Handwashing & Showering To Kids With Autism

Boost Your Child's Health: Easy Hygiene Tips for Kids with Autism.

Handwashing & Showering To Kids With Autism

Kids with autism spectrum disorder (ASD) may have difficulty with personal hygiene routines like handwashing and showering. However, good hygiene is important for their overall health and wellbeing. In this article, we'll discuss some tips and strategies to make handwashing and showering easier and more enjoyable for kids with autism.

The Importance of Personal Hygiene

Personal hygiene is essential for everyone. It helps prevent the spread of germs and keeps us healthy. For kids with autism, personal hygiene can also help improve their social interactions and self-esteem.

Challenges Faced by Kids with Autism

Kids with autism may struggle with personal hygiene routines for a variety of reasons. Some may have sensory processing issues that make the sensation of water or soap uncomfortable. Others may have difficulty with the motor skills required for washing or showering. Additionally, some kids with autism may have difficulty understanding the need for personal hygiene.

Tips for Handwashing

Handwashing is a crucial aspect of personal hygiene. Here are some tips to make it easier for kids with autism:

  • Use soap with a mild scent and texture that your child likes
  • Consider using a visual schedule or social story to explain the steps of handwashing
  • Practice handwashing with your child in a low-stress environment, such as during bath time
  • Offer positive reinforcement, such as praise or a small reward, for successful handwashing

Strategies for Showering

Showering can be a daunting task for kids with autism. Here are some strategies that may help:

  • Start with a visual schedule or social story to explain the steps of showering
  • Consider using a shower chair or bath mat to provide stability and comfort
  • Use a handheld showerhead to give your child a sense of control over the water
  • Experiment with different water temperatures and pressure to find what your child is comfortable with
  • Offer positive reinforcement, such as praise or a small reward, for successful showering

Tips for Getting Kids with Autism to Enjoy Showering and Handwashing

  • While getting kids with autism to engage in personal hygiene routines can be challenging, there are ways to make it more enjoyable for them. Here are some tips that may help:
  • Make it a game - Turn handwashing and showering into a fun activity by making a game out of it. For example, you could have your child wash their hands while singing their favorite song or make up a story about taking a shower.
  • Use sensory-friendly products - Consider using sensory-friendly products like soap with a pleasing texture or scent-free shampoo that won't irritate your child's skin.
  • Offer choices - Allow your child to choose which soap or shampoo they want to use or whether they want to take a bath or shower. By giving them some control over the process, they may feel more comfortable and willing to participate.
  • Create a routine - Establishing a consistent routine for personal hygiene can help kids with autism feel more comfortable and less anxious about the process. Consider creating a visual schedule that outlines the steps of handwashing or showering.
  • Reward positive behavior - Offer positive reinforcement when your child engages in personal hygiene routines successfully. This could be as simple as offering verbal praise, high-fives, or small rewards like stickers or tokens.

By following these tips, you can help your child with autism develop good personal hygiene habits while also making the experience more enjoyable for them.

How to Help Your Child with Autism Understand the Importance of Personal Hygiene?

Understanding the importance of personal hygiene can be challenging for kids with autism. Here are some strategies that may help:

  • Use visual aids: Kids with autism often respond well to visual aids like pictures or diagrams. Consider creating a visual aid that explains the importance of personal hygiene and why it's necessary.
  • Keep it simple: Kids with autism may have difficulty processing complex information. When explaining personal hygiene, use simple language and avoid overwhelming them with too much information at once.
  • Use social stories: Social stories are short narratives that describe a situation and appropriate behavior. You can create a social story that explains the importance of personal hygiene in a way your child can understand.
  • Practice good hygiene yourself: Children often model their behavior after their parents or caregivers. By practicing good personal hygiene yourself, you can set an example for your child to follow.
  • Make it part of your routine: Incorporate personal hygiene into your daily routine so it becomes a natural part of your child's day. This could include brushing teeth after meals or taking a shower before bed.

By using these strategies, you can help your child with autism understand the importance of personal hygiene and develop good habits that will benefit them throughout their lives.

