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Posts Tagged ‘BCaBA’

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.small group training

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

assesment

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?

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Documents

BACB Guideline 3.02 Explaining Assessment Results

Recently, a client planned to attend an upcoming IEP meeting for their child who received school services in a private school and Applied Behavior Analysis (ABA) Therapy from a private provider. The client did not want the ABA provider to attend the IEP meeting. Instead, they asked the ABA provider to submit a report that would be reviewed in the meeting.

The ABA provider informed the client that he was unable to submit a report for a meeting that he could not intend. He cited the BACB Guidelines for Responsible Conduct. The client became very upset and even said “Other BCBAs have done this, why can’t you?”

As a BCBA, we must follow the Guidelines established by the Behavior Analysis Certification Board (BACB). As Augustine of Hippo states, “Right is right, even if no one is doing it.”

The BACB Guideline 3.02 specifies what is expected of BCBAs with regards to their assessments. Specifically:

3.03 Explaining Assessment Results.

Unless the nature of the relationship is clearly explained to the person being assessed in advance and precludes provision of an explanation of results (such as in some organizational consultation, some screenings, and forensic evaluations), behavior analysts ensure that an explanation of the results is provided using language that is reasonably understandable to the person assessed or to another legally authorized person on behalf of the client. Regardless of whether the interpretation is done by the behavior analyst, by assistants, or others, behavior analysts take reasonable steps to ensure that appropriate explanations of results are given.

If a BCBA cannot attend a meeting where his report is reviewed, how can he ensure that the report is interpreted appropriately as the Guidelines state? The BCBA has several options:

  1. Have another appropriately trained BCBA go in his place
  2. Have an appropriately trained BCaBA attend his place
  3. Offer to call in to explain the results
  4. Meet separately from the meeting to review the results

Practicing BCBAs have many job responsibilities and obligations. We are often faced with difficult decisions as a result of those responsibilities. It is imperative that we know our Guidelines for Responsible Conduct and that we follow them to the best of our ability.

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Parents and professionals working together

Parents and professionals working together

Hi and Welcome to What Works Wednesday! where the focus is usually the description of a successful case story. The general public is slowly beginning to learn and appreciate the fact ABA works. However, in an ongoing comprehensive ABA program for individuals, more than just good ABA is required. Parent and professional collaboration is an essential ingredient. In ABA teams at Applied Behavioral Strategies, the BCBAs work to ensure that every case has 4 hours of parent-professional contact at a minimum each month. Collaboration occurs in a variety of contexts.

Team Meetings

In a comprehensive program, it is important for the team to meet frequently to guarantee that the team is implementing programs correctly and that programs are modified so that the child will continue to make progress. In most cases, the team meets twice per month for 2 hours. The first order of business at every meeting: parent concerns. The team includes all therapists, the supervisor (BCBA), the parents, and other outside professionals.

Clinic/Team Meeting Notes

During the team meetings, detailed notes are taken so that team members may review them before therapy. Everyone receives a copy of the notes, including the parents. The notes are also placed in the child’s program book so they are handy for team members.

Communication Logs

In cases where the child receives therapy in a setting where the parent is not present, therapists and supervisors keep a detailed communication log that is sent home with the child each day. These logs keep the parents informed about the child’s day and serves as another way to build cohesive team communication.

Phone Consultation

Supervisors at Applied Behavioral Strategies make themselves available by phone. Supervisors are extremely busy but a great time to return calls is between appointments when driving from place to place (don’t forget to use your headset!). Parents, if you need to speak to your supervisor, let him/her know so that time can be made for the call.

Emails

Finally, email is another way to remain in close contact with parents. Emails can be returned at any time of day; especially when talking by phone is not possible. Emails also provide a written record of your requests and decision making.

In summary, professionals be diligent to ensure parent-professional collaboration. Parents, do not be timid. Partner with your BCBA and team to help propel your child’s progress to its maximum potential.

