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It’s Amazon Prime Day! I’ve compiled several deals on teaching materials, games, books, and more for ABA clinicians to check out. Please note that the prices/discounts shared in this blog are current as of the time of posting. Prices may change at any time. Happy shopping! After your Amazon shopping spree, come back to ABA Resource Center & check out the ABA Resource Store !   Save 25% off all digital resources through 7/19/2024! Office/School Supplies Disinfecting wipes —15% off Scotch Laminator —27% off Laminating sheets —$10.91 36 Pack of BIC pens —$4.49 36 Pack Chisel Highlighters —34% off 24 Pack Mechanical Pencils —$4.49 Sharpie Highlighters —34% off 10Count Wite Out —$10 6 Pack Scissors — $7 12Dry erase markers —$5.69 Teaching Stimuli Learning Resources Pineapple Feelings Identification —38% off Mindfulness cards for kids —20% off Thinkpsych Language Learning Noun Cards —20% off Learning Resources elephant preposition game —39% off Pattern Blocks —27% off Matching pegboard —35% off Visual Schedule —41% off Games/Toys/Reinforcers Noodle Knockout Game (fine motor skills!) —40% off Sensory Scoops --23% off Thinkpsych Talent Jam Game —32% off Sensory Stepping Stones —42% off Busy Board with Light Switches — 37% Chat Chains Conversation Game —33% off Scratch Art —65% off PopTubes —41% off Magnetic Tiles —65% off 32 Set of Fidget Toys —32% off Make a face stickers —20% off 6 Wooden Puzzles —37% off 3 Pack Bubble Timers —20% off Organization & Office Decor But Did You Document It? Sign —$6.29 Table & 6 Chairs --55% off Planner —54% off Desk Organizer —$16.99 Books The Big Feelings Book —37% off Disclaimer: This blog contains affiliate links. If you purchase from my link, I'll earn a small commission.

Kindness is ingrained in us from an early age. We are trained to always be kind to others. As a result, we generously give up our time and effort to care for others and put ourselves on the back burner at the risk of our own mental and emotional health. This is significantly compounded for parents of children with special needs and those in helping professions, such as behavior analysts and social workers, who often sacrifice self-care. Self-care is essential for our mental, physical, and emotional health. It also builds resilience against pressures that we cannot avoid. Self-compassion entails giving ourselves the same love and respect as we do for others. Here are five essential self-care practices I encourage you to try. 1. Start being kind to yourself Avoid self-criticism and quiet the inner critic who is constantly speaking negatively about you. To practice self-care, you must remember that you always have the choice to ignore or listen to that critical voice. Divert your attention by thinking about your positive traits and experiences. This is the first step to ending self-judgment and realizing that negative self-talk is only a way for you to express your concerns and insecurities. You shouldn't view these thoughts as an objective evaluation of yourself. Thoughts are simply private verbal stimuli. They are not facts. You are worthy of kindness. 2. Try something new Try getting out of your comfort zone. Putting your body and mind to work on something you're unsure of can inspire you greatly. When you're in a rut, you may be less likely to contact reinforcement. However, choosing to push yourself by engaging in a novel hobby, learning a new skill, or advancing your education can allow you to access new sources of reinforcement. Please don't feel pressured to skydive or throw your current career out the window; it doesn't have to be extreme. It might be as easy as trying a new lunch spot instead of your usual go-to spot or taking up a new hobby—perhaps reading or gardening. You realize how flexible and adaptive you are when you try something new. It's also important to remind yourself that there is more to you than a parent, behavior analyst, or whatever other titles you hold. 3. Praise and motivate yourself Do you expect perfection from your children, clients, supervisees, or others? My guess is no. Why, then, do we expect perfection from ourselves? It's time to reset that kind of destructive thinking. The next time you make a mistake, treat yourself like you would treat someone else. Consider the comforting phrases and feelings you would use to reassure your child or client in a similar circumstance, as well as the type of support you would offer them, and extend that same grace to yourself. This has never been easy for me. I have always been incredibly self-critical. The High 5 Habit by Mel Robbins is a wonderful read on cultivating a positive self-image. I highly recommend it if this is an area of self-care that you are personally struggling with. You can even read it for free with a free month of kindleunlimited! 