{"title":"Science over Cynicism: The Race to Preserve Best-Practice Applied Behavior Analysis through Expanded Awareness, Advocacy, and Enforcement of the Mental Health Parity and Addiction Equity Act","authors":"Julie Kornack, Karen Nohelty, Marlena N. Novack","doi":"10.1007/s40617-024-00932-2","DOIUrl":"https://doi.org/10.1007/s40617-024-00932-2","url":null,"abstract":"<p>Widespread insurance funding of applied behavior analysis (ABA) as a medically necessary mental health benefit in the treatment of autism spectrum disorder (ASD) has placed behavior analysts in the role of health-care providers, and the race is on to see whether best-practice ABA will be defined by the insurance industry or behavior analysts. Behavior analysts who work with insurance and/or Medicaid have increasingly encountered payor guidelines that interfere with their efforts to implement treatment plans that reflect generally accepted standards of care. When these arbitrary limits are integrated into ABA practices, payors—not science—are shaping how ABA is implemented. Many common payor guidelines, such as location exclusions, caregiver participation requirements, and age and hour limits, violate the federal Mental Health Parity and Addiction Equity Act (MHPAEA). For the first time since MHPAEA became law, federal agencies are scrutinizing payor guidelines and practices through the lens of MHPAEA and working to increase compliance. In this new climate of MHPAEA enforcement, behavior analysts are uniquely positioned to identify, reject, and report improper guidelines that constrain their ABA practices and promote best practices to optimize patient outcomes. This review of MHPAEA in the context of ABA highlights common violations and current advocacy and aims to equip behavior analysts with the tools to free their practices from improper limits.</p>","PeriodicalId":47310,"journal":{"name":"Behavior Analysis in Practice","volume":"47 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140601360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diana E. Parry-Cruwys, Jacquelyn M. MacDonald, Jessica D. Slaton, Allen Karsina, Cormac MacManus
{"title":"Strategies for Incorporating Compassionate Care in a Behavior Analysis Graduate Program","authors":"Diana E. Parry-Cruwys, Jacquelyn M. MacDonald, Jessica D. Slaton, Allen Karsina, Cormac MacManus","doi":"10.1007/s40617-024-00934-0","DOIUrl":"https://doi.org/10.1007/s40617-024-00934-0","url":null,"abstract":"<p>Recent conversations in behavior analysis have increasingly centered around improving compassionate care and cultural responsiveness practices in the field. Behavior analytic graduate programs are uniquely positioned to bring these conversations to the forefront for future generations of behavior analysts. If graduate students are offered education and training in cultural responsiveness and compassionate soft skills, they may be better positioned to serve their future clients. Faculty can prepare to teach and mentor students in this way by first engaging in self-assessment and reflection on these issues, and then by incorporating them into the graduate curriculum through knowledge and skill-building (e.g., readings, role plays, case scenarios). Faculty can also model compassion through thoughtful course design and interactions with students. Areas for future research are also discussed.</p>","PeriodicalId":47310,"journal":{"name":"Behavior Analysis in Practice","volume":"66 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140601600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Deborah A. Napolitano, Lindsay A. Cohen, Traci M. Cihon
{"title":"Behavior Analysis at a Macro Level: The Case for Behavior Analysts in Public Policy Work","authors":"Deborah A. Napolitano, Lindsay A. Cohen, Traci M. Cihon","doi":"10.1007/s40617-024-00928-y","DOIUrl":"https://doi.org/10.1007/s40617-024-00928-y","url":null,"abstract":"<p>Despite some early starts, such as Seekins and Fawcett’s, <i>The Behavior Analyst</i>, 9, 35–45, (1986) description of the stages of public policy making and the ABAI task force on public policy headed by Fawcett et al, <i>The Behavior Analyst, 11</i>, 11–25, (1988), little progress has been made to bring the field of behavior analysis up to the standards of other professions (e.g., pediatrics) in the area of advocacy. In this article we will use experiences in advocating for the profession of behavior analysis in the state of New York to encourage behavior analysts to become involved in advocacy in their state (locally, regionally, state-wide). Further, we suggest that the experiences and observations of professionals who are experts at advocating on a national level (e.g., pediatricians) may be important in encouraging behavior analysts to establish a national advocacy platform. In addition, this article will attempt to make the case as to why it is critical that behavior analysts seek and adopt leadership positions municipally, at the state level, nationally, and even internationally, in the area of advocacy. Finally, we will suggest that there is a need to integrate advocacy into the training and daily activity of behavior analysts and why the field might now be ready for this shift, as we stand on the shoulders of giants.