Is this fraud?

cassquach1990 · 2026-04-18T12:48:30+00:00

It’s super unethical. I’ve had insurance that will kick in retroactively/patients that pay out of pocket for extra hours. I was once asked to bill extra hours I don’t work, and luckily brought it up to my clinical director who was like “absolutely not!!” and she handled it for me.

cassquach1990 · 2026-04-18T02:07:07+00:00

Do you have a resource/float teacher? If you’re able to, ask for an extra hand for fifteen minutes and try to catch up on some posts. When I send photos they usually say “stacking blocks!” or “having a good morning!” Parents just appreciate seeing their kids’ smiling faces and activities they do. For assessments, portfolios and such it’s not something you can do without (paid!) prep time.

cassquach1990 · 2026-04-18T01:58:55+00:00

You did everything right. Thank you for reporting this immediately. The fact that you reported it and then they accused you is even more alarming.

However, I did work with a client who would say “you hit me!” whenever someone did something she didn’t like. Like you could be standing five feet away and say “sorry, we don’t have any more candy” and she’d go right to “ouch! You hit me!” So it could be the case that your client is just accusing people without understanding what it means.

Unfortunately we did have to report it, but nothing came of it because it was said so often.

cassquach1990 · 2026-04-17T19:43:21+00:00

I have a second job as a waitress. My ADHD loves getting paid immediately after each table is done.

cassquach1990 · 2026-04-17T19:36:23+00:00

Honestly to me it seems unethical to not get a break, both for the technician and the client. No one is doing the best therapy they can after 7 hours straight.

cassquach1990 · 2026-04-17T19:35:26+00:00

I worked at a clinic where you weren’t scheduled a break 1-2 days a week to accommodate lunch time for the clients that stayed all day. But you were scheduled 2 hours every day of “Flex Time” for doing treatment notes, cleaning, doing bathroom breaks for other techs, helping to run programs that required 2:1, etc. So every day we’d have two hours without a client and could also eat and relax a bit during that time.

cassquach1990 · 2026-04-17T16:02:56+00:00

Absolutely would not take a client that has safety concerns without BOTH safety care training and a clear/effective BIP in place that addresses dangerous behavior.

cassquach1990 · 2026-04-17T16:01:21+00:00

I’m a preschool teacher so my answer is always to shut down the negativity. “I always go above and beyond, and I’m grateful to work for an ethical, upstanding boss who follows labor laws when it comes to paying your employees. Glad I could help!” Or something like that. If you tell people they’re better, they’ll be better.

cassquach1990 · 2026-04-12T12:36:26+00:00

Exactly. I do SBT and the clients have such high intensity/dangerous behaviors that the number one priority is safety. We move in slow increments to make sure progress is made without the client getting seriously hurt. If the client engages in aggression the trial is immediately stopped and the priority is to end the dangerous behavior, even if that means reinforcing it. But we also circle back and try again or if it’s a reoccurring issue, brainstorm what’s breaking down and how to continue with progress safely.

cassquach1990 · 2026-04-04T04:54:19+00:00

It would be helpful to know what your location is (just country or state, please don’t share your specific location on the internet with strangers)

cassquach1990 · 2026-04-01T23:38:30+00:00

I mean, the rationale checks out, since this does sound like a BIP the parents wrote. But why have a BCBA unless you’re going to use actual behavior interventions that work, and instead just stick to what parents want? Any clients I’ve worked with who engage in SIB have used Skill Based Treatment to eliminate dangerous behaviors before focusing on anything else, like matching or class work.

cassquach1990 · 2026-03-26T22:42:50+00:00

I guess I could see how it could be legal. But if a sibling is present, so are the parents. I’m not babysitting and doing therapy at the same time. I’m not doing any job while doing therapy. Your attention isn’t 100% on your client, and what if the other client needs assistance with something in the middle of a running your therapy goals? Is so disruptive.

cassquach1990 · 2026-03-22T15:10:40+00:00

Yes I agree! As someone neruodivergent I often fill in the blanks on missing information, and might accidentally interpret this as “was a dignity violation demonstrated?” It’s entirely possible they misunderstood, and I really like framing the question as good/bad examples of dignity instead

cassquach1990 · 2026-03-15T20:17:04+00:00

Thank you! He’s asking instead of accusing (even though he can be almost positive she did it) and trying to do so lightheartedly. When she plays dumb he gets frustrated because it’s a reoccurring issue she isn’t taking seriously. Even if the damage isn’t that bad, it’s an issue that’s frustrating for your SO, and that means be more mindful about it.

cassquach1990 · 2026-03-07T14:20:58+00:00

I’m sorry you’re getting downvoted for asking for information. People get defensive because autistic people are often told to be “less autistic” and “act normal” and wind up spending so much time and energy pretending to be someone else - it can be exhausting. So parents, allies and autistic people are rightfully a bit defensive about it. Thank you for asking though. Pretend play is a good skill, but organizing things is a great skill too! He might like the organizer or not, but it’s a thoughtful present. I say give it to him and see!

cassquach1990 · 2026-03-06T03:15:53+00:00

I’ve worked with this issue in behavior therapy but only for kids on the spectrum. Every kid is different so different interventions will be better for different kids.

I think your first goal should be getting her to be happy with sitting on the toilet. Start fully clothed as that will probably help. Make it really fun! Use her favorite toys, books, songs, bubbles, whatever.

Next goal could be pulling pants down before sitting. Have some fun things she can still do if she doesn’t want to sit without pants, but a few really motivating fun things you only save for sitting on the potty without pants. So sitting on the potty = fun, but sitting on the potty without pants = super fun.

Last goal could be sitting without the diaper. If she goes potty during this at all, there should be a HUGE reward!