4. Pay attention to what your body needs When you feel restless, ask yourself about the nurturing things that you can do for yourself. Your body may require a walk at times, while at other times, it may only want you to sit or stay in bed. The chaos of life is inevitable, and sometimes, we have to exert more energy than we feel capable of. But it's important to understand our limits. Do not exert yourself simply because you believe you should if your body is in need of rest. Are you a BCBA or ABA professional struggling with burnout? Read our blog, HELP! Navigating Burnout in ABA! 5. Seek respite for self-care time Being the sole or primary caregiver of a child with special needs is exhausting. I speak from both personal experiences, as well as my many years of professional experience. It's vital to ask for a break and allow yourself a chance to regroup. Seek a trusted friend or family member to watch your children if that is an option. Otherwise, reach out to your community. There are resources out there that may be able to provide respite care funding for families of children with special needs. Self-care is as essential to one’s life as water. In addition to making you realize how deserving you are of kindness, practicing self-care can help you feel less stressed, more confident, and better able to live a well-rounded life. Never forget that mental health matters. The mental health of your loved ones AND you. Disclaimer: This blog contains affiliate links. A small percentage is earned for purchasing through affiliate links. However, the price remains the same for you!

Visual supports are items that prompt or cue an individual to guide them toward engaging in a particular behavior. When working with children, visual supports can be beneficial in preparing them for upcoming transitions, reminding them of behavioral expectations, and guiding them through functional behaviors. Even as adults, we use visual supports, from our planners to organization apps, sticky notes, and more. We'll review a few common visual supports. If you are a parent whose child is receiving treatment, chat with their care team about implementing the most appropriate visual supports for their needs. It's easy to get carried away with trying out multiple visuals, but that can get overstimulating for many kids. Try one thing at a time to get a good idea of what is most helpful and build from there. First-Then Visual Support This tool is simple to create and implement. Its purpose is to help a child understand what's to come next. You can create this with a paper labeled 'first' on the left side and 'then' on the right side. You can use words or visuals to show your learner the current task and what will come next. Typically, the “first” side will have a non-preferred task, such as "clean your room," and the “then” side will have a preferred item or activity, such as "play outside." So, first, clean your room, then play outside. Here's a simple first-then visual you can feel free to download & modify! Stop Signs Ensuring a child's safety is everyone's number one priority. Teaching your learners to respond to stop signs can be a great way to support their safety. Stop signs serve as a visual prompt to remind the learner of areas that are unsafe for them to go alone, such as outside. Playing red light green light with stop and go signs is one fun way to teach children to understand what a stop sign means. Once they understand the meaning of stop and go signs, place a laminated stop sign on the doors leading outside (or any other unsafe areas in the home or learning area). Practice having your learner pause at the door and offer immediate reinforcement for stopping at the stop sign. This will take practice, but once they have the idea down, stop signs can be an excellent prompt! Here's a free downloadable stop & go sign you can print and laminate. Visual Schedules The first-then visual is a simplified visual schedule showing two activities. You can create a full visual schedule to help your client understand several upcoming events. Visual schedules are great for use in therapy sessions and are also highly beneficial for parents and caregivers to use outside of therapy sessions. There are many ways to set up visual schedules. For example, you could set it up as a schedule for the child's full day. You may also create individual schedules to support the child through a portion of the day, such as the bedtime routine or a therapy session. You can use pictures and/or words, whichever works best for your learner. Visual schedules can be made with individual images of items in the child's environment. You can also purchase pre-created visuals. Consider the following options for pre-made visual schedules. Visual Timers Visual timers are a great tool for helping children who struggle to grasp the concept of time understand how much time remains for an activity. The color (watermelon in the below example) on the clock visually displays how much time remains for an activity or until an upcoming transition. Visuals can be so valuable in prompting us through our daily lives. Finding effective visual supports for your learners can make a huge difference in their day-to-day functioning. Disclaimer: This article contains affiliate links. This means I may earn a small commission for purchases made. However, the amount you pay does not change!

