The Importance of Defining the Scope of Practice for Behavior Analysts
The practice of Applied Behavior Analysis (ABA) largely began in 1968 with the publishing of the scholarly article, “Some Current Dimensions of Applied Behavior Analysis” (Baer, Wolf, & Risley, 1968). Since this article was published, the Behavior Analyst Certification Board (BACB) has emerged as an accreditation body which has established quality controls for those providing and supervising ABA services, namely Board Certified Behavior Analysts (BCBAs). Some states have passed legislation mandating that insurance companies provide an ABA benefit for the medical necessity of Autism Spectrum Disorder (ASD).
Certain states (e.g., Massachusetts) have aligned their practice standards for licensed ABA providers with the BACB’s, whereas other states require providers to meet state-specific standards separate from the BACB in order to become a Licensed Behavior Analyst (or Licensed Applied Behavior Analyst [“LABA”] in Massachusetts). Regardless of the state in which a LABA provides services, these professionals are bound by a strict scope of practice which dictates the types of interventions that can be implemented, populations to be served, and issues that can be addressed.
Here are some examples of what a LABA is permitted to practice in Massachusetts (see the FAQ resource in the reference list below for further information):
- Assessing and developing “educated guesses” about the role maladaptive behaviors play in helping learners get their needs met
- Decreasing maladaptive behaviors while replacing them with more functional skills in a learner’s repertoire
- Teaching skills to occur under certain environmental conditions
By contrast, the following activities are prohibited by licensure regulation for LABAs:
- Psychological testing
- Diagnosis of mental health or developmental conditions
- Psychoanalysis, psychotherapy, and cognitive therapy
- Psychopharmacological recommendations
It is important to highlight these distinctions so that parents and caregivers know what to expect when considering ABA as a treatment option for their loved one. However, the demarcating line is not always very clear. For example, LABAs are not permitted to conduct psychological testing or diagnose developmental conditions, yet they have a wide array of specialized assessment tools that they can use to guide the selection of appropriate treatment goals for an individual.
The key difference in these two approaches is that assessment methods which a qualified medical professional uses to diagnose a developmental disability are generally not used by LABAs as a basis for a treatment plan for a specific learner.
Second, ABA is a separate and distinct field from cognitive therapy and psychotherapy, so parents and caregivers should not be expecting their ABA provider to address the emotional underpinnings of their behaviors. It seems as if licensure regulations are echoing the content of Baer et al. (1968), which stipulate that ABA interventions are to adhere to the principles based on the science of human behavior, which implies LABAs are permitted to treat only behaviors that can be seen or heard.
Sources:
Baer, D. M., Wolf, M. M., & Risley, T. R. (1968). Some current dimensions of applied behavior analysis. Journal of Applied Behavior Analysis, 1(1), 91–97.
FAQ resource on Massachusetts insurance mandate for ABA services
