ABA Therapy for Children with Autism

Understanding ABA: More than Just Behavior Modification

Introduction to ABA Therapy

Applied Behavior Analysis (ABA) therapy is widely recognized as a vital intervention for children with Autism Spectrum Disorder (ASD). Rooted in learning theory, it applies structured methods to enhance communication, social, and daily living skills while reducing problematic behaviors. In this narrative, we delve into ABA's methodologies, benefits, controversies, and how families can access quality services.

Defining ABA Therapy

Understanding the Foundations of ABA Therapy

What is Applied Behavior Analysis (ABA) therapy for autism?

Applied Behavior Analysis (ABA) therapy for autism is a structured approach that helps individuals with autism learn skills and reduce problematic behaviors through the principles of reinforcement. It focuses on increasing useful behaviors, such as communication and social skills, while decreasing harmful behaviors through techniques like positive reinforcement and a token economy.

Key components and principles

ABA therapy is personalized and involves creating individualized treatment plans that cater to each child’s specific needs and preferences, often with the guidance of a board-certified behavior analyst (BCBA). Core elements of ABA include:

  • Positive Reinforcement: Rewarding desired behaviors to increase their occurrence.
  • Data Collection: Monitoring progress to modify strategies effectively.
  • Antecedent-Behavior-Consequence (ABC) Model: Understanding behaviors in context of their triggers and outcomes.

Critical understanding of reinforcement techniques

Although ABA has demonstrated effectiveness in improving various skills, it has faced criticism regarding its historical use of punishment and its focus on behavior compliance. Critics argue this can overshadow the need for skill-building. Supporters, however, believe that when implemented thoughtfully, ABA helps autistic individuals gain independence and enhances their ability to participate in society. By emphasizing strengths and tailoring interventions, contemporary ABA practices aim to respect the individual’s unique identity and promote meaningful learning experiences.

Goals and Benefits of ABA

Unlocking the Potential of ABA Therapy for Autism

What are the goals and benefits of ABA therapy in treating Autism Spectrum Disorder (ASD)?

ABA therapy aims to enhance communication and social skills, reduce problematic behaviors, and facilitate greater independence in daily living for children with Autism Spectrum Disorder (ASD). By utilizing individualized treatment plans, ABA tailors interventions to address each child’s unique needs, fostering skill acquisition and application in various settings such as home, school, and community.

Objectives of ABA in treating ASD

Some primary objectives of ABA therapy include:

  • Improving Communication Skills: Enhancing both verbal and non-verbal communication to aid interaction.
  • Social Skill Development: Teaching children how to navigate social situations and form relationships.
  • Reducing Problematic Behaviors: Systematically addressing behaviors that may lead to social or safety concerns.
  • Promoting Independent Living Skills: Supporting the acquisition of self-care and daily living skills necessary for autonomy.

Improvement in life skills through ABA

Consistent application of ABA techniques can lead to significant improvements in critical life skills. ABA therapy focuses on breaking down tasks into manageable steps, using positive reinforcement to encourage successful completion. Notable areas of improvement include:

  • Language Development: Enhancements in expressive and receptive language abilities.
  • Daily Living Skills: Learning to manage tasks such as dressing, toileting, and hygiene independently.
  • Social Interactions and Emotional Regulation: Developing skills to interact with peers and manage emotions constructively.

Family engagement importance

Engagement of families is vital in ABA therapy. Parents and caregivers are trained to apply ABA strategies at home, ensuring continuity and reinforcement of learned skills. Their involvement promotes a collaborative approach, making the therapy process more effective. As advocates for their child’s development, families benefit from understanding ABA principles and can help reduce stress while improving communication with their children.

In conclusion, ABA therapy represents a structured, evidence-based approach that not only aims to improve the lives of children with ASD but also actively involves family members in the therapeutic process, enhancing outcomes and quality of life.

Techniques in ABA Therapy

Exploring Effective ABA Techniques for Skill Development

Overview of Various ABA Methodologies

Applied Behavior Analysis (ABA) includes a range of methodologies designed to help children with autism and other developmental disorders learn new skills and decrease negative behaviors. Techniques are tailored to meet the unique needs of each child, emphasizing individualized treatment plans developed by Board Certified Behavior Analysts (BCBA).

