Profound Autism Life Expectancy

Discover factors, challenges, and interventions for longevity and well-being.

August 13, 2024

Understanding Autism Life Expectancy

When it comes to autism, the life expectancy can vary depending on several factors. It's important to consider the variability in intellectual functioning and understand the definition of profound autism to gain a better understanding of the implications.

Variability in Intellectual Functioning

Autism is a spectrum disorder, and individuals with autism experience a wide range of intellectual functioning levels. According to the World Health Organization, the level of intellectual functioning among autistic people extends from profound impairment to superior levels. This wide range means that individuals with autism may have varying abilities and challenges when it comes to communication, learning, and daily living skills.

Definition of Profound Autism

The term "profound autism" was introduced by The Lancet Commission to describe individuals with substantial intellectual disability who require lifelong care and support. These individuals are often non-verbal or have minimal language and struggle to meet their basic daily needs without assistance. The proportion of individuals meeting the criteria for profound autism varies between 18% and 48% in different cohorts.

Understanding the definition of profound autism helps us recognize that individuals with this level of autism may have more significant challenges and require specialized support to navigate daily life.

When considering life expectancy for individuals with profound autism, it's important to note that research indicates a reduced life expectancy compared to the general population. One study reported an average life expectancy of around 54 years for individuals with Autism Spectrum Disorder (ASD) [2].

Additionally, individuals diagnosed with autism but not intellectual disability had a mortality rate 1.71 times higher than those without these diagnoses, while those diagnosed with both autism and intellectual disability had a mortality rate 2.83 times higher. This leads to a reduction in life expectancy of 6.14 to 14.59 years, depending on the specific diagnosis and gender.

It's important to note that impairments in social reciprocity observed in early childhood have been found to be predictive of mortality in adulthood. Higher lifetime impairments in social reciprocity have been associated with a higher risk of mortality during a 20-year study period. This emphasizes the need for comprehensive support and interventions to address the challenges faced by individuals with profound autism and improve their overall well-being.

By understanding the variability in intellectual functioning and the definition of profound autism, we can work towards providing appropriate support and resources to enhance the quality of life for individuals on the autism spectrum.

Factors Affecting Life Expectancy

When considering the life expectancy of individuals with profound autism, several factors come into play. These factors include mortality rates and ratios, as well as insights gained from sensitivity analysis.

Mortality Rates and Ratios

A matched cohort study in the UK shed light on the life expectancy and years of life lost for individuals diagnosed with autism, providing valuable insights into mortality rates and ratios (The Lancet). The study found that individuals diagnosed with autism but not intellectual disability had a mortality rate 1.71 times higher than those without these diagnoses. On the other hand, those diagnosed with both autism and intellectual disability had a mortality rate 2.83 times higher.

These increased mortality rates have a significant impact on life expectancy. For individuals with autism but not intellectual disability, life expectancy is reduced by 6.14 years for men and 6.45 years for women. For those diagnosed with both autism and intellectual disability, the reduction in life expectancy is even more significant, with a decrease of 7.28 years for men and a staggering 14.59 years for women [2].

Sensitivity Analysis Insights

Impairments in social reciprocity observed in early childhood have been identified as a predictive factor for mortality in adulthood. The severity of impairments in social reciprocity is directly associated with the risk of mortality. For every one point higher score on lifetime impairments in social reciprocity, there is a 27% higher risk of mortality during a 20-year study period.

Additionally, functional impairments play a role in life expectancy. High levels of functional impairments at the start of a study period were associated with increased mortality rates. It is essential to address these impairments to improve not only the quality of life but also the longevity of individuals with profound autism.

Understanding the factors that influence life expectancy in individuals with autism is crucial for developing strategies to promote well-being and longevity. Factors such as overall health status, the presence of chronic conditions, possible side effects of medications, access to healthcare, and personalized interventions significantly impact the life expectancy of individuals with profound autism.

By addressing these factors and providing tailored support, we can work towards improving the outcomes and enhancing the lives of individuals with autism.

