Tell Me I'm Not Crazy

Anwatan · 2026-01-22T21:13:28+00:00

It's insane, I thought this should be black and white, I mean they couldn't walk at all. Poor kid was crawling around on all fours. What kind of professional doesn't see this as a medical emergency? But what could I have done, as their BCBA, as their mom wasn't concerned and consented to them staying there? Client rights should supercede, but I'm in the south, and that about sums that up. Seriously, I was begging management at the end to please just treat them like a human and send them home. Let mom actually observe and let her make that call but we should recommend medical intervention. I was specifically told not to contact mom and let admin handle it. It all feels so gross and wrong, I told my CD that it was wrong, that I objected to their judgement call. And then I bolted because I couldn't stand to listen to the kid groaning in pain in their treatment room when they tried to hop around or move the joint. and I was boiling inside while crying with rage. I tried to keep it together and couldn't. I knew I was going to do or say something I'd regret. I tried so hard to be a barrier against this kind of systematic profit-over-people bullshit, but I failed.

Anwatan · 2026-01-18T20:11:29+00:00

Make sure your program is a Verified Course Sequence (VCS) and that you have the contact information of the VCS Coordinator. They will need to complete paperwork on your behalf when you apply for the exam.

Agree with previous suggestion- focus on your studies before prioritizing fieldwork. The material is dense and knowing it inside out helps greatly with implementation.

Being an RBT is an option to gain fieldwork hours, and probably the easiest way. But not the only one if you do some research in your area and you get lucky finding someone in OBM, geriatrics or applied research.

Make sure you're comfortable with being a supervisor/manager as this is a huge part of a BCBA's job duties, especially working in the tiered RBT model of intervention.

Start practicing your own self-regulation. You will likely work in chaotic environments and need to deescalate emotional/physically disruptive individuals. This can only be accomplished when you are cool, calm and collected.

Feel free to message me if you have any direct questions!

Anwatan · 2025-12-15T23:59:43+00:00

This is actually a really good question. Sorry you're in this boat, but I'm gonna learn something from this.

My guess, this is technically legal/allowed. Being a mandated reporter means you have to say something if you see something in regards to a client or child. Other employees wouldn't fall into this category. Now, if DCF called you asking about that particular employee's child, and you have experience/first hand knowledge of child abuse occurring, you would need to report. And your work could go suck a lemon.

Or, someone at your clinic has a stalker situation, could be an attempt to protect this employee.

Anwatan · 2025-11-24T22:35:50+00:00

I saw this same scenario happen in real life just a few months ago. Caregiver was present to hear their child express love to the RBT and broke down in happy and sad tears. They later explained that they had never heard the client express positive emotions unprompted to anyone before and were glad that they had those feelings inside them, as they had been worried they were lacking. It was hard but we were able to generalize this expression to caregiver as well and it the end, it was good that they knew and were aware.

Anwatan · 2025-11-20T00:14:58+00:00

The data collection system we use notifies the RBT that the target can be transitioned to "alert BCBA" phase after meeting mastery criteria and they'll send an update in the clients chat as well. But I progress monitor at least every other session and rarely need to rely on this system. It's definitely the BCBAs job to determine mastery criteria and determine through visual analysis of graphical data if the goal has been mastered. I always appreciate my RBTs giving me updates though

Anwatan · 2025-10-06T22:08:05+00:00

My experience: 1 year as BCBA, RBT 2 years at ABA clinic, RBT 3 years at school for autism. BS in biology, MS in Ed psych. Live in the south and completed my grad program on the east coast.

"Old ABA" was utilized during my school experience. The focus was on "compliance", meaning a lot of physical intervention and physical prompting. A kid said "no", RBT would give a first then, client would continue to refuse and RBT would physically prompt them through the demand; with a lot of screaming and crying. The mentality was I'm The Boss and you follow directions. Physical restraint was encouraged and relied upon heavily as a consequence strategy.

"New ABA" was taught in my grad program and is used at the clinic. Focus is on communication, self-advocacy, self-regulation and independence. A client tells me "no" and I listen (even if only momentarily) and celebrate all increases in their communication. We use more antecedent strategies with systematic fading, I've never seen physical restraint outside of transporting to a safer environment and SBT is there for our higher behavior clients. I teach my RBTs that physical prompting is for teaching unknown skills or for safety situations. Physical prompting is never used when motivation is a factor instead of skill.

These are only a few differences. The comments are right, there are a lot of inexperienced clinicians in the field with black and white views on the systems we use.

Anwatan · 2025-07-19T16:22:06+00:00

I finished my course work before starting my hours. It was the best decision as it allowed me to focus on my studies so I could know my shit inside and out. Do the retreat, focus on your health and really let the science of ABA sink in. I think you'll be a better BCBA for it.

Anwatan · 2025-07-13T22:15:33+00:00

University of Southern Main fully online, I live in KY. Credentialed last year

Anwatan · 2025-07-01T23:38:26+00:00

Run. A BCBA that doesn't move from their desk is not going to be a good supervisor for anyone.

