Spotting Early Signs Of Autism In Toddlers

Spotting early signs of autism in toddlers? Empower yourself with knowledge, diagnosis, and intervention strategies for your little one's development.

Signs of Autism in Toddlers

Recognizing the early signs of autism in toddlers is crucial for early intervention and support. It's important to remember that every child develops at their own pace, but certain behavioral indicators, social interaction cues, and communication red flags may warrant further evaluation. Here are some key signs to be aware of:

Early Behavioral Indicators

In the first 1-2 years of life, some early signs of autism may become apparent. These signs can vary from child to child, with some exhibiting multiple signs while others may display only a few. Early behavioral indicators of autism in toddlers may include:

Social Interaction Cues

Social interaction plays a significant role in the development of toddlers. It is important to observe whether a child is meeting typical social milestones, such as responding to their name, making eye contact, and using gestures. Some social interaction cues that may indicate autism in toddlers include (Raising Children Network):

Communication Red Flags

Communication development is another important area to observe when looking for signs of autism in toddlers. While speech delays on their own do not necessarily indicate autism, significant delays or difficulties in communication compared to their peers may warrant further attention. Communication red flags may include:

It's important to note that these signs alone may not be definitive indicators of autism. However, if you notice any of these signs or have concerns about your toddler's development, it is advisable to consult with a healthcare professional for a comprehensive evaluation and further guidance.

Remember, early intervention is key in supporting children with autism, and timely identification of potential signs can lead to better outcomes and access to appropriate interventions and therapies. Trust your instincts as a caregiver and seek professional advice if you have concerns about your child's development.

Diagnosing Autism in Toddlers

When it comes to diagnosing autism in toddlers, several steps and professionals are involved in the process. Early detection and intervention are crucial for providing necessary support and resources. In this section, we will explore screening recommendations, diagnostic professionals, and evaluation tools used in diagnosing autism in toddlers.

Screening Recommendations

The American Academy of Pediatrics (AAP) recommends that all children undergo developmental and behavioral screenings during their regular well-child visits at 9 months, 18 months, and 30 months. Additionally, the AAP suggests that children be screened for autism at ages 18 months and 24 months. By the age of 2, an autism spectrum disorder (ASD) diagnosis by an experienced professional can be considered reliable [3].

Early screenings help identify potential red flags and enable timely intervention if necessary. If you have concerns about your toddler's development or notice any signs of autism, it's important to discuss them with your child's healthcare provider.

Diagnostic Professionals

Professionals who can diagnose Autism Spectrum Disorder (ASD) include Developmental Pediatricians, Pediatric Neurologists, Child and Adolescent Psychiatrists, and Psychologists with experience in evaluating and treating individuals on the autism spectrum. These professionals have specialized knowledge and training in ASD diagnosis and can conduct comprehensive assessments to determine if a child meets the criteria for an autism diagnosis. They rely on clinical observations, evaluations, and interviews with parents and caregivers to gather information about the child's development and behavior.

When seeking a diagnostic professional, it's essential to choose someone experienced in evaluating and treating individuals with autism. They will utilize standardized assessment tools and clinical judgment to make an accurate diagnosis.

Evaluation Tools

To diagnose autism in toddlers, professionals use various evaluation tools to gather information about the child's behavior, communication, and social interaction. Two commonly used tools are the Autism Diagnostic Observation Schedule (ADOS-2) and the Autism Diagnostic Interview-Revised (ADI-R).

The ADOS-2 is a structured observational assessment that evaluates social communication, play, and repetitive behavior. It involves direct interaction with the child and provides valuable insights into their social and communicative abilities.

The ADI-R is a comprehensive interview conducted with the parents or caregivers. It covers various areas of development, communication, and behavior. The information gathered through the ADI-R helps professionals understand the child's history and current functioning.

These evaluation tools, along with clinical observations and other assessments, contribute to a comprehensive evaluation of the toddler's development and aid in making an accurate diagnosis of autism.