Discrete Trial Training and Pivotal Response Training

Two common techniques are Discrete Trial Training (DTT) and Pivotal Response Training (PRT).

  • DTT: This method breaks tasks into smaller, manageable steps, rewarding correct responses to facilitate learning. For example, if a child is learning to identify colors, they may first be taught to recognize blue by presenting it repeatedly and offering praise when identified correctly.
  • PRT: Unlike DTT, PRT focuses on pivotal behaviors that can promote broader skill learning. It encourages children to follow their interests, allowing natural learning opportunities in less structured environments.

Function of Positive Reinforcement

Positive reinforcement is a cornerstone of ABA therapy, where rewards are given immediately after a child exhibits a desired behavior, reinforcing the likelihood of the behavior being repeated. This technique not only supports learning but also helps cultivate independence and social skills. For instance, a child may receive a token for sharing during playtime, which can later be exchanged for a small prize. These strategies collectively enhance developmental skills while decreasing unwanted behaviors, making ABA an effective approach for many families.

Improving Skills Through ABA

Enhancing Life Skills with ABA Therapy

How does ABA therapy improve skills in autistic individuals?

ABA therapy enhances skills in autistic individuals by employing techniques grounded in the science of learning and behavior. This evidence-based approach focuses on several key areas:

  • Communication: It teaches verbal and non-verbal communication through methods like the Picture Exchange Communication System (PECS) and Functional Communication Training (FCT), which encourages appropriate expression of needs and feelings.
  • Social Interaction: Techniques such as modeling and pivotal response training facilitate improved social skills by helping children learn to understand social cues and engage with peers more effectively.
  • Self-Care and Daily Living Skills: ABA methods break down tasks like dressing and feeding into manageable steps, aiding children in developing independence.

In addition to skill enhancement, ABA proactively reduces harmful behaviors. By identifying triggers and implementing positive reinforcement strategies, therapists guide individuals to replace inappropriate behaviors with safer alternatives. This dual focus supports not only skill acquisition but also fosters a safer, more adaptive behavior pattern.

The role of Board Certified Behavior Analysts (BCBAs) is crucial in this process. After assessing each child’s unique needs and strengths, BCBAs design personalized treatment plans that promote substantial progress in various developmental domains. Through structured and individualized approaches, ABA therapy significantly improves the quality of life for children on the autism spectrum, preparing them for more functional adult lives.

Controversies in ABA Therapy

What are some controversies associated with ABA therapy?

ABA therapy, while widely recognized for its effectiveness, is not without its controversies. Historically, some critics have pointed to the use of aversive techniques, such as electric shocks, in earlier forms of the therapy. This practice raised ethical concerns about the potential harm inflicted on autistic individuals.

Moreover, the therapy's focus on achieving compliance with neurotypical behaviors has been another source of contention. Critics argue that efforts to suppress behaviors such as self-stimulatory actions, or stimming, may deny autistic individuals the right to express themselves naturally. Such practices can lead to feelings of trauma and, for some, may contribute to conditions like PTSD.

Another major issue is the perceived lack of autonomy within ABA frameworks. Some argue that children may be pushed towards conformity at the expense of personal choice and individual identity. The immediate recommendations for ABA therapy following a diagnosis of autism, sometimes made without a thorough consideration of a child’s unique needs, further compounds these concerns.

Advocates for reform within ABA emphasize the importance of ethical practices that respect neurodiversity. This reflects a shift toward more inclusive and individualized approaches, balancing skill development with the rights of children to retain their innate behaviors and preferences.

Accessing ABA Services

How to find quality ABA programs

Finding quality Applied Behavior Analysis (ABA) programs can be crucial for children with Autism Spectrum Disorder (ASD). Start by seeking recommendations from pediatricians, special education teachers, or other healthcare providers. Additionally, local autism support groups can provide insights on reputable ABA therapy providers. It’s important to research the credentials of the therapists involved and ensure programs use evidence-based practices.

Insurance coverage and diagnosis requirements

Insurance coverage for ABA therapy often depends on a specific diagnosis of autism. Many plans adhere to requirements established by state laws regarding coverage for autism treatment. Families should check with their insurance provider to understand the specifics of their coverage, including necessary documentation from a qualified healthcare provider, such as a BCBA, to authorize treatment.