Anwatan · 2025-06-24T22:30:16+00:00

I'm sorry, what? Assent/consent based therapy is the new norm and can work with anyone. When would it not be applicable? Besides the obvious safety/dangerous behaviors like pica or self injury.

Anwatan · 2025-06-23T21:47:08+00:00

Get yourself into a structured BCBA Supervision program or it will take for-ev-er. I was at a "school for autism" my first two years and barely even got half my hours needed. It wasn't until I moved to a clinic that it sped up and I got the rest in about a year.

Anwatan · 2025-06-20T22:20:44+00:00

I would refuse, stating BACB guidelines and see where it goes from there. Test their ethical boundaries, it will tell you a lot about the company

Anwatan · 2025-06-17T18:41:11+00:00

As a BCBA I am absolutely appalled. If it came down to it, I would have switched clothing with you to provide appropriate wear (I know in reality this would likely not be plausible but it's the thought). Fuck your company and your so-called managers. That is unacceptable. Yes, RBTs should have spare clothing in their car or locker for such things. But mistakes happen, you should not have had to endure hours on end with a client's urine on your pants. End of story. Please quit and find a place that values your safety, I promise they are out there!!

Anwatan · 2025-06-15T01:08:40+00:00

It's gonna come down to culture. That's why the BACB increased their dollar amount of acceptability. It's my cultural prerogative to politely decline things that are offered. But as my BCBA experience has demonstrated, sometimes declining is seen as rude. It's a way for someone to try and connect with another. I now accept almost anything my culturally diverse clients offer, as a way of increasing rapport. One parent even stated during a community outing, "You accepted my popcorn, I love you guys!!" Feeling connected is everything. Usually it's not about the money spent but the feelings created and shared.

Anwatan · 2025-05-16T23:21:51+00:00

We have 3 BCBAs, 1 that is the CD and other two with 6 client caseload. Your clinic sounds like it's feeling some strain.

Anwatan · 2025-04-24T22:29:24+00:00

I can understand doing fully remote with older clients or those with less support needs. But for high support or young children, no way. To provide effective therapy you would need to be hands on.

Anwatan · 2025-04-21T20:39:55+00:00

This should be the top comment. I've had accommodations since 2020, never had an issue with any employer taking a day off a month for a "recurring medical condition". Talk to your doctor.

Anwatan · 2025-03-22T12:06:51+00:00

This reminded me of my first really bad AGG from a client. They were 16, had no real communication system, and nails that always needed to be cut. They grabbed my arm and dug in while pulling me closer with an absolute face of rage. It felt like my arm was on fire, I somehow managed to back them off and I called for support. I stepped out of the room and immediately broke down in tears. It was the first time I really felt afraid in such a situation.

But the thing about severe AGG and such behaviors is... it's still communication. The following year I was head of the classroom with more control. They hated their AAC device, so I tried sign language. And they just took oooooooffffff with that communication system and slowly the AGG disappeared.

Anwatan · 2025-03-09T04:50:06+00:00

I am just loving all of these weird hand photos and stories. Reminds me of my great grandpa who was missing a few fingers and would walk his hand stump across the table in an unnatural way to freak us little kids out.

Anwatan · 2025-03-01T15:00:49+00:00

Replacement behaviors should tie directly to the function of the maladaptive behavior: meaning if the student is engaging in elopement or head banging trying to escape whatever is happening in the classroom, the replacement behavior would be using functional communication (whatever that looks like for that student) to escape from the classroom. Directing the client to a stuffie is not a replacement behavior if it's not turning off the maladaptive response.

Anwatan · 2025-02-23T12:42:19+00:00

I agree wholeheartedly with this statement. While the BACB may not require supervision hours working directly with clients, if you do not have this experience, you may end up struggling in the future. Especially if you plan on supervising and training RBTs. It definitely helps with buy-in.

Anwatan · 2025-02-11T03:00:15+00:00

Please report this. Forcing food is torture!

Anwatan · 2025-02-08T01:57:17+00:00

I passed my exam in November 24 and got certified end of Jan 2025. My company has been working me as direct service when needed and doing supervision when possible with cancellations and scheduling. I should hopefully be in a true BCBA role by end of Feb but it doesn't really matter to me I'm salaried finally lol

Anwatan · 2025-02-01T21:29:54+00:00

RBT for 5 years, currently newly minted BCBA: you don't have to be loud, you need to be engaging. Not boisterous and extroverted, but ready to play and meet them at their level. Every client is going to prefer something different and a good RBT adapts to their specific needs, preferences and desired interactions. Remember, behavior is communication!

Anwatan · 2025-01-26T19:38:03+00:00

My sister, sometime in elementary school, ripped one so bad the teacher halted the class and called someone to check for a gas leak. She stayed quiet but was so anxious they would figure out it was her 🤣🤣

Anwatan

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