Addressing Anxiety or Fear Related to Water

For some kids with autism, anxiety or fear related to water can make showering or bathing particularly challenging. Here are some tips to help address these concerns:

  • Gradual Exposure: If your child is particularly anxious about showering or bathing, consider gradually exposing them to water in a controlled and safe environment. You could start by having them sit in an empty bathtub, then slowly add water as they become more comfortable.
  • Sensory-Friendly Bath Toys: Give your child something sensory-friendly to play with in the bath or shower. This could be a rubber duck, foam letters, or other toys that can help distract them from their anxiety.
  • Calming Techniques: Teach your child calming techniques like deep breathing or counting exercises that they can use when they feel anxious during showering or bathing.
  • Consult with a Professional: If your child's anxiety is severe, it may be helpful to consult with a professional therapist who specializes in working with children on the autism spectrum.

By using these strategies, you can help your child overcome their anxiety and develop good personal hygiene habits.

How to handle resistance or avoidance of personal hygiene routines in kids with autism?

It's not uncommon for children with autism to resist or avoid personal hygiene routines. Here are some tips that may help:

  • Identify the cause: Try to determine why your child is resisting or avoiding personal hygiene routines. Are they experiencing sensory issues? Do they have difficulty with the motor skills required for washing or showering? Are they anxious about the process? Once you understand the cause, you can develop strategies to address it.
  • Offer choices: Giving your child a sense of control over the process can help them feel more comfortable and willing to participate. For example, you could offer them a choice between taking a bath or shower, using soap with a particular scent, or washing their hands before or after dinner.
  • Use positive reinforcement: Offering praise, high-fives, stickers, or other small rewards can motivate your child to engage in personal hygiene routines.
  • Break it down: If your child is overwhelmed by the entire process of showering or handwashing, try breaking it down into smaller steps. For example, start with just wetting their hands before moving on to using soap and rinsing.
  • Make accommodations: Consider making accommodations that will make personal hygiene routines more comfortable for your child. This could include using a shower chair, providing earplugs if they're sensitive to noise from the water running, or allowing them to wear swim goggles if they're uncomfortable getting water in their eyes.
  • Be patient: It may take time for your child to become comfortable with personal hygiene routines. Be patient and celebrate small successes along the way.

By using these strategies, you can help your child with autism overcome resistance and avoidance of personal hygiene routines while also promoting their health and wellbeing.

Strategies to Help Kids with Autism Manage Sensory Processing Issues During Handwashing or Showering

Kids with autism who experience sensory processing issues may find handwashing or showering to be uncomfortable or overwhelming. Here are some strategies that can help:

  • Use a washcloth: Using a soft washcloth instead of your child's hands can reduce the sensation of water and soap on their skin.
  • Try different water temperatures: Some kids with autism may find warm water to be more soothing, while others prefer cooler water. Experiment with different temperatures to find what works best for your child.
  • Use a timer: If your child is sensitive to the length of time they spend washing or showering, consider using a timer to help them keep track.
  • Provide sensory input before or after: Giving your child deep pressure input or allowing them to engage in a sensory activity like jumping on a trampoline before or after handwashing or showering can help regulate their nervous system and make the process more comfortable.

By using these strategies, you can help your child with autism manage their sensory processing issues during handwashing or showering and promote good personal hygiene habits.

Tips for Encouraging Good Hygiene Habits in Kids with Autism

  • Use a token system: Consider using a token system to reward your child for engaging in personal hygiene routines. You can create a chart or board where your child earns tokens for each successful handwashing or showering session. Once they earn a certain number of tokens, they can exchange them for a prize or privilege.
  • Be specific with praise: When offering praise, be specific about what your child did well. For example, you could say "Great job washing all the soap off your hands" instead of just "Good job."
  • Offer choices for rewards: Allow your child to choose their own rewards for engaging in personal hygiene routines. This could include small toys, extra screen time, or a special treat.
  • Make it fun: Incorporate elements of fun into personal hygiene routines to make them more enjoyable for your child. For example, you could use colorful soap or play music during showering time.
  • Gradually reduce rewards: As your child becomes more comfortable with personal hygiene routines, gradually reduce the frequency or size of rewards. Eventually, good hygiene habits should become their own reward.