When was the last time you quit something? When was the last time you said no to a request? But wait, isn't quitting bad? Weren't we always taught "winners never quit" and "once you commit to something, you stick with it"? I encourage you to reconsider that perspective with an invitation to quit. An invitation to simply say no. To let go of things that no longer serve you. Learning to say no and allowing myself to quit things that no longer serve me has been an eye-opener. It started when I began researching Acceptance and Commitment Therapy (ACT). This resulted in me clarifying my values and committing to actions that related to those values. I encourage you to do the same, whether you are a professional in the behavior analysis field or not. My story A quick anecdote here. Without going into too much detail, I quit my job as a clinical supervisor for an in-home ABA company in early 2022. I worked in the field for 13 years at this point. My resignation came after weeks of immense burnout. It was a combination of home stressors on top of work life. I requested modifications to better balance work and home life to reduce my burnout. Unfortunately, my needs did not align with the needs of the company, so I chose to prioritize myself and resign. I did not have another job lined up (whew another one of the things we were always told to never do-Quit without a job lined up). Over the next several weeks, as I transitioned cases and left the clinical field, I closely considered my values as I sought a new position. This led me on the mission toward freelance work and independent practice. It's been a whirlwind as I ventured out into identifying what I wanted out of my life. Saying no and allowing myself to quit was what I needed to live a values-driven life. Perhaps you're reading this and thinking I love my career, can't relate. Rest assured, this message is not solely focused on employment. I encourage you to read on to further explore the benefits of saying no. What are your values? It is encouraged to first evaluate what your values are. Loving Health has a helpful list for evaluating your values across multiple domains of life. It's easy to spout out a few common and generic values like 'family' or 'financial security'. However, to live within your values means diving deeper. Of all that I hold, what can I put down? We have seemingly endless responsibilities. From work expectations to coursework, family, taking care of the home, and countless others. I challenge you to consider all of your responsibilities and what you can comfortably let go of. It doesn't have to be drastic. Please don't all go quit your jobs and come back to blame me when shit hits the fan. 🤣 But I imagine there is at least one action you can make to better live within your values. And it's very likely letting go of something or saying no. What no longer serves you? What provides more stress than value in your life? We all have stressors and that is not something we can expect to ever change. But if stressors are prohibiting you from living a values-driven life, then what changes could you make today to better align? As your boss assigns you another case when you're already at your personal capacity, could you advocate for yourself? "No, I am unable to take on another case at this time due to X, Y, Z. I appreciate your support and understanding." Contrary to previously held popular belief, it is okay to say no. Say no more often. Why say no? Saying no and quitting things that do not add value to your life is a powerful way to practice self-care. Self-care is more than spa days and bubble baths (though I will say bubble baths are one of my favorite self-care activities). Self-care can be considered a repertoire of values-directed actions. Allowing yourself to be a whole, fulfilled person, living in alignment with your values in every facet of life, is perhaps the most radical form of self-care (Fiebig et al, 2020). In order to achieve this, you may need to let go of things that do not add value to your life. Final Thoughts Identifying our values and making values-directed actions is not a one time thing. It is an ongoing process and a commitment to behave in a way that aligns with what we hold as valuable in our lives. If you're anything like me and struggle with saying no, consider today how advocating for yourself by quitting that which does not serve you can liberating. Resources Fiebig, J.H., Gould, E.R., Ming, S. et al. An Invitation to Act on the Value of Self-Care: Being a Whole Person in All That You Do. Behav Analysis Practice13, 559–567 (2020). https://doi.org/10.1007/s40617-020-00442-x https://loving.health/en/act-list-of-values/