Role of Board Certified Behavior Analysts

Board Certified Behavior Analysts (BCBAs) play a critical role in the development and delivery of ABA therapy. They assess individual needs, design personalized treatment plans, and monitor progress, ensuring the therapy aligns with best practices. Families should inquire whether the therapists are BCBAs and consider their experience with similar cases to guarantee appropriate support for their child.

How safe is ABA therapy and how can one ensure the selection of qualified therapists?

ABA therapy can be safe and effective when conducted by qualified professionals who prioritize positive reinforcement and the individual needs of the child. However, parents and guardians must be cautious in selecting therapists, as some may employ outdated or harmful practices. Warning signs of a harmful therapist include coercive methods, a lack of respect for the child's communication preferences, and a focus on compliance over well-being. It is essential to ensure that therapy goals are collaborative and that practices are adapted to respect the child's identity. Overall, families should thoroughly evaluate potential providers, focusing on qualifications and the modern, child-centered approaches in ABA therapy.

Comparing Treatments

How does ABA therapy compare to other autism treatments?

ABA therapy, or Applied Behavior Analysis, is a scientifically-supported intervention designed to enhance essential skills like communication and social interaction in individuals with autism. It is particularly effective for younger children, especially those starting therapy between ages 2 and 6. Research has shown that early intervention with ABA can lead to significant improvements in behavioral and developmental skills, with positive outcomes reported in approximately 63% to 88% of cases.

In contrast, other therapies such as Cognitive Behavioral Therapy (CBT) are more suited for higher-functioning children, generally over the age of 7. CBT focuses primarily on emotional and cognitive processes, helping children manage anxiety and develop coping strategies rather than directly addressing behavior change.

While ABA therapy offers many benefits, including personalized treatment plans designed by Board Certified Behavior Analysts (BCBAs), it has faced criticism for its historical emphasis on compliance and behavior modification, which may overlook the importance of individuality among children on the spectrum. Critics argue that the therapy’s early strategies may have prioritized obedience over exploration of self.

To ensure the best outcomes for children with autism, a holistic approach that includes various therapies—like Speech and Language Therapy and Occupational Therapy—is often recommended. This comprehensive strategy addresses the diverse needs of individuals, combining behavioral approaches with skill-building aspects to foster social-emotional development in a supportive environment.

Parental Involvement and Impact

The Vital Role of Parents in ABA Therapy Success

Importance of Parent Training and Involvement

Parental involvement is critical in the success of ABA therapy. Parents are encouraged to actively learn and apply ABA techniques to reinforce positive behaviors at home. Workshops and seminars help them understand specific strategies that can benefit their child’s development.

Supporting Children in Home Settings

By implementing learned techniques, parents create a consistent environment that fosters skill retention. This involves celebrating successes and gently guiding their child through challenges, making daily routines smoother and fostering independence.

Long-term Impact on Family Dynamics

Parental engagement in ABA not only enhances communication with their child but also reduces parental stress associated with autism-related challenges. Over time, this involvement improves family dynamics, creating a more supportive environment for the child and family unit.

Conclusion: A Personalized Approach to ABA

ABA therapy represents a profound opportunity for positive change in the lives of autistic children. While its individualized, data-driven approach fosters essential skills, the involvement of families remains a cornerstone for successful outcomes. Despite facing criticism, ABA therapy continues to evolve, increasingly emphasizing ethical practices and child-centered care. A thorough understanding of both its strengths and limitations allows for informed decisions that prioritize each child's unique needs and potential. Therefore, ABA remains a key element in the broader tapestry of autism treatment, capable of profoundly enhancing developmental trajectories and quality of life.

References

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How To Find A Great BCBA Supervisor

