The beauty and challenge of autism care is it requires its own spectrum of care and care providers. Board Certified Behavior Analysts train in providing that care. A behavioral support plan is how they provide it. Creating a behavioral support plan requires both a scientific approach and creative implementation. It’s both an art and a science.
The Behavior Analyst Certification Board (BACB) standardizes the basic forms of care. But, every client is different and responds to each intervention in a different way.
Treatment plans 101
Developed by BCBAs, an individualized treatment plan is a huge part of a client’s roadmap to success. They involve a lot of moving pieces and change as the individual’s needs change. As a family member, you can trust that an experienced BCBA has seen problem behaviors before. There are as many different approaches to autism care as there are people with autism.
Gold Star Rehabilitation, an autism care center, puts it this way:
Treatment plans often include strategies to address behavior challenges, teach new skills, and support individuals in various settings, such as home, school, or community. BCBAs also collaborate with other professionals, such as speech therapists, occupational therapists, and educators to ensure a comprehensive and coordinated approach to treatment.
Once the BCBA creates the action plan, the RBTs put it into practice. Afterwards, the BCBA modifies the plan based on feedback from the RBT, observation, and data collection. Communication between the BCBA and RBT is critical for success. The RBTs report how effective it was in reducing unwanted behaviors and BCBAs evaluate any barriers to the plan being effective. For examples of behavior support plans and other intervention plans, check out the following resources:
Cross River Therapy’s BIP example
Association for Behavioral Healthcare Mass BAP guidelines
Achievements ABA Behavior Support Plan
The BCBA approach to autism therapy
Applied Behavior Analysis, or ABA, is the method by which BCBAs analyze and address behavior. ABA involves applying the principles of behavior to create significant, measurable social changes. This process often includes simplifying complex skills and behaviors. These can include social skills, communication, and challenging behaviors.
The provider wishes to improve a client’s outcomes with incremental change. They focus larger behaviors into smaller tasks and reinforce positive behaviors. Timeliness is important here. They address problem behaviors immediately to reduce confusion and improve outcomes. They also analyze and modify environmental factors that may be getting in the way of change.
As you might imagine, this approach requires constant monitoring. BCBAs need to address problem behaviors in the moment. This can be a challenge for providers, as they often have many clients at a time. Again, Gold Star says:
BCBAs are responsible for monitoring progress, making data-driven decisions, and modifying treatment plans as needed. They also provide training and guidance to other professionals, such as Registered Behavior Technicians (RBTs), as well as to family members and caregivers, to ensure consistency and generalization of skills across different environments.
When doing their job right, BCBAs and RBTs act with diligence and tailored care. They use techniques such as social storytelling and role-playing to ensure a better home, school, and work life for people with autism.
Collaborative efforts: working with families and other professionals
BCBAs do not do all this work in a vacuum. It takes a village to provide the right level of care for individuals with autism. BCBAs are in constant communication with parents, teachers, employers, and healthcare providers. They ensure all stakeholders are on the same page, or clients may lose their hard-won progress.
Our resident BCBA, Jennifer Heidt, describes a challenging moment when working with a family with a new autism diagnosis:
“I’ve seen a huge array of emotions, questions, and reactions to getting that diagnosis. I’ve also seen BCBAs spend hours with families in this situation, focusing on helping them see that autism is just a word on a piece of paper. But having that word on the paper opens a world of specialized help for their child. BCBAs are there to help families adjust to their new normal and make an action plan for how to help with any challenges they are facing.”
Care providers and loved ones must present a united front. Consistency creates some of the most positive outcomes for people with ASD. BCBAs can be the most clarifying person in a parent’s life through thoughtful education and collaboration. They provide context and reassurance that progress is being made, and how to keep that momentum.
Challenges and rewards of being a BCBA in the field of autism
BCBAs face unique challenges providing for people with autism. Every client needs a different level of care. As you can imagine, this can be quite labor-intensive. Because one technique worked in the past is not a guarantee that it will work again. Each action plan requires creativity and constant attention to the client. The BCBA must collect the right data and use it to adapt the plan.
Every client’s action plan is its own puzzle to figure out. (That’s why our logo involves puzzle pieces!) Heidt describes one incident with a fellow BCBA as follows:
“She got extra creative when working with a child who showed no interest in responding to tasks that included sitting at the table with materials (e.g., letters, numbers, colors, etc.). The BCBA put the cards all over the floor and on the wall. She then gave the client fun instructions like ‘jump to red’, ‘roll the train to the letter T’, or ‘run and touch the number 5’. As soon as it became an interesting game to the child, we were making progress.”
