I try to stay away from writing articles like these. You know, the ones that insist that it’s time for ABA to get better at something.
“It’s time for ABA to start talking about fun/intraverbals/teddy bears/aliens/(insert anything).”
Trendy thing to post on these days. It’s not that I disagree with these statements necessarily. It’s just that these “hot takes” aren’t really that hot or original anymore. Ironically, they are chalked full of catch phrases that are repeated and sung on a nearly liturgical level. Usually, I’m forced to wonder if these vocalists bother to contemplate the content they produce and echo. Most importantly and recognizably, however, this content highlights problems without offering critically thought out, practical solutions. They become a stage for the writer’s virtuosity…or something.
BUT, today I’m going to do it. I’m going to be that guy that annoys me. (It’s different if I do it, right?)
In the past, I’ve done my best to address some of the areas that I’ve felt traditional BCBA coursework and supervision has fallen short in. My readership for this little newsletter (ahem, sign up below) can tell you that there is a weekly focus on practicality when it comes to what I write about.
Normally I’ll try to hone in on something that helps BCBAs right away. It usually addresses clinical stuff (“How do I program for this?”). Some of these struggles are professional too (“How do I handle this difficult person?”). In many instances, I see the same issues over and over again. Often these issues are rarely addressed in coursework and supervision.
After a number of years watching plenty of BCBAs in professional pain (including myself), I began to brainstorm ways to alleviate that pain. In alleviating it, I came face-to-face with the problems themselves. And—like so many problems—they usually start innocent and small. Changing an integer in the quadratic formula can change the entire appearance of a parabola. A compass that is off by one degree can change the entire destination of an expedition. Likewise, an absent minded inaccuracy or half truth can put our science and its future on a different planet, philosophically, and compromise its effectiveness.
Below are a few of those innocent inaccuracies and faux pas that I’ve observed within coursework, supervision, and the field in general.
We tell ourselves ABA is a science, but forget it’s a service as well.
It is a science, and within that science there are a great number of well researched, terrifically powerful, systems. But it’s a science with an extremely human capacity to it. Tens of thousands of hours of ABA therapy are billed each day. That means thousands of humans—often little humans—are interacting with those powerful systems. Ironically, looking at ABA as “simply a science” sells ABA short. It’s the role that ABA plays in bettering the lives of the human beings that ultimately illuminates its value. Service is that touch point where science meets person. At the very least, that touch point needs to be prioritized and examined.
We think our science of ABA is developed…in reality the science of ABA service delivery is underdeveloped.
The irony continues. Because our emphasis on this interaction between science and person has been limited, we miss out on another science completely—the science of service delivery. Teaching on research on behavior change systems within our science (i.e. pigeons doing cool stuff) is important. But, aspiring BCBAs equally need to leave school with a marked fluency in caseload management and relationship development with stakeholders. Additionally, a field-wide improvement in the functionality of our clinical decision making tools and systems wouldn’t hurt either.
We insist that ABA research and curricula educate ABA service delivery…but we rarely allow ABA service delivery to educate what ABA researches and teaches on.
Ask a BCBA about a clinical or professional headache they are experiencing in practicing ABA on a daily basis. Go ahead and do it. They’ll tell you. (For example, teaching puzzles.) Analyze that headache. Come up with a hypothetical solution for how to alleviate that headache. Test said hypothesis. Publish (and add to future course curricula). Rinse. Repeat. (Obviously, not this easy, but humor me…I’m being that guy).
We overemphasize making BCBAs and underemphasize making Managers.
And, since the science of service delivery is traditionally an educational afterthought, we produce BCBAs who don’t know much about service delivery. And, service delivery pummels them in their first few years. We have to rethink the way we look at the BCBA roll. You don’t need to be a BCBA to practice ABA. You don’t! You need be a manager with a BCBA certification. That’s because being a “BCBA”—as we’ve usually understood it—is arguably a management role. Service delivery consists of managing time, systems, and relationships. Curricula that reflects those needs will go a long way!
Before we end, an anecdote:
I’ll never forget the time that I sat in on an IEP meeting long ago. The BCBA—who was very bright—was attempting to explain to the teachers on her reasoning regarding her client’s toileting protocol. As school staff asked more questions, the very bright clinician finally responded with “Look, I know the science and I have the certification to prove it!". She was right, of course—she knew what she was talking about, too. But, as you could have guessed, it didn’t help the discussion. In fact, it only raised the volatility level more. Her response came across as defensive. She was on her heels for the rest of the meeting.
Why did she say that?
Why did she play the “I’m a BCBA” card?
Answer: It was the only card she had.
In fact, without curricula and supervision that will develop a BCBA’s skill set for situations like this one, we’re effectively telling them that the “I’m a BCBA” card is the only card they’ll ever need. Wrong. Studying the science of service delivery will yield an additional deck of cards to play.
I leave you with this article about the development of the "bed-side manner” among physicians over the last 100 years. It illuminates how deeply personal science can be when it is delivered as a service. This personal aspect—lest we forget—is what gives our field it’s tremendous value.
Thoughts? Hit me back.
Notes. 1) I acknowledge that I provide very little in the way of solution here. Again, I’m being that guy. This is merely a general critique of what I’ve observed in our paradigm over the years. 2) There are a great deal of academics, leaders, and curricula in our field that actively champions everything I’ve talked about above. I sincerely thank them.