As you have likely noticed, the ABA field has grown significantly in the past two decades. The need for behavior analysts is quickly rising. At the turn of the century, there were only 392 Board Certified Behavior Analysts (BCBAs). In the twenty-two years that have followed, that number has risen to 58,345 as of October 3rd, 2022. With this tremendous growth comes tremendous responsibility for supervising behavior analysts. We are responsible for ensuring that the next generation of behavior analysts have a solid understanding of the science of behavior, behavioral principles, and how to apply those to socially significant behavior. We further have a duty to ensure our supervisees are engaging in ethical and compassionate practices. Respectfully, we are dropping the ball on this. When aspiring behavior analysts are assigned busy work like listening to podcasts and writing fictional BIPs, rather than applying skills to actual clients, we should all be concerned about the projection of the field. We can, as a collective field, do better. It starts with the supervising BCBA. First things first Before agreeing to take on the supervision of student analysts, fully consider the magnitude of your responsibilities. I strongly urge against companies requiring all BCBAs to provide supervision. Adding those 4 letters behind your name does not immediately indicate that one is prepared for the responsibilities that come with BCBA supervision. The BACB's recent change requiring a consulting supervisor for newly minted BCBAs appears to demonstrate that concern. Evaluate the needs of the supervisees, the time commitment required, and your available time and resources. Consider whether you have supports in place (i.e. a consulting supervisor) for guidance and support. Consider taking additional courses or training on supervision practices. Consider reviewing the literature on supervision practices and reading behavior analytic supervisory content. Building and Sustaining Meaningful and Effective Relationships as a Supervisor and Mentor is an excellent read for both new and seasoned supervisors. Only proceed with providing supervision once a complete self-assessment has occurred, supporting the notion that you are well prepared for supervisory expectations. Establish Clear Expectations A common concern reported by student analysts (i.e. those pursuing fieldwork hours) is that expectations are not clear at the onset of supervision. The supervisory contract should explain terms, roles, and responsibilities. However, it is beneficial to have an open discussion about all aspects of supervision. Especially for those who are newer to the field, it may be challenging to fully understand what to expect. Provide clear expectations (estimates) for the number of restricted and unrestricted hours that the trainee may accrue. Many trainees who expect to max out at 130/month, are barely getting half of that. While there are many factors that go into these hours, be as thorough and upfront as possible about what they can expect. Discuss the types of tasks and responsibilities that they will be doing for both restricted and unrestricted hours. Monitor body language for signs of understanding and answer questions as needed to further clarify. BCBA Supervision Contract The first requirement of supervision is the creation of a supervision contract. A sample supervision contract, as provided by the BACB, is attached below. It is vital to clearly outline what criteria need to be met for you to sign the monthly and final verification forms. The last thing anyone wants after spending years accruing hours is to hear that their F-EVF can't be signed. Curriculum and/or Structure Supervision activities and meetings must be well-planned and structured. While a curriculum is not in any way necessary to provide effective supervision, it may be desired to take some of the guesswork and prep work out of the equation. You can find a BCBA supervision curriculum here. Regardless of whether or not you use a curriculum, you should have a generally identified structure and flow of supervision. Create an