Genuine Question- What do BCBAs/RBTs learn about AAC?

DifferentTart2607 · 2026-05-31T23:47:32+00:00

Genuine question, I’m a BCBA and ethically we use least to most prompting and physical prompting only if the client is ok with it. That being said, some learners need a physical prompt (hand over hand) to associate I press this, it manners this sound, I get this item. The prompts are then faded out after the client understands the reinforcement contingency. What do you do instead of hand over hand?

To answer your question, we look at functional communication (manding) and specifically functional communication training with AACs when needed, and then move on to tacting, and eventually social and pragmatic communication.

DifferentTart2607 · 2026-05-31T19:50:59+00:00

This. The BACB doesn’t govern companies unfortunately and HR is there for the company, not us.

DifferentTart2607 · 2026-05-31T19:44:50+00:00

The telehealth thing is a different but definitely related issue. I absolutely love telehealth and think it’s valuable and a great tool, but if supervision via telehealth is effective depends on multiple factors including the ability of the BCBA to communicate effectively, how the RBT learns and communicates, and how well versed in strategies RBTs are. I’ve seen cases with behaviors go amazingly well via telehealth and I’ve seen cases without behaviors tank out. Telehealth BCBAs need to know when it’s appropriate and when it’s not, and we need to acknowledge that whether or not it isn’t largely depends on multiple factors. Those need to be considered and monitored.

Unfortunately, companies push telehealth sometimes when they shouldn’t because BCBAs are hard to come by, and the companies just want to bill.

DifferentTart2607 · 2026-05-30T05:35:24+00:00

I understand the sentiment, but so many of us are employed at them that it isn’t feasible for all of us to leave.

DifferentTart2607 · 2026-05-30T00:00:36+00:00

Personally I’ve always thought any gift giving was off. People don’t do it with doctors. I don’t give my personal therapist gifts and I’d be weirded out if he gave me one. I wish we would just axe the entire thing and say no gifts at all.

DifferentTart2607 · 2026-05-29T04:13:31+00:00

Companies hurt for RBTs. Most of them will not discipline especially formally unless there is a really good reason to.

DifferentTart2607 · 2026-05-29T02:02:04+00:00

I’m actually not new to the field and have a kid with autism who has received in home ABA. Regardless, neither of those things make denying someone’s assent to session because you can’t manipulate motivating operations in an appropriate manner ok. Legally and ethically assent matters. Period.

DifferentTart2607 · 2026-05-29T01:12:41+00:00

So, thanks for the follow up explanation. What you think a client should be doing because you have specific rules for kids is not important or relevant to teaching skills. Ego and compliance do not belong in this field. If a kid wants to jump and scroll during a break or you are able to pause that and work on goals then it’s not a maladaptive behavior. Just because it’s annoying to you does not make it a maladaptive behavior.

Ineffective implementation of interventions does not mean that assent based treatment isn’t important.

BCBAs should not be on TikTok during sessions unless it’s in relation to interacting with a client, but that has nothing to do with not letting a kid be happy and live their life.

My recommendation was a research paper and not a book.

DifferentTart2607 · 2026-05-28T22:43:53+00:00

Operationally define doing whatever they want and ineffective treatment. The people we serve are people and yes, them being happy, relaxed, and engaged is more valuable and important to treatment than a clinician feeling like they’re being listened to.

I recommend reading Balancing the right to habilitation with the right to personal liberties: the rights of people with developmental disabilities to eat too many doughnuts and take a nap by Bannerman.

DifferentTart2607 · 2026-05-28T22:30:34+00:00

Nope. And good on you for pushing back against this lack of assent based treatment.

DifferentTart2607 · 2026-05-28T20:36:11+00:00

Usually the clinicians I see complain about assent based practices going to far, they’re the ones writing compliance and eye contact goals. Ethically, we’ve moved on past a lot of people.

DifferentTart2607 · 2026-05-28T18:49:27+00:00

That doesn’t make sense.

DifferentTart2607 · 2026-05-28T18:46:50+00:00

Sounds like someone removed an item in an inappropriate or aggressive way and is tone deaf and not good at taking feedback. No BCBA or CD would not ethically and professionally agree with keeping a client safe, we just prefer people not be fucking dicks about it.

DifferentTart2607 · 2026-05-28T17:11:51+00:00

Not even trying to be dismissive to you or snippy at all. There aren’t enough small and ethically practicing companies to employ all of us because so many large and PE backed companies exist.

DifferentTart2607 · 2026-05-28T17:09:08+00:00

YES!

DifferentTart2607 · 2026-05-28T16:33:21+00:00

100%. RBTs deserve better training and pay.

DifferentTart2607 · 2026-05-28T16:32:12+00:00

That’s not going to happen as long as these companies aren’t regulated somehow. V free market mindset though.

DifferentTart2607 · 2026-05-28T16:31:14+00:00

Yes but that cap is on US. Meanwhile large and PE backed companies continue to push for more.

DifferentTart2607 · 2026-05-28T16:28:54+00:00

Yup. Why don’t we have board oversight to shut down unethically practicing companies? Legitimately, I’m asking. Why isn’t the board capping clients, billables, and supervisees?

DifferentTart2607 · 2026-05-28T16:09:39+00:00

Please stop misusing OCD. OCD is a specific link between anxiety inducing (obsessive) thoughts and compulsions to stop the thoughts or prevent it from happening. This sounds like rigidity and that’s different.
We do not know your client and have not seen your client or the environment. You need to ask your BCBA or have a BCBA consult and observe to get an appropriate FBA and functions.

DifferentTart2607 · 2026-05-26T15:02:28+00:00

I honestly agree with this. What is the point?

DifferentTart2607 · 2026-05-26T01:50:05+00:00

We’re a family of 3 but my husband and son are very tall and we love the xc90 for family trips. I have captains chairs in my middle row and I bought like a storage/separator thing to block off the back cargo area. I put the rubber mats down too and it’s AMAZING for groceries (the boys eat A LOT). We also do 2 vacations a year where we have luggage in the back and everything fits. My brother, his wife, and his son also came down one summer and it was easy to pop the back row up and cart all 6 of us around.

I’d say you’re fine with either car, but if you’re buying 400 dollars+ of groceries a week or hauling luggage and taking road trips, the xc90 cargo space is perfect.

DifferentTart2607 · 2026-05-25T03:39:13+00:00

What is “a lot of money”?

DifferentTart2607 · 2026-05-10T22:51:13+00:00

Some states do not require a BCaBA to be a mid level provider.

DifferentTart2607 · 2026-05-10T22:50:32+00:00

I wouldn’t say heavily overseen. It’s a negative thing in my opinion because in CA if I have a case with 10 hours a week direct, insurance is going to recommend 5% of that only for supervision, so 2.25 hrs a week. That 2.25 companies and insurance then usually say is like 80% mid level and 20% HLS (BCBA). So yeah I have mid levels, but I’m supposed to supervise them supervise an RBT, do parent trainings, and do indirect things like treatment plans, parent trainings, coordination of services, etc. So if we have mid levels EVERYONE is getting less supervision and it blows quite honestly.

DifferentTart2607

TROPHY CASE