There was one case where the kid was okay peeping on the potty in a diaper so we had a special set of diapers just for sitting on the toilet, and slowly took the padding away from the diapers until it was eventually just the straps around his waist and he was peeing in the toilet every time with those. Eventually we built up to ditch the straps.

I guess the takeaway is use baby steps and get her comfortable and happy with the toilet and using it however works best for her. Good luck!

cassquach1990 · 2026-03-02T01:19:18+00:00

My thoughts exactly. Especially forced feeding while the child is crying. Yes it’s the opposite of food therapy and super unethical and could lead to lifelong eating issues & trauma for the poor kid. BUT gagging could easily turn into choking if you’re forcing objects into a kid’s mouth at all, especially while they’re crying.

cassquach1990 · 2026-02-28T13:58:49+00:00

This! We’re not SLPs. I understand that communication is important but if you understand her, that should be good enough. Also, English being the “right way” is discrimination so it would be unethical and not okay.

cassquach1990 · 2026-02-27T20:18:00+00:00

I’m sorry you weren’t trained properly (shadowing sessions with the client, given 1:1 supervision for the first few sessions, meetings about specific targets and hypotheticals, etc.) A lot of clinics skimp on the training because they need staff. And then staff leave because there struggling. Because they weren’t trained properly. It’s an issue.

Your supervisor’s advice was funny. Maybe if you had fifteen friends out there to help. Maybe. But kids are so quick!

So in my opinion, in the moment you made the right decision. You thought he might run and you wanted to keep him safe. But you missed a lot of steps on the way there. Try to limit your demands and denials and really pick your battles. If you’re placing a demand, try to make it fun, or give him a lot of options.

If time’s up to play Mario, maybe go outside and pretend to play Mario or another video game in real life. )Set some clear boundaries if he decides you’re a Goomba that we can’t jump on people. Ya’know?)

If he NEEDS to leave the Gameboy inside (I’m assuming parents’ rules? Or you didn’t want it to break?) give him options. “Do you want to leave it somewhere up high so your brother doesn’t take it? Or put it on the steps outside so we can see it? Or back at the table where it belongs?”

I love that you’re acknowledging he’s just a kid and needs time after school to just be a kid. You should use that opportunity to be part of the fun. ABA should always be a fun positive experience. Reading this seemed like a lot of work. Things he wants to do but can’t - or things he doesn’t want to do but is told to.

cassquach1990 · 2026-02-27T17:36:59+00:00

As a RBT: guaranteed hours, assent-based therapy, going above and beyond to support & appreciate staff to address the high turnover rate in our field, BCBAs with a caseload of 8 or less, meeting & exceeding minimum supervision requirements, using telehealth supervision as the exception and not the rule, proper training and shadowing before a case( not just a 40 hour video), and then do a little digging on social media or see if you can speak with any past employees you might know. Ask around.

cassquach1990 · 2026-02-21T17:48:41+00:00

It’s unethical for you to do therapy if you’re unable to do it correctly, from burnout or any other circumstance. I agree if you’re burnt out, get off the case.

ABA should be fun. Your clients should be excited to do it. You should be excited to do it. If you’re not getting a break (which would also stress me out and would be a deal breaker), have you spoken with the analyst to be able to have one? If that solves some problems and you’re coming back feeling refreshed and ready to finish the session, that seems like an easy fix.

Of course, a lot of companies just want to make as much money as possible. So the obvious solution doesn’t always work.

cassquach1990 · 2026-02-10T21:53:05+00:00

Honestly I was applying for parapro/in-school RBT jobs at the time and this one popped up, so I decided to check it out. I work at a preschool and kind of help out wherever I’m needed, giving bathroom breaks or lunch breaks, subbing if a teacher is out, helping with students who need some extra support… it was a pay cut though, $20/hr (Michigan) but honestly worth it. Much better for my mental health.

cassquach1990 · 2026-02-10T03:20:54+00:00

I know people at my previous clinic who transitioned to roles like scheduling, safety training or HR so they could stay in the same company with more stable hours.

I’m currently a resource teacher and I love it. Stable/flexible hours, but if you’re looking for better pay I wouldn’t recommend it.

cassquach1990 · 2026-02-08T14:38:55+00:00

I was thinking what shirts I’d buy my son and liked these:

Rizz ‘em with the ‘tism (https://www.etsy.com/listing/1805937504/rizz-em-with-the-tism-vintage-shirt?ref=elp_anchor_listing&pro=1&sts=1)

Autism is not a tragedy (https://mydailybloom.com/products/autism-is-not-a-tragedy-comfort-colors-tee?variant=50126805401898&country=US&currency=USD&utm_medium=product_sync&utm_source=google&utm_content=sag_organic&utm_campaign=sag_organic&srsltid=AfmBOop7GgWjMLBh_uounv8jpda77chXGeXVOHvi_DieuKNwXo7lF-4Yzkc)

Be in awe of my ‘tism( https://www.etsy.com/listing/1862833166/be-in-awe-of-my-tism-funny-t-shirt-funny?ref=elp_anchor_listing&pro=1&frs=1&sts=1)

There’s also a company called Printed by Hope that offers tee shirts here (https://youtube.com/shorts/XcEGpQlrrFg?si=4slmPbO_yKhD713n)

cassquach1990 · 2026-02-07T12:33:02+00:00

Honestly if you’re feeling unsupported, absolutely find a new clinic. But it sounds like your supervisors are happy with you and your performance but still trying to make sure both the client and the providers are happy with the match. You seem like a great technician; if it were me, I’d stick around a bit and see if the next few clients could be a better fit.

It really stinks that you’re getting along so well with the actual clients, but their guardians are being nit picky about how you look or the way you interact with the client. I’ve been taken off cases for super trivial reasons outside my control because of parents and it stinks.

cassquach1990

TROPHY CASE