agenda to keep things organized and well-prepared. The following shares general tips for planning and structuring supervision. Modify this in whatever way works for you and your trainees. Prior to each meeting Create a shared agenda in which items can be added throughout the week/time leading up to the meeting date. The supervisor should review this shared agenda prior to the meeting to briefly prepare for questions, concerns, or areas of interest noted by the trainee. Start of the meeting At the start of each meeting, review the agenda items together. Address any emergent items on the agenda first. Throughout the meeting Once emergent matters are addressed (if applicable), follow up on the last meeting. Discuss an overview of the last meeting, review goals that were implemented, and follow up on any "homework" or tasks that the trainee has been assigned. Supervision meetings should address: The development of knowledge and skills per the 5th edition task list Client scenarios, questions, concerns Ethical scenarios-Ideally applicable to clients, though fictional may be appropriate as well Feedback on recent observations and/or client tasks Soft skill development End of meeting Summarize discussions and feedback that was provided throughout the meeting. Identify and assign action items, both for the supervisee and yourself. Clearly outline the next steps in observable and measurable terms. Sign monthly verification forms, if necessary. Behavior Skills Training (BST) What seems to be often forgotten is that the principles of behavior apply beyond our work with clients. Behavioral principles we have developed knowledge and competency in with the populations we work with, also apply to the individuals we supervise. Supervision must be provided using evidence-based practices. We should be training our supervisees to competency. As such, behavior skills training is an effective method to be used in supervision. Learn more about BST basics here. Evaluate the Effects of Supervision Per ethics code 4.10, behavior analysts are responsible for creating systems to evaluate the effects of their supervision. High-quality supervision should first and foremost be evident in the progress your supervisee is making. If they are making minimal progress through competencies, consider what you can do to modify the environment to increase their success. In addition to their progress, what feedback do they have specifically for you as their supervising BCBA? There should be systems in place to actively seek this feedback and make modifications as necessary. Positive effects of supervision should also be evident in the progress the clients are making. If the clients that the trainee is working with are making less than desired progress, consider whether supervisory practices can be modified to increase this success. Additionally, actively seek feedback from the client and/or caregivers regarding the trainee's progress, as that is another way to monitor and evaluate the effects of one's supervision. Don't forget about soft skills Teaching social and interpersonal skills during BCBA supervision is a requirement per the BACB as outlined in the Supervision Training Curriculum. However, this continues to be an area often missed in supervisory practices. Make a concerted effort to include the trainee's development of soft skills such as perspective-taking and problem-solving. 25 Essential Skills & Strategies for the Professional Behavior Analyst is an excellent read with tips and strategies in the area of interpersonal skills. As supervisors, we hold a vital responsibility to develop knowledgeable, ethical, and compassionate behavior analysts. Consider this responsibility with the weight that it truly holds. Resources https://www.bacb.com/bacb-certificant-data/ Andzik, Natalie & Kranak, Michael. (2021). The Softer Side of Supervision: Recommendations When Teaching and Evaluating Behavior-Analytic Professionalism. Behavior Analysis Research and Practice. 21. 65-74. 10.1037/bar0000194. Sellers, T. P., Valentino, A. L., & LeBlanc, L. A. (2016). Recommended Practices for Individual Supervision of Aspiring Behavior Analysts. Behavior analysis in practice, 9(4), 274–286. https://doi.org/10.1007/s40617-016-0110-7 Disclaimer: Affiliate links are included in this post. This means I earn a small commission on purchases, though there is no change to the total cost for you!

