An Evaluation of the Impact of Supervision Intensity, Supervisor Qualifications, and Caseload on Outcomes in the Treatment of Autism Spectrum Disorder

Using the ADDIE Model of Instructional Design to Create Programming for Comprehensive ABA Treatment

ABA research abounds with articles on increasing or decreasing a small set of behaviors. These articles fit nicely within the framework of Focused ABA Treatment in which the goal of treatment centers on only a few behaviors. However, many behavioral practitioners spend most of their time developing Comprehensive ABA Treatment in which a large number of behaviors are systematically changed across multiple developmental domains. Few resources are available to help in designing and implementing such programming. This article presents a model from the field of instructional design for the development of comprehensive programming. Applying the ADDIE model-Analyze, Design, Develop, Implement, Evaluate-the article identifies a consistent process to follow, critical actions to take, and helpful resources to use when developing comprehensive programming for individuals with autism.

Supervision for Aspiring Behaviour Analysts in Australia: An Exploration of Current Practices, Challenges, and Opportunities

Effective supervision is a key component of the development of effective and ethical behavior analytic repertoires. However, the provision of supervision may be challenging in countries where behavior analysis is an emerging profession and there are few qualified practitioners. We conducted a mixed-methods survey study to examine the supervision practices of board certified behavior analysts (BCBAs) in Australia, and perceived challenges related to the provision of supervision. Respondents reported using a variety of supervisory practices to meet the demand for supervision, but a lack of time, resources, and geographical location posed challenges. Based on these findings, we provide several recommendations for addressing identified challenges. Although each recommendation has been contextualized to meet the needs of the Australian behavior analytic community, these recommendations may be useful in other parts of the world where behavior analysis is an emerging profession or there are few BCBAs to meet the needs of a growing behavior analytic workforce.

Designing A Successful Supervision Journey: Recommendations and Resources for New BCBA Supervisors

As of 2022, board certified behavior analysts who are certified for less than 1 year and have met the qualifications to serve in a supervisory capacity are required to meet with a consulting supervisor if they wish to supervise trainees' fieldwork experience. These guidelines establish a different supervisory level of accountability in our field, supervision for supervisors. Recommendations that are uniquely tailored for new supervisors and address the relationship between new and consulting supervisors have not yet been published. In this article, we share recommendations and resources with new supervisors. We extend current literature by outlining steps new supervisors can take and resources they can use to prepare for a successful supervision journey with their consulting supervisor and supervisees.

Saudi Expert Consensus-Based Autism Spectrum Disorder Statement: From Screening to Management

Background: There is a large gap between the needs of individuals diagnosed with autism spectrum disorder (ASD) and the currently available services in Saudi Arabia. Services are often difficult to access, inconsistent in quality, incomplete, unsatisfactory, and costly. As such, there is a national need for expert consensus on the appropriate standards for the assessment and management of children on the autism spectrum. Methodology: A guideline development group (GDC) was formed by professionals representing all related specialties and institutions involved in the management of individuals on the autism spectrum in Saudi Arabia. They met on a regular basis over 21 months. The guideline development process consisted of five steps starting from reviewing existing guidelines and ending with discussing and writing this manuscript. A formal voting process was utilized and recommendations were discussed until a consensus was reached. Results: There was consensus on the following: A specialized diagnostic assessment needs to be carried out by an experienced multidisciplinary team for children referred to assess for ASD. They should be assessed for medical etiology, their behavioral history carefully reviewed, and symptoms directly observed. Longitudinal assessments are encouraged to reflect the effects of symptoms on the individual’s ability to function while with their family, among peers, and in school settings. An additional formal assessment of language, cognitive, and adaptive abilities as well as sensory status is essential to complete the diagnostic process. Interventions should be individualized, developmentally appropriate, and intensive, with performance data relevant to intervention goals to evaluate and adjust interventions. Target symptoms must be identified to address and develop monitoring systems to track change. Conclusion: ASD is a complex condition with widely varying clinical manifestations, thus requiring evaluation and intervention by a range of professionals working in coordination. Behavioral and environmental interventions are the key to optimal outcomes, in conjunction with medications when indicated for specific symptoms. Parental involvement in interventions is vital to sustaining therapeutic gains.

Brief Report: Medicaid Expansion and Growth in the Workforce for Autism Spectrum Disorder

Over 700,000 children throughout the U.S. have received insurance coverage through welcome mat effects of Medicaid expansion, including children with autism spectrum disorder (ASD). Utilizing health workforce data from the Health Resources and Services Administration, we examined workforce growth (2008-2017) among three types of health providers for children with ASD as a result of Medicaid expansion: child psychiatrists, board-certified behavioral analysts (BCBAs) and pediatricians. We found that state Medicaid expansion was associated with a 9% increase in BCBAs per 100,000 children one year after enactment, a 5% increase in child psychiatrists, and was not associated with growth in pediatricians. Results indicate the importance of new policies that directly address a shortage of providers for children with ASD.