When it comes to diagnosing autism in toddlers, it's important to consult with professionals who specialize in ASD diagnosis. Through screenings, evaluations, and the use of assessment tools like the ADOS-2 and ADI-R, diagnostic professionals can provide valuable insights into a toddler's development and help determine the presence of autism. Early identification and intervention pave the way for appropriate support and resources to enhance the child's overall well-being and development.

Understanding Repetitive Behaviors

Repetitive behaviors are one of the main signs that may indicate the presence of autism spectrum disorder (ASD) in toddlers. These behaviors are characterized by repetition, rigidity, and a lack of adaptability. Understanding the characteristics of repetitive behaviors, their impact on daily life, and effective management strategies can help caregivers and individuals with autism navigate these behaviors.

Characteristics of Repetitive Behavior

Repetitive behaviors in the context of autism can manifest in various ways. Some common characteristics include:

It's important to note that not all repetitive behaviors are indicative of autism. However, when these behaviors are persistent and significantly impair daily functioning, it's important to seek professional evaluation for a comprehensive assessment.

Impact on Daily Life

Repetitive behaviors can have varying impacts on daily life. While some repetitive behaviors may be harmless or even comforting to the individual, others can interfere with certain activities and lead to alienation or isolation.

For example, engaging in repetitive movements may draw unwanted attention or make it challenging for individuals with autism to interact socially. Rigidity in routines can make it difficult to adapt to changes in the environment or participate in new activities. These behaviors can also affect academic performance, as they may interfere with attention and focus in the classroom.

Management Strategies

Managing repetitive behaviors in children with autism requires a personalized approach that takes into account the individual's specific needs and preferences. Here are some strategies that can be effective in managing repetitive behaviors:

By implementing these strategies, caregivers and therapists can support individuals with autism in managing their repetitive behaviors, promoting their overall well-being and enhancing their quality of life. It's important to consult with professionals experienced in working with individuals with autism to develop an individualized plan that addresses the specific needs of each individual.

Early Intervention Strategies

When it comes to supporting children with autism, early intervention strategies play a crucial role in promoting their development and improving outcomes. Here are three effective strategies commonly used in early intervention programs: Applied Behavior Analysis (ABA), Sensory Integration Therapy, and Communication Enhancement.

Applied Behavior Analysis (ABA)

Applied Behavior Analysis (ABA) is a widely recognized and evidence-based therapy for individuals with autism. It focuses on teaching and reinforcing positive behaviors while reducing challenging behaviors. ABA therapy utilizes principles of learning theory to analyze and modify behaviors, helping children with autism develop new skills and improve their overall functioning.

The goal of ABA therapy is to target specific behavioral goals and create individualized treatment plans. Highly structured and systematic, ABA interventions break down skills into smaller, manageable steps, making the learning process more attainable for children with autism. Through positive reinforcement, such as rewards and praise, ABA helps children acquire new skills, improve communication, develop social interactions, and reduce problematic behaviors.

Sensory Integration Therapy

Sensory Integration Therapy is another intervention strategy commonly used for individuals with autism. It aims to help children better process and respond to sensory information, ultimately improving their overall functioning and reducing repetitive behaviors. Sensory integration therapy involves engaging individuals in activities that provide sensory input to help them regulate their responses to different sensory stimuli.

During sensory integration therapy, therapists create a sensory-rich environment that allows children to explore and interact with various sensory materials and experiences. This therapy helps children develop sensory processing skills, improve their ability to respond appropriately to sensory input, and reduce sensory sensitivities that may contribute to repetitive behaviors.

Communication Enhancement

Communication enhancement strategies are vital for individuals with autism to improve their communication skills and reduce frustration associated with communication difficulties. Speech therapy, also known as speech-language pathology, is a common approach used to support language development and improve communication abilities. Speech therapists work with individuals to address speech articulation, language comprehension, vocabulary development, and expressive language skills.

In addition to speech therapy, alternative communication systems, such as picture exchange communication systems (PECS) or augmentative and alternative communication (AAC) devices, can be used to enhance communication for nonverbal or minimally verbal individuals with autism. These systems provide visual supports and aids to help individuals express their needs, thoughts, and feelings.