It is no secret that the ABA field has a troubled past. While the science of behavior analysis is sound, the application of behavioral principles can vary so significantly. As such, we have a great chance of causing harm. This conflicts with our ethical duty to avoid harm to our clients who are often in a vulnerable population. ABA therapy has changed dramatically over the years. Many common practices that were regularly used a decade ago, are used minimally today, for good reason. However, despite the field's continuous growth, there are unfortunately many practitioners who continue practicing "old-school ways". As such, there are many red flags to look out for when choosing an ABA provider for your loved one, or when choosing a provider to work for. 1. A focus on reducing self-stimulatory behavior Stimming (short for self-stimulatory behavior) is a type of behavior commonly associated with autism. However, everyone stims. Actions we do that feel good like hair twirling, biting our nails, and rocking in our chairs are all common self-stimulatory behaviors. Because stimming is a symptom of autism, many in the field have considered it necessary to implement interventions when a learner engages in stimming such as arm flapping and spinning. Reducing stimming was a common practice up until recent years. However, we have come to understand how ableist this perspective and practice is. If we are not expecting everyone to eliminate all stimming, why are we expecting autistic children to? Because stimming is a part of the symptomatology of autism? Because we want to help them to "fit in"? If stimming is causing harm to the child or others, an intervention is likely needed. Or if the child indicates a desire to reduce this behavior, then it is totally acceptable to target. However, if it is entirely harmless, does not interfere with quality of life, and the learner does not request support in reducing the behavior, then it is likely unnecessary to target. A provider who has a heavy focus on reducing self-stimulatory behaviors for all learners should be avoided. 🚩 2. Focus on sustained eye contact Some providers believe that eye contact needs to be taught in order for clients to be successful in life. While teaching a child to orient their body or direct their eyes toward a stimulus, can be beneficial for many life skills, sustained eye contact is not necessary. Think about conversations you have on a daily basis. How long do you maintain eye contact with the other person? Most people at least glance away every now and then. However, I have seen some providers program for direct eye contact for 30-60 seconds. Not only is this unnecessary for communication, but many autistic adults have also spoken out about how physically painful sustained eye contact is. A 2017 article covered one study on this topic, identifying the various reasons why autistic individuals struggle with eye contact. When a provider has a narrow view on eye contact, blindly (pun intended) targeting direct and sustained eye contact for all learners, you may want to consider steering clear! 🚩 There are many ways to target attending without forced eye contact. 3. Aiming to "recover" or cure autistic people The idea of "recovering" an autistic person is new to me. I read about it in a few social media posts recently and was appalled, to be frank. An autistic individual doesn't need saving from their disorder. Many autistic individuals consider their autism to be a significant part of who they are. Of course, the spectrum is wide. Many people are in need of a significant level of care, requiring more support than others. Regardless, the goal of therapy should never be to recover or cure the child. If you hear those words, run. 🚩 4. Forced Compliance This is a very common practice that is only slowly starting to fade away (Painfully slowly). There has been a long-held belief that our clients must follow every instruction we provide. If not, they will think that they can get away with anything. We must show them who the boss is. A black-and-white view on compliance is dangerous in many ways. Our clients are often of a vulnerable population and as such, are susceptible to abuse. Teaching them to blindly follow all commands from an adult or person of authority is a dangerous, slippery slope. I, again, go back to whether we force 100%, immediate compliance with neurotypical children. I would argue that we do not. It is not uncommon for a parent or caregiver to give their child a few reminders before they actually follow through on an instruction. Furthermore, we often allow neurotypical children to request for modifications when given a demand ("Can I have 5 more minutes to finish this show?"). So why are we requiring autistic children to drop everything the exact second we provide a demand? ABA providers should be trained in assent and acknowledge assent-withdrawal. Forced follow through should only be used when a client is engaging in highly dangerous behavior which may cause harm to themselves or others. For example, they're running toward traffic and you tell him to stop. To keep them safe, it would be necessary to physically intervene. If you're considering a provider for your child or for a new place of employment, consider asking them whether they follow assent-based practices. If they do not or are unfamiliar with the term altogether, that is likely a sign to look elsewhere. 