Understanding the Role of a BCBA SupervisorWhen seeking autism treatment, finding the right Board Certified Behavior Analyst (BCBA) supervisor is crucial. A BCBA supervisor plays a vital role in overseeing and guiding the treatment process for individuals with autism. Let's take a closer look at what a BCBA supervisor is and why their role is essential in autism treatment.What is a BCBA Supervisor?A BCBA supervisor is a professional who has earned board certification as a behavior analyst and has extensive experience working with individuals with autism. They have completed advanced coursework, gained hands-on experience, and passed a rigorous examination to obtain their certification.Typically, BCBA supervisors work directly with individuals with autism, their families, and a team of behavior technicians or therapists. They design and implement behavior intervention plans, assess progress, and provide ongoing supervision and support to ensure effective treatment.The Importance of a BCBA Supervisor in Autism TreatmentA BCBA supervisor plays a crucial role in the success of autism treatment. Here are a few key reasons why their involvement is vital:Expertise and Knowledge: BCBA supervisors possess specialized knowledge and expertise in applied behavior analysis (ABA) and autism treatment. They stay up-to-date with the latest research and best practices, enabling them to provide evidence-based interventions tailored to the unique needs of each individual.Treatment Planning and Oversight: BCBA supervisors are responsible for developing comprehensive treatment plans based on thorough assessments. They oversee the implementation of these plans, ensuring that interventions are appropriate, effective, and aligned with the individual's goals and needs.Supervision and Training: BCBA supervisors provide ongoing supervision to behavior technicians or therapists working directly with individuals with autism. Through regular meetings and observations, they offer guidance, feedback, and training to ensure the highest quality of care and treatment fidelity.Data Collection and Analysis: BCBA supervisors monitor and analyze data collected during the treatment process. This data helps them evaluate progress, make data-driven decisions, and modify intervention strategies as necessary.Collaboration and Advocacy: BCBA supervisors collaborate with other professionals, such as speech therapists, occupational therapists, and educators, to ensure a comprehensive and integrated approach to treatment. They also serve as advocates for individuals with autism and their families, helping them navigate the healthcare and educational systems.Finding a qualified and experienced BCBA supervisor is a crucial step in the autism treatment journey. Their expertise, guidance, and support can make a significant difference in the progress and overall well-being of individuals with autism.Identifying Your NeedsBefore embarking on the search for a BCBA (Board Certified Behavior Analyst) supervisor, it is important to clearly identify your goals and needs. This will help you find a supervisor who aligns with your specific requirements and can provide the support necessary for effective autism treatment.Assessing Your Goals and NeedsTo begin, take some time to reflect on your goals for autism treatment and the specific areas where you need assistance. Consider the following questions:What are your primary goals for autism treatment?Are there any specific areas of concern or challenges that you would like the BCBA supervisor to address?What are your expectations regarding the frequency and duration of supervision sessions?Do you have any preferences or requirements regarding the location or format of supervision sessions?By assessing your goals and needs, you will have a clearer understanding of the qualities and expertise you are looking for in a BCBA supervisor.Determining the Scope of Supervision RequiredThe scope of supervision required will vary depending on the individual and their unique circumstances. Consider the following factors to determine the level of supervision needed:Experience and expertise: Are you seeking a supervisor with extensive experience in working with individuals with autism or specific expertise in certain treatment approaches?Intensity of support: Do you require intensive supervision, including frequent in-person meetings and regular feedback, or are you looking for a more flexible arrangement?Treatment setting: Will the supervision primarily take place in a clinical setting, a school, or in the home environment?Legal and ethical considerations: Are there any specific legal or ethical requirements that need to be considered, such as adherence to state or local regulations?Understanding the scope of supervision required will help you narrow down your search and find a BCBA supervisor who can meet your specific needs.By assessing your goals and determining the scope of supervision required, you will be better equipped to find a BCBA supervisor who can provide the necessary support and guidance for effective autism treatment.Finding Potential BCBA SupervisorsWhen searching for a BCBA (Board Certified Behavior Analyst) supervisor, it's important to explore various avenues to find potential candidates who can meet your needs. Here are three ways to find potential BCBA supervisors:Referrals from ProfessionalsOne effective way to find a BCBA supervisor is through referrals from professionals in the field. Reach out to your child's primary care physician, pediatrician, or any other healthcare professionals who specialize in autism treatment. They often have connections with BCBA supervisors and can provide recommendations based on their knowledge and experience. Additionally, therapists, educators, and other individuals who work with individuals with autism may also be able to offer valuable referrals.Online Directories and