</p>","PeriodicalId":47310,"journal":{"name":"Behavior Analysis in Practice","volume":"51 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140601285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comparison of Acquisition Criteria Applied to Individual and Sets of Tacts: A Systematic Replication","authors":"Hung Chang, Tania Nainani, Ji Young Kim","doi":"10.1007/s40617-024-00933-1","DOIUrl":"https://doi.org/10.1007/s40617-024-00933-1","url":null,"abstract":"<p>The experimenters examined two different levels of acquisition criteria—Set and Operant Analysis—to assess acquisition and response maintenance of tact operants for four participants. Set Analysis involved replacing acquired operants at a set level, whereas Operant Analysis involved replacing acquired operants at an individual operant level. All participants required fewer instructional trials to acquire tacts under the Operant Analysis condition. Three participants maintained a similar number of operants in both conditions, whereas one participant maintained more operants under the Set Analysis condition.</p>","PeriodicalId":47310,"journal":{"name":"Behavior Analysis in Practice","volume":"34 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140322819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lauren Lestremau Allen, Leanna S. Mellon, Noor Syed, Joy F. Johnson, Armando J. Bernal
{"title":"Neurodiversity-Affirming Applied Behavior Analysis","authors":"Lauren Lestremau Allen, Leanna S. Mellon, Noor Syed, Joy F. Johnson, Armando J. Bernal","doi":"10.1007/s40617-024-00918-0","DOIUrl":"https://doi.org/10.1007/s40617-024-00918-0","url":null,"abstract":"<p>Individuals within the Autistic and Neurodivergent communities have shared numerous concerns about applied behavior analysis (ABA). These criticisms often relate to the ableism reflected within current practices, which have impeded the dignity and autonomy of many individuals with disabilities served through ABA. Both within the field and outside of the field, there is a growing acknowledgment of the need to listen, reflect, and reconsider approaches to service delivery, which can ultimately benefit service recipients well beyond the Autistic or Neurodivergent communities. ABA is committed to being responsive to consumers, even when the social validity data are unfavorable, and the path forward is unclear. This article will provide an overview of historical and current perspectives regarding disability rights, the Autistic and Neurodiversity advocacy movements, and disability as a form of diversity. Calls to action will be presented with accompanying neurodiversity-affirming actions for behavior analytic practitioners. These calls to action are informed by feedback from the Autistic and Neurodivergent communities as well as other interested parties and are related to (1) client identity and language; (2) dignity, self-determination, choice, and assent; and (3) social validity, which may be acted on through compassionate and affirming approaches.</p>","PeriodicalId":47310,"journal":{"name":"Behavior Analysis in Practice","volume":"22 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140301107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Organizational Behavior Management Approaches to Advancing Compassionate Care in Research and Practice","authors":"Kristin M. Hustyi, Tabitha N. Hays","doi":"10.1007/s40617-024-00927-z","DOIUrl":"https://doi.org/10.1007/s40617-024-00927-z","url":null,"abstract":"<p>Compassion in health care has been associated with improved patient outcomes, better treatment adherence, patient engagement, and satisfaction. However, much of this literature is limited by weak design and measurement strategies. Despite researchers’ efforts to demystify compassion and produce an evidence-based understanding of it, empirical models and definitions remain a work in progress. In this article, we discuss how contemporary methodological features of organizational behavior management (OBM) could be used to advance our understanding of compassionate care and its impact on important outcomes for patients, clinicians, and organizations alike. Recommendations for measuring, assessing, and intervening at both the individual and systems-level to promote compassionate care are provided. Though the origin, development, and maintenance of compassion may be complex, it is clear that behavior analysts have an ethical obligation to invoke compassion in their service to others. Likewise, those at the executive level of decision making in organizations have an obligation to purposefully design environments that support behavior analysts’ engagement in compassionate care. Viewing compassionate care through a systems lens may help to align the values and goals of patients, clinicians, and organizations by treating compassion like a critical business metric.