🚩 5. High recommended hours for all clients When a provider recommends a high number of hours (i.e. 30-40/week) for all learners, regardless of need, that is a major red flag. 🚩 If your child is recommended for a high number of hours, without the provider being able to justify that need, it is possible that they are motivated to bring in clients with a high number of hours, rather than focusing on individual needs. The number of hours recommended should always be based on individual need. 6. Using food as a reinforcer This is a hotly debated topic. I won't go as far as to say it's a blatant red flag because it is such a widely used practice. I expect it will take quite some time for us as a field to move away from edibles altogether. Perhaps we'll refer to this one as a yellow flag. Food is a primary reinforcer. That is, it is something that is innately valuable to humans. Other primary reinforcers include water, warmth/regulated temperature, and sex. It can be damaging to use food as a reinforcer, as food should be provided non-contingently. This may cause children to learn to rely on food to deal with their emotions. In a society where childhood obesity is a health concern, there are also issues with it potentially leading to obesity. Since I have referred to this as more of a "yellow flag", I would recommend asking a potential ABA provider/employer what their policies are regarding using food as reinforcers. Ideally, they would at least use them as a last resort and never a first. 7. Refusal to collaborate with other providers ABA is not a one-size fits all therapeutic approach. Many children thrive in other therapies like speech and OT, either on their own or in combination with ABA. A narrow view of ABA as the one and only therapy for autistic children is concerning. It is important for us to consider other perspectives and collaborate with other providers for the benefit of our clients. If a provider refuses to do so, that is not only a red flag, but also an ethical violation. Takeaways My main takeaway for you is to thoroughly research a provider, their practices, and values, and see how they align with yours. Prior to initiating services or employment with a new provider, see if any of these main red flags are present. Don't be afraid to ask more questions to get a better understanding before moving forward. I also want to emphasize that we are all learning and growing. My intentions in this article are not to shame individual providers who are likely doing what they have been taught and surely mean no harm. However, we have a responsibility to our clients to continuously evolve and not simply intend no harm, but actually do no harm. This means shifting our perspectives and long-held beliefs and changing the way we practice. Resources Aston University. (2016, April 12). Rewarding children with food could lead to emotional eating. ScienceDaily. Retrieved August 23, 2022 from www.sciencedaily.com/releases/2016/04/160412090707.htm https://www.fortahealth.com/resources/stimming-in-children-with-autism Trevisan DA, Roberts N, Lin C, Birmingham E. How do adults and teens with self-declared Autism Spectrum Disorder experience eye contact? A qualitative analysis of first-hand accounts. PLoS One. 2017 Nov 28;12(11):e0188446. doi: 10.1371/journal.pone.0188446. PMID: 29182643; PMCID: PMC5705114.

My article on red flags in ABA providers generated a great deal of interest from caregivers and clinicians in the ABA field. Those red flags include potentially harmful practices that parents, caregivers, and providers should be aware of. Through my 15 years in the field, I have seen firsthand the tremendous things that ABA can do for the clients we serve. Even more in the last few years, clinicians have listened to the voices of those we serve and subsequently made changes in their practices. ABA has incredible potential for positive change. As such, I want to highlight the amazing work many practitioners in the field are doing. As you pursue an ABA provider for your child or for employment, consider these GREEN flags! These signs indicate ethical and effective practices. 1. Individualization Each individual we work with is unique in their strengths, needs, and interests. Programming straight from an assessment or based on a cookie-cutter curriculum does not benefit the learner. To teach socially significant skills, we should be creating each goal unique to exactly what the learner needs. If a provider values individualization, that's a green flag in my book! 2. Honoring Assent Withdrawl Since our learners typically are not able to provide consent, we gain consent from parents and caregivers. However, we should still be ensuring that our learners are providing assent for therapy. I encourage everyone to seek employment or therapy with providers who understand assent and honor assent withdrawal. Does the provider force follow-through or allow modifications when assent is withdrawn? Furthermore, does the agency train its employees on assent and assent withdrawal? If so, green flag! 3. Balanced BCBA Caseloads The size of a BCBA's caseload is likely to depend on many factors, including the number of direct hours they're supervising for each case, the complexity of each case, and other responsibilities. BCBAs who have caseloads that are well-balanced may be more likely to provide effective case oversight. BCBAs who are overworked with high caseloads