Speech-Language Pathologists and Behavior Analysts: A Survey of Video Modeling Use and Perspectives

Speech-language pathologists (SLPs) and board-certified behavior analysts (BCBAs) work with clients with autism spectrum disorder (ASD). In general, these practitioners support a variety of skills during treatment, including language, social skills, daily living, and academics. Video modeling (VM) is an intervention that is often used to improve skills (e.g., independent living, social, behavioral, academic) for clients with disabilities. It is unknown how SLPs and BCBAs are specifically using VM to support clients, including those with ASD. The primary purpose of this study was to use an existing perception scale to analyze SLPs' and BCBAs' perspectives on and use of VM. Results have indicated that while most practitioners have heard of VM and use it with clients, barriers related to training and video creation still exist. VM is still predominantly used in clinics and special education classrooms, indicating that this evidence-based strategy is being used, but more training and generalization support is needed.

Supervision for Certification in the Field of Applied Behaviour Analysis: Characteristics and Relationship with Job Satisfaction, Burnout, Work Demands, and Support

Background: Supervision of behavior analysts seeking certification and supervision of service delivery are key processes in the provision of quality behaviour analytic services to individuals with developmental disabilities. Our study is the first to examine international supervisory practices within the field of applied behaviour analysis. Method: An online survey was distributed to 92 professionals internationally, assessing supervisory practice, supervisor support, work demands, job satisfaction, and burnout. Results: Findings indicate high satisfaction with the supervisor and supervisory experience. Excessive work demands positively correlate with high burnout and low job satisfaction. Half of all professionals only worked with one or two clients before certification. Supervisor and collegial support seem to decrease the likelihood of suffering burnout and increase job satisfaction, although relationships were not statistically significant. Conclusions: Supervisor and collegial support warrant further research as protective factors. Implications for an evidence-based supervisory practice that produces ethical and competent supervisees are discussed.

Board Certified Behavior Analysts' Supervisory Practices of Trainees: Survey Results and Recommendations

The field of behavior analysis relies on supervised fieldwork to shape the repertoires of individuals aspiring to sit for the Behavior Analyst Certification Board® (BACB®) exam. Board Certified Behavior Analysts® (BCBAs®) who are providing supervision to those seeking certification must follow the supervision and ethics requirements as directed by the BACB. We conducted a survey of BCBAs currently providing supervision to gather information about current practices and barriers. The top areas of success and need are presented based on the responses of 284 participants who completed the entire survey, along with recommendations.

An Evaluation of a Mobile Application Designed to Teach Receptive Language Skills to Children with Autism Spectrum Disorder

The current study evaluated the effectiveness of a mobile application, Camp Discovery, designed to teach receptive language skills to children with autism spectrum disorder based on the principles of applied behavior analysis. Participants (N = 28) were randomly assigned to an immediate-treatment or a delayed-treatment control group. The treatment group made significant gains, p < .001, M = 58.1, SE = 7.54, following 4 weeks of interaction with the application as compared to the control group, M = 8.4, SE = 2.13. Secondary analyses revealed significant gains in the control group after using the application and maintenance of acquired skills in the treatment group after application usage was discontinued. Findings suggest that the application effectively teaches the targeted skills.

An evaluation of the effects of intensity and duration on outcomes across treatment domains for children with autism spectrum disorder

Applied behavior analysis (ABA) is considered an effective treatment for individuals with autism spectrum disorder (ASD), and many researchers have further investigated factors associated with treatment outcomes. However, few studies have focused on whether treatment intensity and duration have differential influences on separate skills. The aim of the current study was to investigate how treatment intensity and duration impact learning across different treatment domains, including academic, adaptive, cognitive, executive function, language, motor, play, and social. Separate multiple linear regression analyses were used to evaluate these relationships. Participants included 1468 children with ASD, ages 18 months to 12 years old, M=7.57 years, s.d.=2.37, who were receiving individualized ABA services. The results indicated that treatment intensity and duration were both significant predictors of mastered learning objectives across all eight treatment domains. The academic and language domains showed the strongest response, with effect sizes of 1.68 and 1.85 for treatment intensity and 4.70 and 9.02 for treatment duration, respectively. These findings are consistent with previous research that total dosage of treatment positively influences outcomes. The current study also expands on extant literature by providing a better understanding of the differential impact that these treatment variables have across various treatment domains.

Some Tools for Carrying Out a Proposed Process for Supervising Experience Hours for Aspiring Board Certified Behavior Analysts®

While task clarification, goal setting, feedback, and behavioral skills training (BST) are well-supported methods for performance improvement, there is no standardized approach to supervising aspiring Board Certified Behavior Analysts® (BCBAs®) that specifies how such practices should be used within a comprehensive supervision system, namely for supervising those who are still accruing experience hours for the purpose of becoming board certified. This article outlines a systematic approach to BCBA supervision and provides a set of tools that supervisors can use to ensure that they are engaging in empirically based supervision practices.

Guidelines for the Establishment of a University-Based Practical Training System

Individuals interested in applying to sit for a Behavior Analyst Certification Board® (BACB) examination are required to accumulate a predetermined number of experience and supervision hours under the BACB Experience Standards (BACB, 2015c). Currently, the BACB allows students to accumulate these hours while enrolled in a higher education training program that contains a BACB-Approved Course Sequence (ACS). There are numerous professional and financial benefits for programs offering practical training opportunities to students. However, creating a viable practical training system requires careful planning and organization. The purpose of this paper is to provide some guidelines and recommendations for establishing one type of university-based practical training system using community-based sites.