By using these tips and strategies, you can help encourage good hygiene habits in kids with autism while also making the experience more positive and rewarding for them.

Tips for Teaching Proper Handwashing Techniques for Kids with Autism

Here are some tips on how to teach proper handwashing techniques for kids with autism who have difficulty with fine motor skills:

  • Break it down: Handwashing involves several steps, including wetting hands, applying soap, lathering, scrubbing, rinsing, and drying. For kids with autism who have difficulty with fine motor skills, it may be helpful to break down each step into smaller components.
  • Provide physical guidance: Depending on your child's needs and abilities, you may need to provide physical guidance to help them perform each step of handwashing correctly. This could include holding their hand while they apply soap or guiding their fingers through the motions of scrubbing.
  • Use visual aids: Visual aids like diagrams or pictures can be helpful in showing your child the correct way to wash their hands. You could create a visual schedule that outlines each step of handwashing or use pictures to illustrate each step.
  • Practice frequently: Like any skill, proper handwashing takes practice. Encourage your child to practice washing their hands frequently throughout the day, especially before meals or after using the bathroom.
  • Use positive reinforcement: Offering praise or small rewards for successful handwashing can help motivate your child and reinforce good habits.

By using these strategies, you can help teach proper handwashing techniques for kids with autism who have difficulty with fine motor skills.

Tips for Handling Aggression or Self-Injurious Behavior During Personal Hygiene Routines in Kids with Autism:

  • Identify triggers: Try to identify what is causing the aggressive or self-injurious behavior during personal hygiene routines. Is it a sensory issue? Are they feeling overwhelmed or anxious? Once you understand the trigger, you can develop strategies to address it.
  • Use visual aids: Visual aids like social stories or diagrams can help prepare your child for what to expect during personal hygiene routines and reduce anxiety.
  • Create a calming environment: Consider creating a calming environment for your child during personal hygiene routines. This could include playing soft music, using aromatherapy, or using dim lighting.
  • Use positive reinforcement: Offering praise or small rewards for successful completion of personal hygiene routines can help motivate your child and reinforce good habits.
  • Take breaks: If your child becomes agitated or upset during personal hygiene routines, take a break and try again later. It's important not to force them to continue if they're feeling overwhelmed.
  • Seek professional help: If your child's aggression or self-injurious behavior persists despite these strategies, it may be helpful to consult with a professional therapist who specializes in working with children on the autism spectrum.

By using these strategies, you can help manage aggression or self-injurious behavior during personal hygiene routines in kids with autism while also promoting their health and wellbeing.

FAQs

How often should my child shower or bathe?

The frequency of showers or baths can vary depending on your child's age, activity level, and personal preferences. As a general guideline, most kids benefit from bathing at least once or twice a week. However, if your child is particularly active or prone to sweating, more frequent bathing may be necessary.

What type of soap or shampoo should I use?

This can vary depending on your child's skin type and any allergies they may have. It's important to choose a soap or shampoo that is gentle and free of harsh chemicals. You may need to experiment with different products to find what works best for your child.

Should I supervise my child during showers or baths?

Depending on your child's age and abilities, you may need to supervise them during showers or baths to ensure their safety. For younger children or those who require assistance with washing, supervision is particularly important.

What if my child refuses to participate in personal hygiene routines?

It's not uncommon for children with autism to resist or avoid personal hygiene routines. Try using some of the strategies outlined in this document, such as offering choices, using positive reinforcement, and breaking down tasks into smaller steps. If the issue persists despite these efforts, it may be helpful to consult with a professional therapist who specializes in working with children on the autism spectrum.

Summary

Personal hygiene routines like handwashing and showering are important for the health and wellbeing of kids with autism. By using the tips and strategies discussed in this article, you can help make these routines easier and more enjoyable for your child. Remember to be patient and offer positive reinforcement, and you will help your child develop good hygiene habits that will benefit them for life.

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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