are more likely to become burnt out and unable to provide adequate supervision, thus resulting in poor outcomes for both clients and RBTs whom they supervise. I can't necessarily provide an exact "acceptable" caseload size for everyone, as it will greatly depend on the BCBAs' experience, other non-billable responsibilities, the complexity of cases, hours, and more. My recommendation, however, is to ask a potential provider what the BCBA caseload is like and consider the overall expectations of the position to determine if the BCBA is likely to provide adequate supervision and oversight with the caseload size. Consider that funding sources often require 10-20% BCBA oversight, so if a child is receiving 30 hours/week, a BCBA needs to provide 3-6 hours of supervision. This does not include parent training or re-assessment. Providers who ensure appropriately sized caseloads are a definite green flag! 4. Parent Training and Support ABA is most effective when skills and behaviors generalize to the people that matter most for the individual--Family! Teaching caregivers to implement strategies that have proven effective during therapy sessions is vital to a child's ongoing improvement. Providers who value parent training and support their staff in the development of training caregivers are another green flag! 5. Naturalistic Teaching There is nothing innately wrong with sessions that are DTT-based, especially when provided with children who thrive in that setup. However, naturalistic teaching provides so many opportunities for generalization and facilitates an enriched and enjoyable therapeutic setting. For that reason, providers who prioritize naturalistic teaching strategies are a green flag! This goes back to point #1 though-Individualization! There should never be a one-size-fits-all approach. If a child learns better through discrete-trial training, that is a-okay! 6. BCBA-Owned I consider BCBA-owned agencies a green flag! BCBAs are ethically obligated to abide by the Code of Ethics set forth by the BACB. Therefore, the policies they create and enforce should (in a perfect world) align with ethical and effective practices. I don't intend to claim that ABA companies not owned by BCBAs are unethical or less likely to provide effective care. However, I do believe that an agency owned by a BCBA is more likely to advocate for and train their employees on best practices, with a stronger focus on quality of care, as opposed to increasing revenue. This is not an all-exhaustive list. There are so many amazing clinicians out there doing great work in the ABA world. Keep advocating for effective and ethical care!

Autism is a developmental disorder characterized by deficits in communication and social skills, as well as restrictive and repetitive behaviors. Autism is a spectrum disorder, with a wide range of symptom presentations. For decades, the primary vernacular when referring to autistic individuals was to use person-first language. Let's explore why there has been a push in recent years to move toward an identity-first approach. What Is Person-First Language? First things first, what is the difference? "Person with autism" uses person-first-language (PFL). This language puts the person first before the diagnosis. Why Do We Use Person-First Language? Autism awareness has greatly increased over the last several decades. As such, the stigma surrounding a diagnosis has changed. In the past, when autism diagnoses were much rarer, it was believed that person-first language was the most respectful language that emphasized the individual as a person, rather than solely their diagnosis. This is similar to other diagnoses such as bipolar or ADHD. Referring to someone as a "bipolar individual" would typically be frowned upon and considered dehumanizing. What is Identity-First Language? Identity-first language puts the diagnosis at the forefront, with the person second. "Autistic individual/child/adult" uses identity-first language. Why Do Some People Use Identity-First Language? Many autistic adults in recent years have advocated for using identity-first language. This is because, unlike with many other diagnoses, autistic individuals often consider their diagnosis to be a major part of who they are as a person. In one survey conducted in March 2022, the autistic community overwhelmingly supported identity-first language, with 76% in support. While this clearly does not represent all autistic individuals, it is helpful to understand what a majority of a group prefers. So Which Should You Use? While the reasoning for initially using PFL makes sense, I strongly urge the use of identity-first language. However, individual preferences should always be considered. If you are unsure what a particular person prefers, just ask! Why Does it Matter? If you are not autistic, you may be wondering, why does it matter? Isn't this irrelevant? No. To many autistic adults, this absolutely matters. Identity-first emphasizes how their autism diagnosis plays a major role in who they are. It also reinforces their diagnosis as a positive cultural identifier. Autistic individuals' perception of the world is different and their input should be respected, especially for something as personal as the way in which others refer to them. Resources https://autisticnotweird.com/autismsurvey/ https://www.verywellmind.com/should-you-say-person-with-autism-or-autistic-person-5235429