Challenges Faced by Autistic Individuals

Living with profound autism presents unique challenges for individuals, affecting various aspects of their lives. Two significant challenges faced by autistic individuals are social reciprocity impairments and functional impairments, which can impact their well-being and, in some cases, contribute to mortality rates.

Social Reciprocity Impairments

Autistic individuals often experience difficulties with social reciprocity, which refers to the ability to engage in reciprocal social interactions and understand social cues. Impairments in social reciprocity observed in early childhood have been found to be predictive of mortality in adulthood. A study conducted over a 20-year period demonstrated that for every one-point higher score on lifetime impairments in social reciprocity, there was a 27% higher risk of mortality.

This highlights the significance of addressing social communication challenges and fostering social skills development in individuals with profound autism.

Functional Impairments and Mortality

Functional impairments, including difficulties in activities of daily living, can have a substantial impact on the overall well-being and life expectancy of autistic individuals. High levels of functional impairments at the start of a study period were associated with increased mortality rates.

In a 20-year study, individuals diagnosed with autism but not intellectual disability had 1.71 times the mortality rate of people without these diagnoses, resulting in a reduction in life expectancy of 6.14 years for men and 6.45 years for women.

Furthermore, individuals diagnosed with both autism and intellectual disability had 2.83 times the mortality rate, leading to a reduction in life expectancy of 7.28 years for men and 14.59 years for women.

It is crucial to address functional impairments and provide appropriate support and interventions to enhance the quality of life for individuals with profound autism. This may involve personalized interventions, occupational therapy, and the use of assistive technologies to improve independence in daily activities and promote overall well-being.

Understanding and addressing these challenges faced by autistic individuals is crucial for improving their quality of life and promoting their overall health and well-being. By offering support, access to healthcare, and personalized interventions, we can help individuals with profound autism overcome these challenges and lead fulfilling lives.

Addressing Health Disparities

When it comes to individuals with profound autism, addressing health disparities is crucial to improve their overall well-being and life expectancy. Access to healthcare and personalized interventions play significant roles in ensuring that individuals with autism receive the necessary support and care they need.

Access to Healthcare

Unfortunately, individuals with autism often face challenges in accessing appropriate healthcare, which can contribute to reduced life expectancy. Disparities in healthcare access persist from childhood to adulthood for individuals with autism, as highlighted by a study published in the National Center for Biotechnology Information [3]. Limited access to healthcare can result in delayed or inadequate medical intervention, leading to negative health outcomes.

To address this issue, it is crucial to improve healthcare access for individuals with autism. This can be achieved by promoting autism awareness among healthcare providers, ensuring that healthcare facilities are equipped to accommodate the unique needs of individuals with autism, and providing resources for families and caregivers to navigate the healthcare system effectively. By addressing these barriers, we can help individuals with autism receive timely and appropriate medical care.

Personalized Interventions Impact

Personalized interventions play a vital role in improving the health outcomes and life expectancy of individuals with profound autism. Factors such as overall health status, presence of chronic conditions, possible side effects of medications, access to healthcare, and personalized interventions significantly impact the life expectancy of individuals with autism spectrum disorder (ASD).

Research has shown that individuals with ASD have higher rates of health problems across various domains compared to controls. They may also be at risk of taking increasing numbers of medications over time, which can have potential side effects. Therefore, personalized interventions tailored to the specific needs of individuals with profound autism are essential.

These interventions can include behavioral therapies, sensory integration techniques, speech and language therapy, and occupational therapy. By providing individualized support and interventions, we can address the unique challenges faced by individuals with profound autism and improve their overall health and quality of life.

By addressing health disparities and improving access to healthcare, as well as implementing personalized interventions, we can work towards promoting the longevity and well-being of individuals with profound autism. It is crucial to recognize their distinct healthcare needs, advocate for their rights, and ensure that they have equal opportunities to lead fulfilling lives.

Global Perspectives on Autism Care

When it comes to autism care, a person-centered approach is crucial in providing the best possible support and interventions for individuals with autism. This approach, as proposed by the Lancet Commission, emphasizes personalized care based on the unique needs and preferences of each autistic individual and their family [1]. By considering factors such as costs, burden, and individual preferences, this approach aims to optimize the quality of care and support for individuals with autism.

