Autism & Pediatric Therapy: Navigating Change in H1 2025 – M&A Shifts and Capital Trends
- lflopezcobo
- Jul 1
- 5 min read
Mergium analyzes mergers, acquisitions, and private placements in the autism services and pediatric therapy sectors, with data spanning 2019 to mid-2025.
M&A Activity: The Half-Year Snapshot
The first half of 2025 saw robust M&A activity, with 20 transactions recorded. This is a strong showing, especially when you compare it to the full-year totals of 35 transactions in 2024 and 36 in 2023.
Source: Mergium research.
Notes:
2025 figures up to June 30th, 2025
This analysis:
Focuses on practices that offer: (1) therapies for kids and young adults with autism and other disabilities; (2) treatments such as behavioral (applied behavioral analysis (ABA)), developmental (speech, occupational, physical, feeding therapies, and others), educational, and social relational; (3) services in-clinic, in-school, in-home, and/or telehealth; and (4) testing for autism.
Excludes companies that develop and market solutions, products, and tools to providers and families such as: (1) IT solutions (software, apps, and the like); (2) technologies for diagnostics tests (e.g. MARABio, Cognoa, BioROSA, EarliTec); (3) medications; (4) matching platforms; and (5) virtual reality devices.
Types of transactions and buyers:
PE (Buyout): Transactions by private equity firms (“PE”).
PE (Secondary Buyouts (SBOs)): Sale of practices by one PE to another PE.
PE (Platform): Typically, after closing of an M&A by a private equity, the acquired company (“Platform”) grows through acquisitions (“add-ons”) of smaller practices and de novo locations. The acquisitions of those smaller practices are registered here.
Strategic Buyer: These are acquisitions of practices done by a company that is not a PE, nor a Platform of a PE.
The study includes sales of majority and minority interests:
Sales of majority interests - 100% or more than 50% of shares or interests.
Sales of minority interests - Less than 50% of shares or interests.
Strategic Buyers Drive M&A Forward
Merger and acquisition activity spearheaded by strategic buyers continued its impressive momentum. There were 9 transactions in the first half of 2025, marking the highest annual number of deals by strategic investors in the entire 2019-2025 period. What's more, acquisitions by strategic investors have steadily gained ground as a percentage of overall transactions compared to other investor types.
Source: Mergium research.
M&A Landscape Shifts in Q2 2025
The second quarter of 2025 brought a notable shift in the industry's merger and acquisition dynamics, primarily driven by a sharp decrease in acquisitions by platform companies. This marks a structural change, favoring:
· More acquisitions by strategic investors.
· Fewer buyouts by private equity firms.
· An increase in secondary buyouts, likely linked to the extended holding periods of many platform companies.
As anticipated, Q2 2025 saw a drop in overall acquisitions, with only 5 deals recorded compared to 15 in Q1 2025. This slowdown is directly tied to a cocktail of economic uncertainties.
On the macroeconomic front, Q2 was plagued by concerns over international trade terms (tariffs), potential higher inflation, the path of changes in interest rates, and a general consumer apprehension about an economic slowdown and impending inflation, as indicated by the University of Michigan's Surveys of Consumers.
From a microeconomic perspective, M&A activity in Q2 2025 was further impacted by the uncertainty surrounding potential Medicaid cuts stemming from the "Big and Beautiful Bill."
Source: Mergium research.
Extended PE Holding Periods Poised to Boost Future M&A
Private equity firms typically hold their platform companies for about five years. As of mid-2025, of the 86 platforms acquired through buyouts or secondary buyouts that Mergium has tracked, roughly 36% have now been held for longer than this five-year average.
This extended holding period suggests that these mature platforms are increasingly likely to be preparing for an exit. We anticipate this will lead to a surge in secondary buyout activity. However, this push towards exits has likely slowed down add-on acquisitions in the short term, as many platforms focus on getting ready for sale. Once these platforms are sold, they're expected to resume pursuing additional M&A (add-on transactions) to fuel their continued growth.
Source: Mergium research.
Private Placements Remain Steady in First Half of 2025
The first half of 2025 saw private placements hold steady when compared to the same period in 2024. We recorded four private placements in both periods, with the total capital raised also remaining remarkably similar: $92 million in H1 2025 versus $95 million in H1 2024.
Historically, most capital raises since 2019 have been for amounts under $5 million, with the $5 million to $20 million range being the next most common.
Source: Mergium research.
Notes: Private placement: These are acquisitions of shares and debt instruments by private investors when a company sells newly issued shares or acquires debt. These transactions are regulated by the U.S. Securities and Exchange Commission.
What's Next for M&A and Capital Raises
As we move into Q3 and Q4 2025, industry players—both buyers and sellers—should gain more clarity on the macroeconomic and microeconomic factors that have been creating uncertainty. This improved visibility could lead to a potential uptick in M&A transactions over time.
We anticipate the structural shifts in M&A will persist. This means we'll likely continue to see more deals driven by strategic investors, a decrease in add-on acquisitions, and a continued trend of secondary buyouts.
Private placements are also expected to increase over time. This growth will be fueled by greater awareness among owners about the availability of private capital and the ongoing professionalization of smaller practices in the sector.
What Acquirers Seek in M&A Targets
Buyers in this sector are on the lookout for merger and acquisition targets that demonstrate several key qualities:
Strong clinical outcomes and a clean compliance record with both Medicaid and private insurance.
Consistent revenue growth coupled with sustainable, healthy profit margins.
A diversified mix of payers and clear potential for future growth.
Low therapist turnover and effective management.
Well-functioning information systems (both financial and operational) and established, efficient internal processes.
Effective training models that foster positive learning environments.
Seller valuation expectations that are realistic and aligned with current macroeconomic conditions and the economic realities of the segment.
Additional resources:
If you need assistance selling or valuing your pediatric therapy practice, contact us.
If you need to read more about how to sell your pediatric therapy practice (ABA, OT, PT, ST), click here.
If you need to read more about selling a business, read more
If interested in reading more articles and insights by Mergium, click here
If interested in knowing about our experience in selling / acquiring healthcare services companies, click here