A San Antonio occupational therapist has been charged with continuous sexual abuse of a child after a 12-year-old girl with autism told her pediatrician that he had been abusing her during in-home therapy sessions she had been receiving since she was 4 years old. Lewis Trudell Barber was arrested on allegations of sexually abusing the autistic child patient under his care, according to court records, and booked into Bexar County jail.
According to an affidavit cited by the San Antonio Express-News, the girl told her pediatrician on September 24, 2024 that Barber had touched her breasts and genitals. The pediatrician then reported the alleged abuse to the Bexar County Sheriff's Office. Barber had treated the girl since she was 4, and he worked for Aveanna Healthcare on San Antonio's southwest side at the time of the alleged abuse, per the affidavit described in the paper's reporting.
The girl told investigators the abuse happened during therapy sessions at her house and at her aunt's house, according to the affidavit. She said Barber exposed his genitals to her, forced her to touch his genitals, and forced her to perform oral sex, according to a forensic interview conducted by ChildSafe. The girl also said she would tell Barber to stop and that she was scared to speak up, per the affidavit.
How the Outcry Reached Investigators
Texas law requires healthcare professionals and therapists to report any suspected child abuse to law enforcement or child protective services within 24 hours, a mandate under Texas Family Code Section 261.101 that shortened the reporting window from 48 hours in 2025, according to the Texas Department of State Health Services. That duty is what obligated the girl's pediatrician to alert law enforcement once the outcry was made.
From there, the case moved to ChildSafe, the sole accredited Children's Advocacy Center in Bexar County. The nonprofit conducts forensic interviews designed to let child victims share details of abuse just once for both law enforcement and medical teams, and sexual abuse cases make up 79% of its workload, according to ChildSafe. ChildSafe describes itself as a nonprofit providing therapy and crisis intervention in child-abuse cases. The same organization's data shows Bexar County has consistently recorded the highest proportionate rate of confirmed child abuse cases among major metropolitan counties in Texas.
Charges Carry a Mandatory Minimum of 25 Years
Barber has been charged with continuous sexual abuse of a child under the age of 14, a first-degree felony. He faces a maximum sentence of life in prison if convicted, and a $10,000 fine, with his bail set at $100,000. Under Texas Penal Code Section 21.02, part of the state's version of Jessica's Law enacted in 2007, that charge carries a mandatory minimum of 25 years in prison with no option for probation or deferred adjudication, according to legal analysis published by Varghese Summersett.
The statute also lowers the bar for conviction in cases involving ongoing abuse: prosecutors can secure a conviction if at least two abusive acts occurred over a span of 30 or more days, and jurors do not need to unanimously agree on which specific acts took place, so long as they agree at least two occurred, per the same legal analysis.
Employer Praise and Professional Fallout
Barber had been licensed as an occupational therapist since 2008. Mesa Vista Health Center named him its employee of the month in March 2025, saying he was a great example of customer service and positivity every day to residents and staff. The National Board for Certification in Occupational Therapy suspended his occupational-therapy license in July 2025.
The national board enforces an independent code of conduct and reports formal credential suspensions or revocations to state licensing boards nationwide, according to the National Board for Certification in Occupational Therapy. In Texas, the Texas State Board of Occupational Therapy Examiners, governed by the Texas Executive Council of Physical Therapy and Occupational Therapy Examiners, holds separate statutory authority to suspend or revoke practitioner licenses following misconduct investigations, though it remains unclear what, if any, additional administrative action that board or Aveanna Healthcare and Mesa Vista Health Center have taken internally.
A Pattern Researchers Say Raises the Stakes
Research synthesized by the Centers for Disease Control and Prevention and the Vera Institute of Justice indicates that children with developmental disabilities or autism are more than three times as likely to be sexually abused as neurotypical children, a disparity often tied to communication barriers and dependency on daily caregivers. Aveanna Healthcare, which employed Barber, is a national pediatric home health agency operating across more than 30 states, including 45 branch locations in Texas offering home-based therapy and private-duty nursing.
The case adds to a string of recent Bexar County prosecutions involving caregivers and professionals accused of abusing children in their care. Hoodline has previously reported on a 22-year-old Bexar County detention officer arrested in May on charges of continuous sexual abuse of a disabled child after a 13-year-old girl with disabilities was abused multiple times. Other recent local cases have involved a San Antonio teacher and a man accused in a three-year child sex abuse case, both charged under the same continuous-abuse statute.
It remains unresolved whether additional patients have come forward with outcries against Barber, and the timeline for a formal grand jury indictment and any license revocation proceedings by the state board has not been established. The reporting on Barber's arrest and the details of the affidavit were first published by Annasofia Scheve of the Express-News, who covers crime and breaking news for the paper and joined the outlet in 2023.