Implementing a person-centered approach requires a comprehensive understanding of the skills and needs of each autistic person and their family. This information serves as the foundation for developing treatment goals and strategies tailored to the individual's specific requirements. By taking into account the individual's strengths and challenges, interventions can be designed to promote their overall well-being and enhance their quality of life.

Investment in research is vital for advancing autism care worldwide, especially in low-income and middle-income countries (LMIC). The Lancet Commission emphasizes the importance of increasing research funding in these settings to identify effective interventions, improve diagnosis and awareness, and provide services that meet the needs of autistic individuals and their families in resource-constrained environments [1].

In lower-resource settings, it is essential to explore feasible possibilities for parent-delivered interventions. Providing parents with training and guidance enables them to actively participate in their child's treatment and support. This approach has shown promising progress in some Asian and African countries. Additionally, supporting autistic children in regular schools is crucial for their development, but it requires increased availability of special education teachers with autism training [1].

Prioritizing clinical research is essential for identifying effective treatment strategies for autistic individuals and their families. The Lancet Commission calls for randomized controlled trials to evaluate short-term interventions, considering factors that affect outcomes. The aim is to develop effective and affordable treatment strategies that can be implemented worldwide, including in resource-constrained settings.

By focusing on interventions that can be implemented within the next five years, the goal is to provide accessible and evidence-based care for individuals with autism.

By adopting a person-centered approach and increasing investment in research, global perspectives on autism care can be enhanced. This approach ensures that interventions and support systems are tailored to meet the unique needs of individuals with autism and their families.

With continued efforts to improve diagnosis, awareness, and treatment strategies, we can strive for a world that provides comprehensive and effective care for individuals with autism, regardless of their geographical location or available resources.

Promoting Longevity and Well-Being

When it comes to individuals with profound autism, promoting longevity and overall well-being is of utmost importance. There are various factors that contribute to the well-being of individuals with profound autism, including genetic and environmental factors, as well as the implementation of technology-assisted interventions.

Genetic and Environmental Factors

Genetic factors play a significant role in the etiology of Autism Spectrum Disorder (ASD). While the genetic basis of ASD is complex, specific genetic syndromes such as fragile X syndrome, tuberous sclerosis, 15q11-q13 duplication syndrome, and Rett syndrome are associated with a higher risk of ASD [4]. Understanding the genetic factors involved in profound autism can help inform personalized interventions and support strategies to promote well-being.

In addition to genetic factors, environmental factors also contribute to the risk of ASD. Maternal exposure during pregnancy to substances like anti-seizure medications, environmental pollutants, infections, and poor nutrition may increase the risk of ASD by affecting fetal brain development and the maturation process of the nervous system. By promoting a healthy and supportive environment, caregivers can help create a positive impact on the well-being of individuals with profound autism.

Technology-Assisted Interventions

Technology-assisted interventions have become increasingly important in the treatment of individuals with profound autism. The use of computers, tablets, smartphone apps, and virtual reality technology provides interactive learning tools and games designed to improve social skills, communication, and cognitive functioning in children with ASD. These interventions offer innovative ways to engage individuals with profound autism, promoting their overall well-being and enhancing their quality of life.

Implementing technology-assisted interventions requires a person-centered approach, tailoring the interventions to the unique needs and preferences of each individual. By incorporating these technological tools into therapy and educational programs, individuals with profound autism can benefit from personalized interventions that address their specific challenges and promote their overall well-being.

By understanding the genetic and environmental factors that contribute to profound autism and incorporating technology-assisted interventions, caregivers and professionals can promote the longevity and well-being of individuals with profound autism. It is essential to continue investing in research and support strategies that focus on improving the lives of individuals with profound autism and providing them with the support they need to thrive.

References

[1]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10388786/

[2]: https://www.goldenstepsaba.com/resources/profound-autism-life-expectancy

‍[3]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6713622/

‍[4]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11163702/

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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

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