The holiday season is a time typically spent preparing for festivities with family and friends, and thinking about the year ahead — goals, plans, and resolutions. Given the difficulties of 2020, this piece pivots a little, focusing more on the wishes and dreams we have for the ABA field. I composed four questions and sent them out to all of our clinicians on staff here at CentralReach, weaving their responses into this blog post. The questions (crafted to help our clinicians think about the past year, how it has affected ABA, and what we can do to propel our field forward) and most common and impactful takeaways found among the responses are touched on below.
Question: What changes do you wish to see in regard to the delivery of services?
There have already been many changes this past year around how services are delivered, most notably through the utilization of telehealth. In order for our field to continue growing and showing the world all the great things we can provide from our science, we need to think about what our future can hold. The most common response to this question was expanding the reach of ABA to other industries and populations outside of the autistic community. The science of behavior analysis can provide benefits to other disciplines — including education, human services, safety, organizations, and more. The list could go on endlessly, but we could truly be making an impact on every industry in which human behavior is involved.
One of my favorite responses to this question was provided by Cassi Breaux, M.A., M.S., BCBA, LBA and CentralReach’s Manager of Educational Content Development. It involved client assent and dignity in programs. Client assent goes beyond the general need for consent in practice, but ensures clients are providing continual assent at every moment they are participating in services. Assent is a critical aspect in ensuring the respect of the clients we work with — whether it be the autistic community or any other population we serve.
An example of assent in practice would be to ask a client if it’s okay to provide a physical prompt while completing a task. If they say no, then the clinician should not provide that physical prompt.
Some other themes that I wanted to highlight from this question were responses related to adopting specialties similar to other medical fields, continued utilization of telehealth services, and better general public education about ABA.
Question: What changes do you hope to see between family dynamics and relationships with clinicians/technicians?
Dr. Shannon Hill, BCBA-D and CentralReach’s Senior Learning Designer stated something important that I feel the field is still in the early learning stages of understanding and working with, which is the contingencies families face in tandem with their children receiving services.
There are clients that receive 30-40 hours of ABA treatment; essentially a full time job. In some cases, it’s not that the parent doesn’t want to participate, but rather that they don’t have the time. Things like work, other children, and other obligations are barriers. As a field, we need to find flexible ways to involve families in the treatment planning aspect of their child’s care so that transitioning the plan to an in-home setting becomes easier (and more successful) while at the same time respecting and working around their time constraints. When you involve the parent, they are more likely able to commit to what they are able to manage. This early engagement can help ensure that you are creating an intervention plan that parents can follow through with later on.
This goes along with what the majority of what others stated; a way to provide better training to caregivers. BCBAs are great at devising intervention plans and determining what is evoking a specific behavior, but training caregivers to provide that same level of intervention is likely not suitable. An intervention should be created in a way that allows the parent to easily take over at any point. As clinicians, we went through years of fieldwork and coursework — parents shouldn’t have to possess those same requirements in order to interpret and complete an intervention plan with their child.
Question: Based on your experience as a clinician, what are some changes you’d hope to see organizations make in order to better support their staff?
This year, we have seen a tremendous amount of change — and from that change, great ideas can be formed regarding how to improve organizational systems moving forward. In asking this question, the intention was to focus on the key areas organizations can look to improve as they begin to expand services to more locations, centers, and clients.
One of the most prevalent themes in the responses centered around training and caseload ratio. There are more and more BCBAs entering the field each year, and the volume of services required for the autistic community continues to rise. Many clinicians feel that the amount of training provided is inadequate in ensuring that they are providing services ethically, effectively, and appropriately. In addition, the caseload ratio is so high at some organizations that trying to find time for that training can be difficult.
A lower caseload for clinicians would allow for more (and more effective) training, encourage a better work-life balance, and increase the overall quality of care provided to the client. Our clinicians and technicians are the heart of an ABA organization, and CentralReach’s Director of Clinical Programming, Dr. Kerri Milyko, BCBA-D, put it best: “they need to be treasured like family.”
When staff feel like they are being heard and valued as sacred members of the team, the better quality of work they will produce, leading to better outcomes for the clients they serve. Several other important takeaways included incorporating ABA principles into the management practices of businesses and collaborating more effectively with other professions.
Question: What advancements in technology (outside of CentralReach) would you hope to see in 2021 and beyond?
Technology was an area that dominated the year in 2020, and the field of ABA has seen a tremendous boost in telehealth services. It’s no surprise that one of the most common responses to this question was a desire to see telehealth continue as a practice moving forward. Telehealth will not be the first treatment modality for every client, but 2020 has taught us that it can become effective for many different reasons.
With technology continuing to play an increasing role in the field of ABA, Cara Soto, MA, BCBA and CentralReach Sales Engineer provided a great point — technology must become more affordable. There are many clients out there that use augmentative communication devices — and they are not inexpensive. It would be wonderful to see more affordable solutions offered, perhaps even covered by insurance companies or government assistance programs. Many families are already struggling financially, and if access to these types of devices are limited, we are potentially inhibiting a child’s ability to learn.
Another common theme within the responses to this question was related to augmented or virtual reality. A virtual reality device would allow clinicians another form of intervention for the clients unable to learn through the more traditional methods, or serve as supplemental training. We already see augmented reality playing a role in other industries, so why not ABA?
After reading the responses from our talented and insightful clinicians, I encourage you to ask yourself the same four questions and jot down your responses. Then, ask yourself, “what can I do to make an impact?” We can all help in some way. Each and every action makes a difference, and we have the ability to turn hopes and dreams into reality if we unify in our mission.
About the Author
Justyn Harvey, M.Ed., BCBA
CentralReach, Customer Success Manager
Justyn found his way to the field of behavior analysis when he moved to Florida for a job as a Behavior Technician after graduating with his Bachelor’s Degree in Psychology from the Ohio State University. He was very passionate about the work he was doing and went on to pursue his Master’s Degree and certification in behavior analysis.
After spending a few years working his way up from an RBT to a BCBA, he came across CentralReach where he realized that he could make a more national impact by assisting ABA companies with a software to automate some of the daily administrative tasks and allow for more time with the clients who need it.