Unimed Goiânia descredencia clínicas de autismo; mães temem regressão em 200 crianças

In early June, roughly 200 children in Goiânia will lose access to the specialized autism clinics where they have spent months or years building trust with therapists and learning to navigate carefully structured routines. Unimed Goiânia, the health insurance cooperative, has decredentialed four clinics—Instituto Kids, Mundo Kids, MCB Espaço Terapêutico, and IDK Instituto Desenvolver Kids—with approximately 45 days' notice and no formal communication from the insurer itself. The mothers of these children learned about the decision from clinic staff or social media posts, not from their insurance company.

For families managing autism spectrum disorder and other neurodevelopmental conditions, this is not a simple matter of switching providers. Children receiving care at these clinics typically attend multiple therapy sessions daily across six or more disciplines: psychology, occupational therapy, speech therapy, physiotherapy, psychomotor therapy, and psychopedagogy. Some children attend 16 hours of therapy per week; others receive 20 to 40 hours. The therapeutic relationship itself—the trust built between child and therapist, the familiarity with a specific space and routine—is considered essential to progress. Disrupting that relationship can trigger regression in development, behavioral setbacks, and emotional distress.

Giselle Oliveira, an attorney and mother of an autistic child, represents families now organizing both individual and collective lawsuits against Unimed's decision. Her own children have been receiving care at Instituto Kids for nearly two years. "Neurodivergent children need adaptation," she explained. "It's not simply ending here and going somewhere else. There is a bond with the therapists, with the environment, with the routine and with the entire team." Her children attend four hours of therapy daily—a schedule she says is impossible to replicate in the clinics currently credentialed by Unimed, where many locations offer only one hour per day.

Marcela Alvarenga's son Saulo attends 16 hours of weekly therapy across six modalities at Instituto Kids. She learned of the decredentialing from a therapist, then from the clinic itself—never from Unimed. "We received no official communication from Unimed," she said. Saulo took months to adjust to his therapeutic routine and build confidence with his care team. The prospect of sudden displacement terrifies her. "Autistic children have great difficulty adapting. The therapeutic bond takes a very long time to build. It takes months for a child to feel comfortable in that space and with that therapist." She worries that an abrupt move could cause severe emotional and cognitive harm.

Nádia Ribeiro, a psychologist and mother of seven-year-old Miguel, discovered the decredentialing through the clinic's Instagram account. Unimed never contacted her directly. Miguel has been receiving psychology, pedagogy, and speech therapy for nearly two years—a slow process of building trust that could unravel overnight. "Some children won't accept the new environment," Nádia said. "Everything will have to start from zero: new environment, new therapist, new routine. This can cause regression in development."

Representatives of the affected clinics, speaking anonymously, estimate that more than 200 families will be directly impacted and that thousands of therapy sessions monthly will be interrupted. They report that Unimed cited expansion of its own internal structures as the reason for decredentialing, but the clinics say the insurer's own facilities cannot absorb the demand. Sessions at Unimed's internal clinics are often shorter—30 minutes instead of an hour—and sometimes conducted by therapeutic aides rather than specialized professionals. The clinics point to one case: a child with autism spectrum disorder and Down syndrome who has been in care since six months old and is now five years old. "Years of therapeutic work being interrupted abruptly," one representative said.

The financial barrier is also severe. Private therapy sessions cost between 150 and 180 reais each. For a child needing 20 to 40 hours weekly, the monthly cost becomes prohibitive for most families. Giselle Oliveira called it "unfeasible for the majority of families." The broader context is a surge in neurodevelopmental diagnoses in recent years, which has increased demand for specialized therapies—particularly those using ABA methodology, which the decredentialed clinics employ. Goiânia currently faces a shortage of long-duration specialized care slots, especially for children requiring high therapeutic loads.

Families are pursuing two strategies: individual lawsuits and collective action with the Public Ministry. The core complaint is not that decredentialing itself is illegal, but that Unimed executed it without adequate notice, without a reasonable transition period, and without ensuring the network could absorb the displaced patients. In response, Unimed stated that it "fully observed all provisions in the respective service contracts" and assured that "no one will be left without care." For the families involved, that promise rings hollow against the reality of their children's needs and the clock ticking toward June 14.