January 08, 2025 | Authors: Reeva Dani and Valerie Mendonca
Butterfly Learnings was cofounded in 2021 by Dr Sonam Kothari and her partner, Dr Abhishek Sen, as a full-stack phygital paediatric health platform to address the therapy gap in children’s behavioural and developmental health. Sonam, a practising paediatric neurologist in Mumbai, had been observing a concerning pattern with her patients—mostly neurodivergent children with developmental and behavioural issues. After consultation and diagnosis, she would give them therapy referrals. However, during follow-up consults, she noted no improvement—if not regression—in the child. She observed a mismatch between therapist expertise and the specific needs of neurodivergent kids. According to Abhishek:
There was a quantity and a quality problem. There was no standard for pedagogy or practice—some therapists were very good, some were very bad, and a few were in between.
Sonam and Abhishek founded Butterfly Learnings to ameliorate the care lacuna for children facing challenges with neurodiversity. It offers a multitude of therapy solutions and support tailored for them. Its offerings include occupational and speech therapy, and its unique value proposition is Applied Behavioural Analysis (ABA) therapy—an evidence-based treatment approach to improve social interaction and communication skills in children with neurodevelopmental disorders. Butterfly Learnings employs over 400 behavioural therapists and operates 52 therapy centres in multiple cities and towns across Maharashtra, Gujarat, and Rajasthan. It raised USD 1.5 million in seed funding in September 2022 to build and scale its digital platform and expand geographically, followed by USD 3.8 million in Series A funding in April 2024 to scale to 200 centres across multiple Indian states.
Neurodivergence is a nonmedical term that describes human brain development and functioning that differs from what is typically considered the norm. It is a dynamic concept, and the conversation on its meaning and contours is open-ended. Several conditions—including neurodevelopmental disorders, learning disabilities, and certain genetic conditions—are associated with neurodivergence. It is distinct from but associated with mental health conditions and is subject to significant social stigma.
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ADHD, ASD, learning disabilities such as dyslexia or dysgraphia, speech and language disorders, and neuromotor impairments all fall under the broad umbrella term of neurodivergence.
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Some estimates suggest that 15-20% of the global population is neurodivergent.
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In India, approximately 12% of children suffer from neurodevelopmental disorders.
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Research shows that behavioural therapy is one of the options that uplifts a neurodivergent person’s experience and quality of social interactions. Yet, neurodivergent children have few options for accessing therapy in India as awareness and acceptance of neurodivergence are at a relatively nascent stage. Behavioural therapies to address neurodivergent conditions often overlap with treatment offerings for mental health disorders. India’s behavioural and mental healthcare services and support lag far behind global standards. The space is hard to solve for, partly due to social stigma around these conditions and partly due to an insufficient therapist supply and poor patient adherence.
However, startups are demonstrating the growth potential in the neurodivergence space by focusing on novel and inclusive treatment approaches for developmental and behavioural issues. The ecosystem is catching on to the developing awareness of neurodivergence and mental health in the public domain.
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A 2022 Blume Ventures report estimated the Indian mental health industry (including developmental health) to be a USD 3 billion market, of which the market for online and offline therapy for children and adolescents is USD 660 million.
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Startups in the space have innovated technological tools such as automated and AI-driven apps, tech-enabled and educator-led interventions, and interactive robotics to help neurodivergent individuals develop cognitive, speech, and communication skills. Behavioural health-focused ventures offer digital therapy mechanisms, AI and technology-assisted screening, diagnostic and assessment services, training and support for parents and caregivers, and special education programmes. Within this landscape and context, Butterfly Learnings is building pedagogy, personnel, and expertise for paediatric behavioural therapy.
Wenger, Trayner, and de Laat (2011) designed the Value Creation framework to assess the value—importance, worth, or usefulness—of learning enabled by social networks and community. We adapt the framework for behavioural healthcare to examine the value Butterfly Learnings has created.
The seven value creation cycles of immediate, potential, applied, realised, strategic, enabling, and transformative value are ongoing and circuitous. There is neither hierarchy nor a simple linear causal chain of values. When theorised as loops, these values feed into and amplify each other. Value creation is interpretive and serves as a shared language to discuss and understand implementation.
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We use the value creation framework to examine if and how Butterfly Learnings is systematising service provision for paediatric behavioural healthcare. Our study assesses the impact of a sustained intervention in producing informational transparency and measurable results-based outcomes in the behavioural healthcare space.
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Value Creation Framework, adapted for Butterfly Learnings from Wenger-Trayner et al. (2019).
Focused conversations, discussions, and purposeful participation produce immediate value in the form of answers, solutions, help, or perspectives. The COVID-19 pandemic had forced children to remain at home, cut off from peers for over a year when Butterfly Learnings opened its first therapy centre in Thane, Maharashtra, in April 2021. The social isolation had led to children increasingly showing signs of psychosocial issues, loneliness, and withdrawal behaviour. Seeking support for their children, parents committed to travelling to the therapy centre during the second wave of the pandemic.
Research shows that the social taboo around neurodevelopmental issues often limits the remedial care or community support available to parents. In this context, Abhishek believes that parents found the help, solidarity, and evidence of clear clinical outcomes that Butterfly Learnings promised to be a good value proposition.
Activities and interactions can produce knowledge capital whose value lies in its potential to be realised later. Knowledge capital refers to information, tools, references, new ideas, social resources, and learning opportunities. Participation and training can cultivate the potential for future collective practice, innovation, and startup action in the neurodivergence domain. Butterfly Learnings made efforts to develop this potential value by creating a pool of trained therapists and publishing research. Research on therapy outcomes is crucial for corroborating successes or setbacks.