Applied Behavior Analysis (ABA) is a scientific approach to understanding behavior and changes in behavior. Using the principles of Applied Behavior Analysis, individuals can be taught new skills across behavior, communication, and social skills. ABA sets itself apart from other therapies in that all decisions are data-driven. A clinician will decide to modify or continue an intervention based on the impact it has had on behavior. This is where a BCBA or Board Certified Behavior Analyst is involved.
Board Certified Behavior Analysts, also known as BCBAs, are Master’s or PhD-level clinicians who deliver ABA therapy and study the principles of behavior change. BCBAs deliver ABA therapy in a variety of settings, most commonly with individuals on the autism spectrum.
The BCBA is responsible for:
- Working closely with the client and their family to develop a treatment plan that maps to their specific needs and goals
- Overseeing client progress and communicating that clearly with the client and their family
- Modifying the treatment plan or interventions based on the client’s progress
The role of a BCBA can look different based on the environment, whether conducting services in a clinic, home, school, community, or virtually.
At the start of therapy, a BCBA will conduct an initial assessment which includes an interview with parents or caregivers and an observation video call or meeting with the client. This initial assessment is an opportunity for parents or caregivers to share their main priorities/concerns and helps a BCBA decide which assessment to implement during the direct observation.
When directly observing a client, the BCBA will assess various skills across these 3 areas:
This can look like labeling items, communicating wants/needs, identifying emotions, etc.
Developing Treatment Plans
Once the assessment is complete, the BCBA will use the results to create goals that are unique to the individual. For example, if during the direct observation, a child was hitting to ask for a toy, and wasn’t able to vocally request the item, a goal may be added to work on communicating to access items as a replacement for hitting/aggression.
The treatment plan includes, but is not limited to:
- results from the initial assessment
- recommended hours for therapy
- a plan for discharge/transition from therapy
- a behavior intervention plan
- behavior reduction/replacement goals
- client skill acquisition goals
- caregiver training goals
BCBAs will then review the treatment plan with both the client and caregivers for approval.
Supervising RBTs/ABA Therapists
In most ABA therapy models, there is a tiered model where BCBAs oversee the treatment and train Registered Behavior Technicians or ABA Therapists to deliver the therapy. BCBAs will supervise the therapists at a minimum of 5% of the hours spent delivering services. During these supervisions, BCBAs will deliver feedback, model protocols, and modify any therapy programming based on a client’s progress. Sometimes BCBAs will step into the session to assist with behavior management.
Providing Parent Training
One of the most important roles of a BCBA is to provide parent/caregiver training and support. BCBAs will work with caregivers and parents on various strategies that can be implemented outside of direct therapy sessions to support the generalization and maintenance of skills.
BCBAs may work with parents on strategies to replace and reduce inappropriate behaviors, as well as strategies to promote the use of appropriate behaviors - these techniques are called reinforcement, shaping, and chaining. During these training sessions, BCBAs may model various procedures, conduct role play with caregivers, and provide opportunities for caregivers to practice the skill with their child. These training sessions are a great opportunity for caregivers to express any concerns and for BCBAs to provide updates on ongoing progress.
Conducting Data Collection/Analysis
Making data-based decisions is paramount to the success and implementation of ABA therapy. When delivering treatment, the therapist will collect data on all targeted skills and behaviors for the BCBA to assess progress. If a client is working on vocally requesting items using one word, the BCBA will add a specific data-collection goal for the therapist to track client independence using a specific intervention. When the BCBA analyzes the data, they will assess whether the progress is on an increasing or decreasing trend (i.e. is the client making progress or regressing? Is the client making progress or is there no change?).
Based on this analysis, the BCBA will determine whether to continue or modify the current intervention. Each behavior, communication, and social goal will have its own collected data for the BCBA to analyze and track progress. BCBAs will also consider environmental factors and their potential impacts on behavior and progress. In other words, if a client leaves for a 2-week vacation, a BCBA may add a note to the client’s graphs upon their return to therapy to assess a potential relationship between a 2-week absence and their overall progress.
Direct-Service BCBA Model
While the tiered model of ABA is most common, some companies are implementing the direct-service BCBA model. Rather than having a BCBA oversee treatment and train therapists to implement, the BCBA will instead oversee the treatment AND implement. This model is most commonly found in telehealth settings and provides an opportunity for the BCBA to work even closer with clients and their families. Through this model, BCBAs can create protocols, implement the intervention, and modify procedures more often.
Compassionate, Collaborative Support
When finding a qualified BCBA, it is important to consider your child’s individual needs. If a child has a history of abuse, it’s important to find a BCBA with trauma-informed training and experience. If a child has severe feeding concerns, find a BCBA with experience and training on feeding. Many BCBAs will post their experiences on websites such as LinkedIn, where parents/caregivers seeking therapy may find BCBAs who fit the desired criteria. While some BCBAs are specialized in certain areas (ex. Sleeping concerns, feeding, severe behavior), many BCBAs are well-versed in various skill sets. This is something to consider when reviewing a BCBA’s experience: regardless of whether a BCBA has the specific direct experience you are seeking, they may still be a great fit for your child. Ultimately, finding a provider who is compassionate, collaborative, eager to determine the right intervention for your child, and prioritizes reinforcing appropriate behaviors over punitive measures is most crucial for your child’s success.
If you’re ready to learn more about ABA therapy for your child, reach out to us today. We have compassionate and board-certified autism clinicians prepared to answer your questions and get you started.