Always remember you’re working with children. Making it fun can make a world of difference.
There may be many challenges of working with clients with autism. But the long-term benefits outweigh them every time.
There’s no better feeling than achieving a breakthrough after working with a client day after day to learn new skills. Both the client and their family are happy, and your job becomes easier. Plus, you build trust with the client that can help you in tough times moving forward.
Finding a qualified BCBA for autism therapy
Finding a qualified BCBA for autism therapy can be a difficult decision. There are many factors to consider. You want someone capable and qualified, but sensitive to the individual needs of the person with autism. When interviewing potential companies or independent BCBAs, you should keep the following factors in mind:
- Has the BCBA worked with your loved one’s age group before?
- Has the BCBA worked one-on-one with clients before? (Or groups, as the case may be.)
- What were some of the most challenging moments with clients and how did they proceed?
- Where did they get their RBT and BCBA training? Was it online and self-paced, online and live, or in-person? Is the organization who trained them reputable?
- Is their certification up to date?
- Can they provide a list of references of supervisors and past clients who can recommend them?
- What are their greatest strengths as caregivers?
- How would they describe their leadership style toward RBTs?
For family members, use the BACB certified registry to search for registered BCBAs. You can narrow your search by city and state. The bottom line when searching for a BCBA is to be patient. Don’t feel like you’re stuck with your selection once you’ve made it. There are plenty of qualified behavior analysts, and more every day. There’s a BCBA for every family.
Finding the right care facility, client, or family
As a BCBA, you have a right to understand the type of client and family with whom you’re agreeing to enter into a contract. Don’t forget that you’re interviewing your employer, too! Action Behavior Centers has an excellent list of questions to ask them.
Ask about continued learning resources and career advancement. You should also know how much hands-on vs. administrative work they expect. Clarify work-life balance and PTO, and how many clients the BCBA is expected to take on for their caseload.
When interviewing with clinics, make sure you know how much of the work is in-home client care vs. clinic services. Find out their BCBA turnover rate ,which can be a measure of employee satisfaction. Learn what kind of workplace culture they try to promote, according to Lauren Broadwell of Kind Behavioral Health.
What kind of career advancement can a BCBA expect?
There are a few career path options for BCBAs. For one, they can receive their Doctorate degree in behavioral health to become a BCBA-D:
BCBAs with doctoral or postdoctoral training in behavior analysis may apply for the designation of Board Certified Behavior Analyst-Doctoral® (BCBA-D®). The BCBA-D designation is not a separate certification and does not grant any privileges beyond BCBA certification. If you hold the BCBA-D designation, you may function in the same capacity as a BCBA (i.e., as an independent practitioner who provides behavior-analytic services.
BCBA-D requirements, from the Behavior Analyst Certification Board.
BCBAs with a doctorate are expected to take on more complex responsibilities. They’re usually compensated well for this increase.
As a BCBA, you can work for schools, residential facilities, hospitals, community groups, or in private practice.
Finally, the demand for BCBAs is on the increase. The Bureau of Labor Statistics expects a 20% pay increase across the board over the next ten years.
BCBAs play an integral role in the lives of people with autism. Their importance cannot be overstated. They can be hands-on with clients or operate as a coordinator and strategist for the various RBTs on the ground. Whether they’re working for a family, a school system, or a behavioral health center determines the form of the work. This also affects job security and potential upward mobility.
The field of behavioral health is quite new compared to others. Needs and expectations can change quickly. The upside is BCBAs can shape the common language and strategies for care that are the norm. The need for caring, capable professionals grows daily, but you get to see your hard work pay off. When it comes to the intersection of pay and job satisfaction, few roles meet the same level as a BCBA.
What about you?
- Are you an RBT looking to make an upward move?
- A BCBA looking to expand their skills or recertify?
- A client or family member trying to understand the roles of all the caregivers involved?
- A curious seeker in the field of behavioral health?
Behaviorly is here to guide you through the process with live, capable instructors to answer your every question.
Feel free to reach out to us for a personal consultation, or explore our product offerings and resources to learn more.
Additional Resources:
Indeed’s Comprehensive Guide to Becoming a BCBA
Autism support group directory by state, U.S. Autism Association
Autism support groups by relationship and type, Autism Speaks BCBA resources & teaching materials, ABA Resource Center
Further reading:
Applied Behavior Analysis for Teachers, 9th edition by Paul A. Alberto
Teaching Individuals with Developmental Delays by O. Ivar Lovaas