</p>","PeriodicalId":47310,"journal":{"name":"Behavior Analysis in Practice","volume":"34 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140200058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Avoiding Abuse of Power: A Case for Compassionate, Participant-Centered Research","authors":"Jamine Dettmering, Tajma Hodzic","doi":"10.1007/s40617-024-00925-1","DOIUrl":"https://doi.org/10.1007/s40617-024-00925-1","url":null,"abstract":"<p>Although applied behavior analysis (ABA) is a science committed to improving the lives of others in socially meaningful ways, it exists within complex structures of power that are at odds with the values of our science. Current research practices perpetuate the oppression of people with disabilities. For too long ABA researchers have disproportionately conducted research with people with disabilities without their input. It is time for a paradigmatic change toward more compassionate and participant-centered research practices. In this article, we (1) highlight the concerns with current research practices and how ABA may perpetuate ableism; (2) provide suggestions for more compassionate, participant-centered research using two applied research studies to illustrate compassionate research in action; and (3) point to systems-level changes that we believe will disrupt oppressive and ableist research practices.</p>","PeriodicalId":47310,"journal":{"name":"Behavior Analysis in Practice","volume":"94 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140149721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Behavior Analysis Services on the Island of Curaçao: Increasing Dissemination, Capacity Building, and Access to Care","authors":"Gabrielle I. Torres, Moraini A. U. Isenia","doi":"10.1007/s40617-024-00922-4","DOIUrl":"https://doi.org/10.1007/s40617-024-00922-4","url":null,"abstract":"<p>Although applied behavior analysis (ABA) is a well-supported evidence-based practice in the United States, other countries have a lack of national practice standards, training programs, and public policy that has made it challenging for practitioners to provide services to individuals diagnosed with autism spectrum disorders and other developmental disabilities. In addition to these barriers, smaller countries, like the island of Curaçao, must also contend with their small size and limited resources. Nonetheless, over the past 6 years a small multidisciplinary team has established an ABA therapy center, identified some funding sources for families who may not have the resources to afford these private pay services, and created a training program for local people interested in a career in behavior analysis. The steps taken, barriers encountered, and successes achieved, provide a guide for others attempting to make an impact when resources are limited. With these achievements, Curaçao joins a small group of other islands that are paving the way for the establishment and regulation of behavior analysis in the Caribbean.</p>","PeriodicalId":47310,"journal":{"name":"Behavior Analysis in Practice","volume":"87 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140149390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Waxing and Waning of Establishing Behavior Analysis in a Latin American Country","authors":"Jessie Arroyave Tefel","doi":"10.1007/s40617-024-00923-3","DOIUrl":"https://doi.org/10.1007/s40617-024-00923-3","url":null,"abstract":"<p>Behavior analysis is an extraordinary science and used wisely, can make crucial contributions to individuals, groups, and even entire countries. Thus, behavior analysis should be a science available and known to all, regardless of origin, culture, race, ethnicity, or gender. As an advocate for the use and dissemination of behavior science in Latin American countries and as the first person to be certified in my country, I present my experience as a Latin American woman in the field of behavior analysis and invite other women in Latin America to pursue behavior analysis. This article provides a description of the challenges in practicing ABA internationally, outlines my actions to overcome those challenges, and includes specific recommendations to other practitioners in the field.</p>","PeriodicalId":47310,"journal":{"name":"Behavior Analysis in Practice","volume":"15 12 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140125541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effect of Repeated Reading on Reading Fluency for Adults with Specific Learning Disabilities","authors":"Madeline Halkowski, Richard M. Kubina","doi":"10.1007/s40617-024-00926-0","DOIUrl":"https://doi.org/10.1007/s40617-024-00926-0","url":null,"abstract":"<p>The current study implemented an alternating-treatments design with Standard Celeration Charting. The applied experiment occurred via telecommunication and assessed the effectiveness of repeated reading (RR) on reading fluency for two adults with specific learning disabilities using high-level and low-level reading passages. Participants reread each passage until they met a predetermined fluency criterion. We measured participants reading fluency using correct words per 1 min (CWPM) and assessed for retention at 1 week, 2 weeks, and 1 month. Both participants reached their fluency aims and maintained their progress postintervention.</p><p>• RR can improve reading fluency for children and adults with reading deficits.</p><p>• RR practice sessions require minutes to implement, which offers great flexibility for scheduling.</p><p>• Telecommunication represents an effective modality for implementing RR procedures for adults with reading disabilities.</p><p>• Participants in the study retained their fluency gains post-intervention, supporting that time spent on RR may represent a good investment for clinicians.</p>","PeriodicalId":47310,"journal":{"name":"Behavior Analysis in Practice","volume":"66 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140097777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}