injurious behaviors or severe aggression. These clients are often referred to us by other professionals when they don’t know what else to do to help them.
What has been your most satisfying moment in busines?
I’m blessed to work in a field where I can see meaningful results everyday through the progress of our students. In the last year, it has been amazing for me to see our growth. We have doubled in the number of therapists we have on staff and the number of families we are able to serve.
Think of a milestone you had with your business
2018 will be our 15th year in business!
How did you accomplish it? How did you feel?
I feel we really built a quality program that has withstood the test of time. We were trailblazers in many ways and I’m so proud of what we’ve accomplished as a business, all the quality therapists we have trained over the years and the families and children we have helped.
Alternatively, what is something you do regularly that gives you fulfillment in your business life? Helping customers? Making something more accessible? Offering a healthcare service?
I am fulfilled daily when I see our clients making noticeable gains in their skills. I am fulfilled daily when I see therapists and teachers so happily and effectively teaching our kids. I am fulfilled when I see the change in our families from despair to hope to happiness.
What does the future hold for your business? What are you most excited about?
We’ve recently expanded to build a program that is specially designed for older learners. We call it the Bridges Program as we are helping to bridge learning to the community and life beyond school. The building has a workout room, kitchen, vocational lab, daily living lab, a social skills lab, technology lab, individual classrooms and therapy rooms and an outdoor area. We hope to continue to expand funding options for adults and build more connections in the community for employment.
Alternatively, what do you dream about one day achieving with your business?
So many dreams, so little time! I’d love to publish some of the research we have been doing and possibly a book on our consulting and training work to help teachers and school districts utilize the science of ABA in the classroom. I’ve also always wanted to own our own property and create a campus with outdoor space for gardening, raising animals, etc. Another dream is to explore more outreach opportunities working in foreign countries that do not have access to ABA services.
What business books have inspired you?
Outliers By Malcolm Gladwell. I love his writing style and how he gathers his research. In this book, he studies what makes high achievers different by looking at people’s culture, upbringing, generation and experiences. He emphasizes the importance of finding meaningful work and the hours of practice needed to be an expert in any area.
Alternatively, name something you’ve been meaning to read, and what it was about the book that caught your attention.
Bringing Out the Best in People: How to Apply the Astonishing Power of Positive Reinforcement by Aubrey Daniels
There is an area of research in our field called Organizational Behavior Management (OBM) and Aubrey Daniels is a leader in this area. He has worked with Fortune 100 companies and start-ups utilizing scientifically-based behavioral tools and principles to address workplace issues. This has just been updated to include current issues. I think it is important to balance my reading of the literature in my field of practice as a BCBA but also in my role as Executive Director. It is nice that I do not have to go outside of my field of study to do both.
What is a recent purchase you have made that’s helped with your business?
We recently invested in a scheduling and medical billing software system. It has helped to streamline our systems and make them more efficient.
What did it help you to achieve?
It allowed us to track claims more accurately and bill out more efficiently which improved our cash flow. It has also allowed us to perform higher level analysis of errors and denials to improve our business systems.
You started the company as a single woman and now you are a mother of 3. How has that experience changed how you work?
My priorities have evolved over the years. I know longer work and travel 24/7. I believe becoming a wife and mother has helped me become a better therapist and leader. I have a better understanding of the emotions, frustrations and stress that can come with raising children having lived it now. Although my children do not have autism, they each have presented with their own unique challenges and learning differences. I have experienced getting evaluations, working with teachers on implementing their accommodations, going to therapies and the challenges of working with them at home, getting your own work done as well as housework and finding time to be with your spouse. Being a mom has given me more empathy as a therapist and business owner for what our families are experiencing. I can give more realistic recommendations and have patience when follow through doesn’t happen. Having a family has also changed how I work as I prioritize work/life balance now. I am not at the clinic every day, I am very choosy about when I travel, I am careful to keep homework, dinner and bedtime routines with our kids and to be there for special events at school, etc. I try to unplug for those times and then check in with email again right before bedtime.