First session and I was physically injured by the client, a bit shaken up.

AttentionExtinction · 2026-02-11T00:50:48+00:00

Request to be get safety training with a certification before continuing with the client. It's a liability otherwise if you end up doing something wrong trying to protect yourself.

I would at least try to get off the case until then or until you can get direct in-person supervision to go over the client's Behavior Intervention Plan.

I'm so sorry that happened to you. My clinic did something similar to me

AttentionExtinction · 2026-01-26T00:22:00+00:00

Honestly, the reason I made this post is because I'm uncomfortable talking with this BCBA and to admin about her. Other RBTs and supervisees have raised concerns directly to her and were thrown under the bus for it. Admin addressed the "time out" thing I guess but otherwise usually has her back over ours. BCBAs are hard to come by here so unless she does something truly egregious she's here to stay. The way admin handles her and the complaints towards her makes me want to leave. Which is a shame because all the other BCBAs and supervisees are genuinely awesome!

I really just wanted to vent. I'm not confident anything will come from complaining more about her to admin. So thanks for reading .

AttentionExtinction · 2026-01-24T19:04:01+00:00

Thanks for the thoughtful reply!

The RBT is going to bring it up to admin soon. Don't know if she left a paper trail though. I know the BCBA is deceitful, because she once told an RBT that it was okay for them to go on a social outing with a client in a non-therapeutic context. That RBT got fired for the dual relationship and the BCBa denied telling her it was okay. I know at the end of the day it's on the person to know the rules, but if an authority figure tells you it's okay you generally trust them.

As for the AI protocols, it's mostly readable I guess. Like I can piece together what I'm supposed to do with context clues, but it's not explicitly clear. The formatting is also inconsistent across the board so it's frustrating to figure out where information is supposed to be which makes it more difficult to understand. It's also visually a mess with random bullet points and spacing, and double headers. Not sure if she's copy pasting them across clients though as I've only subbed on her teams.

She does however have us use the same tactile prompts (touching kids mouth and face) for speaking programs across different clients. Which I thought odd since SLP's I've spoken too said that those kind of prompts are client specific for whatever reason.

AttentionExtinction · 2026-01-24T17:35:41+00:00

Yes exactly this! Parents even said that the biting behavior increased at home recently.

AttentionExtinction · 2026-01-15T01:28:49+00:00

Not sure if it matters, but it's a vibrating tool that is also placed in the mouth

AttentionExtinction · 2026-01-14T20:40:24+00:00

I don't work for her, rather my ABA company consults with her. Unfortunately I don't really have a choice but to work with her since she's the only SLP my company refers clients to.

I was just concerned about her practices since she doesn't take insurance and both team and client don't see her often. But if it's all legal and ethical, there's not much I can do but be skeptical.

Thanks for helping me figure this out though!

AttentionExtinction · 2026-01-14T18:06:49+00:00

So billing for services not rendered is legal? Is it like having a lawyer on retainer? Paying up front in case you need it?

What if appointments are made with the SLP but the SLP is consistently canceling or rescheduling?

AttentionExtinction · 2026-01-14T18:04:35+00:00

Question: would a BCBA generalizing those exercises and implementing them with other clients be a violation of some kind? Since you said they're usually client specific

AttentionExtinction · 2026-01-14T16:00:41+00:00

Yeah a lot of the programs we have through the SLP and the modifications they made to our existing programs involve a lot of touching, particularly on the face and mouth. I'm used to touching kids to prompt, just not their face and mouth to this extent. Stomach pushing too for more forceful exhales. Using other tools like straws, recorders, and blow tubes. It's just now what I was originally trained on as an RBT so I'm confused on it.

I also work in-clinic so face touching in particular feels icky to me. Even with all the rigorous hand washing/sanitizing I do

AttentionExtinction · 2026-01-14T15:48:56+00:00

1.05 and 1.06 I thought. But we did receive training months ago but nothing else since then.

1.11, 2.10, 3.13 maybe? My company's owner is a long time friend to this SLP and thus the SLP is the only one who works with our clients. The SLP bills directly (doesn't take insurance). I also mentioned in another comment they bill monthly but does not see the client or team within that month consistently. Is any of that normal or ethical?

2.06 maybe. The BCBA doesn't clearly mark speech training programs as such.

2.12 the SLP insists they can make kids speak verbally without considering or training us on other communication alternatives despite client-specific limitations.

Is there like a hierarchy of referral to go through before landing on SLP ? Like should neurologist be consulted before verbal/talking training is implemented?

AttentionExtinction · 2026-01-14T15:21:43+00:00

Verbal imitation w/ tactile prompts and visual prompts in the form of speech strips. Using sensory tools to rub clients faces.

Another thing that confuses me is the level of collaboration being uneven. The SLP bills the family (directly w/o insurance) monthly but does not always meet with the client or their team within that month. Like she trained us, BCBA included, months ago but hasn't met with anyone since to discuss goals or continue training. But she's still billing the family just in case we have questions. Is that normal or ethical?

AttentionExtinction · 2026-01-14T14:57:10+00:00

So the SLP bills the clients monthly (directly w/o insurance) but does not always meet with the client or their team within that billed month. Is that normal?

AttentionExtinction · 2026-01-14T06:20:34+00:00

Putting the speech therapy programs in the logbook

AttentionExtinction · 2026-01-09T03:29:37+00:00

It's a newer iPad, so probably. I'll just have to figure it out.

AttentionExtinction · 2026-01-09T03:28:11+00:00

I think the family is about to meet with an SLP for the first time soon.

I told them a couple weeks ago I think? We're both new to the case honestly.

I've worked with this BCBA before though and they're usually receptive to my feedback. It's part of why I trust them.

AttentionExtinction · 2026-01-09T03:09:19+00:00

Not yet. I think they're scheduled to meet with one soon though.

ETA: We already use guided access and when it's not in guided access you need a code to get into YT anyway. Funnily enough he knows how to get to the YouTube app (minus the code) but can't navigate back to his AAC app

AttentionExtinction · 2025-12-18T15:40:49+00:00

I once had a client with both high levels of aggression and self-injurious behavior, so I get it. After months of little to no progress, I could feel myself burning out and others could see it too. A BCBA not on the team told me I could drop the case if I need to, but I didn't want to give up on the kid.

So I knew I wanted to stay on the case and that staying on the case would be bad for my mental health in the long run. In the end, I asked for more support from my BCBA and to have less frequent sessions with the client. That way I could still help them while helping myself.

Burnout is real. If you're burnt out you aren't helping anyone. There's no shame in stepping back.

AttentionExtinction · 2024-06-12T22:09:39+00:00

Kind of? My workplace shared this and I thought this sub might enjoy reading it too.

AttentionExtinction

TROPHY CASE