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New Year ResolutionAs behavior analysts, we are faced with many responsibilities. Before we even think about seeing clients, we must first acknowledge the need to uphold our ethical obligations. We have a number of rules and principles to keep in mind. These include, but are not limited to the following:

  • Core ethical principles for psychologists
  • BACB Guidelines for Responsible Conduct
  • State Laws
  • Federal Laws

As we embark on the new year, I have a few resolutions for me and my fellow behavior analysts to consider.

  1. I will strive to keep reinforcement a top priority by conducting preference assessments and reinforcer inventories frequently (relates to BACB Guideline 4.05)
  2. I will strive to keep my client’s rights ahead of my own interests and conveniences (relates to BACB Guideline 2.0)
  3. I will strive to engage in professional behaviors at all times so that others view our profession with high regard (relates to BACB Guideline 7.01)
  4. I will strive to remain current in the research related to my area of practice (relates to BACB Guideline 1.03)
  5. I will strive to be the best behavior analyst that I can be (relates to Guideline 1.0)

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The field of behavior analysis is growing. This is due in part to:

  1. International Board Certification in Behavior Analysis (www.bacb.com)
  2. Increased insurance legislation mandating coverage of Applied Behavior Analysis (ABA) (http://www.autismspeaks.org/advocacy/states)
  3. Increased behavioral needs of all children

Demand

Because of these, and other reasons (e.g., CT has a law requiring BCBA {or similar} supervision of some school programs), BCBAs are hot commodities. Check out Craig’s List in your area and count how many companies are hiring behavior therapists and/or behavior analysts. Agencies will pay top dollar for a highly qualified and experienced BCBA. In fact, a recent email went out to certain BCBAs advertising up to $125,000 annually for a BCBA on the east coast.

Overworked?

Recently the Behavior Analysis Certification Board, produced two important documents. You can read more about them here and here. Essentially, the Board described expectations for supervisors regarding case loads and professional duties. Supervising the provision of ABA services requires on-going and regular contact with the client and therapists on the team. To do this well, BCBAs should maintain a small case load. If the BCBA has a BCaBA to assist with some duties then additional clients may be served. The bottom line is that clients need regular contact and supervision of the program.

In some instances, an agency may hire a BCBA and expect the BCBA to provide all the services for the clients or students within the agencies. For example, numerous school districts hire one BCBA to cover the entire caseload of special education students. The end result is poorly supervised ABA programs and a BCBA who is unable to fulfill his/her job duties effectively.

Important Personal Duties

In addition to all the professional duties required, BCBAs must also tend to multiple personal duties. These include:

  • maintaining certification
  • completing continuing education credits
  • registering for and attending conferences
  • reading and keeping up with the professional literature

During the course of the continuing education webinars provided by Applied Behavioral Strategies, LLC (an approved BACB provider), BCBAs seem to be so busy that they:

  • don’t have time to check their email
  • forget to include important documentation such as BACB certification number
  • forget to come to the webinar

Yes, BCBAs are so busy that they forget to come to a webinar that they have paid for and one that they need in order to maintain their certification.

So, slow down, organize yourself, make priorities, and do not overextend yourself. You owe it to your clients and you owe it to yourself.

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Hi and welcome to Ask Missy Mondays where I respond to a question from readers. Today’s post is a follow-up to a previous post on Supervision where Karen had asked “what are the rules on ABA supervision?

Recently, the Behavior Analysis Certification Board (BACB) issued a document related to practice guidelines. While the practice guidelines are specifically related to the provision of ABA services for individuals with autism, readers are provided with clarity regarding the supervision expectations for clients.

The BACB has this to say about on-going supervision of ABA services:

“Although the amount of supervision for each case must be responsive to individual client needs, 1-2 hours for every 10 hours of direct treatment is the general standard of care. When direct treatment is 10 hours per week or less, a minimum of 2 hours per week of clinical management and case supervision is generally required. Clinical management and case supervision may need to be temporarily increased to meet the needs of individual clients at specific time periods in treatment (e.g., intake, assessment, significant change in response to treatment).