Early intervention programs that incorporate a combination of ABA, sensory integration therapy, and communication enhancement have been shown to be effective in improving outcomes for children with autism. By addressing the unique needs of each child and providing targeted support, these strategies empower children with autism to reach their full potential and thrive.

Developmental Regression in Autism

Developmental regression, also known as autistic regression, is a phenomenon where children or teenagers experience a loss of communication and social skills and are later diagnosed with autism. Recognizing the signs of regression, understanding the diagnostic process, and accessing appropriate treatment and support are crucial for children and their families.

Recognizing Regression Signs

Recognizing the signs of developmental regression in children is essential for early intervention and support. Parents are advised to trust their instincts and seek help if they notice any concerning changes in their child's development. Some common signs of regression may include:

If parents observe any of these signs, it is recommended to reach out to a child and family health nurse or a general practitioner (GP) who can refer the child to a specialist doctor for further evaluation and confirmation of the condition.

Diagnostic Process

The diagnostic process for developmental regression involves a thorough assessment by a specialist doctor. The doctor will conduct a comprehensive physical examination and may recommend additional tests such as saliva, blood, or urine tests, an electroencephalogram (EEG), and a magnetic resonance imaging (MRI) scan of the child's brain. Other assessments, including hearing and eye examinations, may also be recommended to rule out any underlying medical conditions.

Treatment and Support

Early diagnosis of developmental regression is crucial as it allows for early intervention and support. The specific treatment and support needed for children with developmental regression will depend on the cause and type of skill loss. It often involves a multidisciplinary approach with different healthcare professionals, including pediatricians, psychologists, speech pathologists, and occupational therapists, working together to provide comprehensive care.

The goal of treatment and support is to help children with developmental regression participate in activities at home, school, and in the community. This may include the use of medication, behavioral therapies, speech therapy, occupational therapy, and other types of intervention tailored to the individual needs of the child. Early intervention and ongoing support can have a significant impact on a child's development and overall well-being.

By recognizing the signs of developmental regression, undergoing the diagnostic process, and accessing appropriate treatment and support, children with developmental regression can receive the help they need to reach their full potential and improve their quality of life. It is crucial for parents and caregivers to be proactive in seeking assistance and working closely with healthcare professionals to address the unique challenges associated with developmental regression.

Communication Milestones in Toddlers

Communication plays a vital role in the development of infants and toddlers. They begin to communicate through gestures, sounds, facial expressions, movements, and language. As they grow, they start to understand words and express themselves in their own language, learning the rules of conversation along the way [11]. Communication milestones provide a guide for typical patterns of growth and development. Let's explore three key milestones: receptive language development, expressive language development, and social engagement skills.

Receptive Language Development

Receptive language refers to a toddler's ability to listen to and understand language. They begin to make sense of gestures, facial expressions, tone, and words before they can verbally express themselves. Through nurturing relationships, infants and toddlers learn how to understand language and respond appropriately. Receptive language development is an essential foundation for communication.

Expressive Language Development

Expressive language involves a toddler's ability to communicate their thoughts and feelings using sounds, gestures, facial expressions, and words. As early as one month, infants may begin to coo, and by 24 months, toddlers can use two- or three-word sentences. Expressive language development allows toddlers to express their needs, desires, and ideas, forming the basis for effective communication [11].

Social Engagement Skills

Social engagement skills are crucial for infants and toddlers to participate in communication exchanges with peers or adults. They learn to use sounds, gestures, facial expressions, and words by interacting, talking, reading, and singing with adults. These social interactions build their understanding of turn-taking, joint attention, and the give-and-take of conversation. Social engagement skills lay the groundwork for effective communication and meaningful connections with others [11].

Parents should generally be aware of their toddler's communication skills and be concerned if they notice significant delays or difficulties compared to what is typical for their age group. While milestones can vary for each child, it is important to consult with a healthcare provider or a speech-language pathologist if there are any concerns about a child's communication development. Early intervention plays a crucial role in addressing potential delays or disorders and can significantly improve outcomes for the child [2].

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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