Applied Behavior Analysis (ABA ) services by a Board Certified Behavior Analyst (BCBA) are becoming increasingly common. If you are new to our blog, you may read more about ABA services here and you may read more about a BCBA here.
Today’s post is really for BCBAs and BCaBAs. However, we always welcome parent and teacher readers because everyone can learn from one another.
Are You Doing Due Diligence?
What is “due diligence”? While there are several definitions, the most appropriate definition here is: “acting with a certain standard of care” (Wikipedia).
Standard of Care
What is the standard of care within ABA? The best resource available, in my opinion, is the practice guidelines produced by the Behavior Analysis Certification Board (BACB). The BACB created a beautiful and comprehensive manual describing the standard of care in behavior analysis. The manual is called, “Applied Behavior Analysis Treatment of Autism Spectrum Disorder: Practice Guidelines for Healthcare Funders and Managers”. You may download the manual here. The manual doesn’t talk about caseload for BCBAs who consult with teachers, classrooms, and schools. Rather, the manual discusses ABA services for individual children.
Tiered Services
One important feature regarding ABA services is the tiered model of service delivery. Just like in medical care, the licensed vocational nurse (LVN) provides direct care, he is overseen by the registered nurse (RN), who follows a treatment plan developed by a physician. In ABA, a technician provides direct care to clients. The technician is overseen by a BCaBA or a BCBA. The BCBA develops the treatment plan and oversees the individuals providing direct care.
If you are a BCaBA, you must work under the guidance and supervision of a BCBA. BCBAs are independent practitioners. However, I know very few BCBAs who want to be on their own. Most of the individuals I have met, want to work alongside a team of professionals in order to solve the most complex cases. Behavior therapists are not independent practitioners either and they, too, must work under the guidance and supervision of a BCBA or BCaBA.
Caseload
How many students are on your caseload?
How many should be on your caseload? This manual has great recommendations regarding the appropriate caseload for BCBAs. The recommendation is based on the type of case. For example, a comprehensive case would require more intense supervision while a case focusing on one are of learning (e.g., toileting), may need less supervision.
Case Oversight
All ABA cases, including the technician, will need supervision. Case supervision may come in the form of indirect services (e.g., graphing, analyzing data, writing reports) or direct supervision (e.g., modeling program implementation, collecting interobserver agreement, or completing fidelity checks). While case supervision will vary from child to child, the BACB recommends 2 hours of case supervision for each 10 hours of service.
Take a moment and reflect on your cases. Are you doing due diligence?
Hi! Thank you for this article! It is very helpful.
I feel that I have read (in various documents from ABAI, APBA, BACB, the AMA’s interpretation of our guidelines etc – there are really too many to read.) that the “guideline” is that supervision should be anywhere from 10%-30% of direct therapy hours.
I see that you mentioned the 20% rule here. Could you please clarify…. from your reading and research, is the 20% a hard and fast rule or do you find that there is a bit of leeway and anywhere form 10-30% (depending upon the client of course) is appropriate and the 20% is just the average of that?
I apologize if I am incorrect on the 10-30%. I just feel like every document that I read on this subject has a different percentage value on it.
Thanks!
Hi Tyrrell and thanks for writing. The BACB revised practice guidelines for autism services indicates that 20% is the average. The document indicates that this may vary more or less depending on client needs. Thus, it makes sense that 30% would be appropriate in cases with severe challenging behavior or more comprehensive services.