A number of factors increase or decrease clinical management and case supervision needs on a shorter- or longer-term basis. These include:
• treatment dosage/intensity
• client behavior problems (especially if dangerous or destructive)
• the sophistication or complexity of treatment protocols
• the ecology of the family or community environment
• lack of progress or increased rate of progress
• changes in treatment protocols
• transitions with implications for continuity of care

Within the same document, the BACB discusses case loads for BCBAs. Specifically, they suggest:

  • The average caseload for one (1) Behavior Analyst supervising comprehensive treatment without support by a BCaBA is 6 – 12.
  • The average caseload for one (1) Behavior Analyst supervising comprehensive treatment with support by one (1) BCaBA is 12 – 16. Additional BCaBAs permit modest increases in caseloads.
  • The average caseload for one (1) Behavior Analyst supervising focused treatment without support of a BCaBA is 10 – 15.
  • The average caseload for one (1) Behavior Analyst supervising focused treatment with support of one (1) BCaBA is 16 – 24.
  • As stated earlier, even if there is a BCaBA assigned to a case, the Behavior Analyst is ultimately responsible for all aspects of case management and clinical direction. In addition, it is expected that the Behavior Analyst will provide direct supervision 2-4 times per month.

Keep in mind that these recommendations are related to comprehensive programs for children with autism.

We hope this helps to clarify our previous suggestions about supervision of ABA programs. We applaud the BACB for providing these guidelines that will prove helpful to behavior analysts, parents, and school district staff alike.

 

 

 

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Hi and welcome to Ask Missy Mondays where I respond to a question from readers. Today’s question comes from Gwen who writes:

“My high functioning 7-year-old is in mainstream 1st grade with an aide. Her biggest problem is laughing and saying, “No!” as an attempt to avoid working. She is not disruptive enough to be sent to the resource room, yet she is non-compliant which is not appropriate for general education. Our ABA team has tried token systems and they did not work.They tried PEC cards for “quiet time” and “stop talking” but those strategies did not work.

At home, I simply say in a firm voice,  “It’s time to work” and she does it. She may giggle and say repeatedly, “all done!” but the work is completed and it is usually correct!

Do you have any tips for us? She is simply running over them”

Hi Gwen! thanks for coming back to visit. We are sorry to hear that you are having troubles with your daughter’s behavior. Let’s talk about a few things.

Function of Behavior not Form

First, so many times teachers and other professionals fall in to the trap of treating a behavior based on its form (how it looks–or what behavior analysts call topography of the behavior). However, we should not attend to the form of the behavior as much as we should attend to its function (the result of the behavior).

Functional Behavior Assessment (FBA)

We cannot effectively address a behavior without first knowing it’s function (why is your daughter doing this?). We typically understand the function by taking careful ABC data. We could also do some manipulations if necessary to prove why she is doing the behavior.

Your Daughter

Based on what you’ve told me, it seems that she is getting an awful lot of attention for her behavior (e.g., “no talking” and “quiet time” contingent on the behavior). If that is the case, a simple intervention of attending to her for good behavior (i.e., attending and working) and ignoring the junk behavior (i.e., work refusal and laughing) should be effective. Both techniques should be used in combination to ensure effectiveness of the intervention.

Example:

Seat work time. Your daughter laughs and says, “no”.

The teacher and aide should immediately turn their backs to her and instead give all of their attention to the other kids in class who are working quietly. The adults should say “I like how Johnny is working quietly” and “Suzie, you are doing great quiet work”

When your daughter is quiet and working, the teacher or the aide should immediately turn to her and give her praise for working quietly.

Class-Wide Reinforcement

The teacher may want to consider a class-wide reinforcement system so that all the children can be rewarded for staying on task and completing work

Keep me posted on how things go!!

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