DatabasesUtilizing online directories and databases can be a convenient and efficient method of finding potential BCBA supervisors. There are several reputable websites and platforms that provide comprehensive listings of BCBA supervisors in your area.These directories often include information about their credentials, experience, and areas of expertise, allowing you to narrow down your search based on your specific requirements. Consider using trusted directories, such as those provided by professional organizations or autism advocacy groups.Local Autism Support GroupsEngaging with local autism support groups can be an invaluable resource for finding BCBA supervisors. These groups typically consist of parents, caregivers, and individuals with autism who share information, resources, and recommendations.By connecting with these groups, you can tap into their collective knowledge and experiences to identify potential BCBA supervisors. Attend support group meetings, participate in online forums, or join social media groups dedicated to autism support in your community. These interactions can help you gather insights and recommendations from people who have firsthand experience with BCBA supervisors in your area.By exploring referrals from professionals, utilizing online directories and databases, and engaging with local autism support groups, you can broaden your search and find potential BCBA supervisors who may be a good fit for your needs. It's important to keep in mind that each method has its own advantages, so consider using a combination of approaches to maximize your chances of finding the perfect BCBA supervisor for your situation.Evaluating BCBA SupervisorsWhen searching for a BCBA (Board Certified Behavior Analyst) supervisor, it is crucial to thoroughly evaluate potential candidates to ensure they meet your specific needs. Here are some key factors to consider when evaluating BCBA supervisors:Reviewing Credentials and ExperienceReviewing the credentials and experience of BCBA supervisors is essential in determining their qualifications for the role. Look for the following information:Credential or Experience and Importance‍‍Board Certification as a BCBA: EssentialYears of Experience as a BCBA: ImportantSpecializations or Areas of Expertise: Relevant to Your NeedsContinuing Education and Professional Development: Demonstrates CommitmentTake note of the BCBA supervisor's credentials and experience to determine if they have the necessary knowledge and skills to provide effective supervision.Assessing Communication and Interpersonal SkillsEffective communication and interpersonal skills are vital for a successful BCBA supervision relationship. Consider the following factors during your assessment:Skill and Importance‍‍Active Listening: EssentialClear and Concise Communication: EssentialEmpathy and Understanding: ImportantCollaborative Approach: ImportantA BCBA supervisor with strong communication and interpersonal skills will be able to effectively communicate goals, provide feedback, and establish a positive working relationship.Requesting References and Client TestimonialsTo gain insights into the BCBA supervisor's performance and reputation, it is recommended to request references and client testimonials. This feedback can provide valuable information about their professionalism, effectiveness, and ability to work with individuals with autism.When contacting references, consider asking questions such as:How long have you worked with the BCBA supervisor?Did they demonstrate expertise in your specific needs?How did they communicate and collaborate with you?Did they provide constructive feedback and support?Were they responsive to your concerns or questions?Client testimonials can also offer valuable perspectives on the BCBA supervisor's approach and effectiveness in delivering quality supervision.By thoroughly evaluating BCBA supervisors based on their credentials and experience, communication and interpersonal skills, and client feedback, you can make an informed decision when choosing the right BCBA supervisor for your needs. Remember, finding the right fit is crucial as the BCBA supervisor will play a significant role in guiding and supporting autism treatment.Interviewing Potential BCBA SupervisorsOnce you have identified potential BCBA supervisors for autism treatment, the next step is to interview them to ensure they are the right fit for your needs. This section will guide you through the interview process, including preparing questions, discussing their approach and treatment philosophy, and addressing availability and logistics.Preparing Questions for the InterviewBefore the interview, it's helpful to prepare a list of questions to gather relevant information and assess the suitability of the BCBA supervisor. Consider the following questions:Can you tell me about your experience working with individuals with autism and your specific expertise in this area?How do you approach individualized treatment planning for your clients with autism?What strategies do you use to address challenging behaviors in individuals with autism?How do you involve the family and caregivers in the treatment process?Can you describe a successful case or outcome you have achieved with a client with autism?Asking About Approach and Treatment PhilosophyDuring the interview, it's important to ask the BCBA supervisor about their approach and treatment philosophy. Understanding their methods and beliefs will help you determine if they align with your goals and values. Consider asking the following questions:What is your overall treatment approach for individuals with autism?How do you incorporate evidence-based practices into your treatment plans?Do you take a collaborative approach, involving other professionals such as speech therapists or occupational therapists?How do you stay up-to-date with the latest research and advancements in autism treatment?Discussing Availability and LogisticsIn addition to assessing their qualifications and treatment approach, it's crucial to discuss practical matters such as availability and logistics. This will ensure that the BCBA supervisor can accommodate your needs and fit into your schedule. Consider discussing the following points:What is your availability for supervision sessions? Are you able to accommodate my preferred days and times?How frequently will supervision sessions occur, and for how long?What is your preferred mode of communication? Are you accessible for questions or concerns outside of scheduled sessions?Do you have any geographical restrictions or limitations on the areas you serve?By asking these questions and having open discussions during the interview, you can gain valuable insights into the BCBA supervisor's approach, experience, and availability. This will help you make an informed decision when selecting the right BCBA supervisor for your autism treatment journey. Remember to take notes during the interview process to compare and evaluate the candidates effectively.Making the DecisionWhen it comes to finding the perfect BCBA Supervisor, making the right decision is crucial for the success of autism treatment. It's important to carefully consider various factors and weigh the pros and cons before finalizing your choice. Trusting your instincts and starting the supervision process are also essential steps in this decision-making process.Weighing the Pros and ConsTo make an informed decision, it's helpful to weigh the pros and cons of each potential BCBA Supervisor. Consider the following factors:ProsExtensive experience in autism treatmentStrong communication and interpersonal skillsPositive client testimonialsConvenient location and flexible schedulingConsLimited availabilityHigher cost of supervisionDiffering treatment philosophyLimited references availableBy evaluating these pros and cons, you can gain a clearer understanding of the advantages and potential drawbacks associated with each BCBA Supervisor. This analysis will help you make a decision that aligns with your specific needs and goals.Trusting Your InstinctsWhile it's important to consider objective factors when choosing a BCBA Supervisor, trusting your instincts is equally valuable. Pay attention to your gut feelings and instincts during the evaluation process. If you have a positive connection with a particular BCBA Supervisor and feel comfortable discussing your concerns and goals, it may indicate a good fit.Remember that the trust and rapport between you and the BCBA Supervisor are crucial for effective collaboration. If you have reservations or doubts about a potential supervisor, it's important to listen to those feelings and continue your search until you find someone you trust and feel confident in.Starting the Supervision ProcessOnce you have made a decision and selected a BCBA Supervisor, it's time to start the supervision process. This typically involves an initial meeting to discuss goals, expectations, and logistics. The BCBA Supervisor will provide guidance, support, and ongoing supervision to ensure the effective implementation of autism treatment plans.During this initial meeting, it's important to establish clear lines of communication and discuss any specific requirements or preferences you may have. This will help set the stage for a productive and collaborative relationship between you and the BCBA Supervisor.Remember, finding the perfect BCBA Supervisor is a process that requires careful consideration and evaluation. By weighing the pros and cons, trusting your instincts, and starting the supervision process, you can make an informed decision that sets the foundation for successful autism treatment.FAQsWhat qualities should I look for in a BCBA supervisor beyond just their credentials?It's not just about the letters after their name. Seek someone who values mentorship, understands your goals, and resonates with your approach to learning.How do I know if a BCBA supervisor will be a good fit for my learning style and career goals?Look for supervisors who take the time to understand your individual learning needs and align with your professional aspirations. A good fit goes beyond just qualifications.Is it okay to ask potential BCBA supervisors about their teaching philosophy or mentoring approach?Absolutely! In fact, it's encouraged. Understanding their approach gives you insights into whether it aligns with your learning preferences and goals.Should I consider geographical location when choosing a BCBA supervisor?It depends on your preferences and the flexibility of the supervisor. Some interactions may be in person, but many supervisors are open to virtual meetings, expanding your options.How important is it to find a BCBA supervisor with experience in my specific area of interest within Applied Behavior Analysis?It can be beneficial, but it's not the only factor. A supervisor with a broad understanding of ABA principles can often guide you effectively, even if they haven't specialized in your specific area.SummaryAs we wrap up the quest to find that perfect BCBA supervisor, remember that this journey is as much about connection as it is about credentials. It's about finding someone who not only guides you professionally but also understands your unique aspirations and learning style.So, go beyond the checklist, trust your instincts, and seek a supervisor who not only helps you grow in the field of Applied Behavior Analysis but also supports you in becoming the best version of yourself. Your ideal BCBA supervisor is out there – here's to a collaborative and fulfilling professional partnership ahead!Sourceshttps://hoomhouse.com/blog/how-to-find-a-bcba-supervisorhttps://www.iloveaba.com/2014/12/are-you-great-supervisorhttps://readysetaba.com/finding-quality-supervision-for-bcba-bcba