Understanding Autism in Adulthood

Explore understanding autism in adulthood, addressing challenges and resources to enhance quality of life.

Understanding Autism in Adulthood

Prevalence of Autism in Adults

Autism spectrum disorder (ASD) is not only prevalent among children but also affects many adults. In the United States, it is estimated that 1 in 45 adults are diagnosed with autism, highlighting the importance of providing effective resources and services to support their daily lives [1]. Understanding this prevalence can help parents recognize the significance of advocating for appropriate support and resources for their children as they transition into adulthood.

Statistic Value
Estimated prevalence of autism in adults 1 in 45

Resources for Adults with Autism

Various organizations offer a range of resources aimed at assisting adults with autism in navigating the complexities of adult life. Autism Speaks focuses on addressing diverse needs, such as rights awareness, therapy options, employment, and independent living resources [1]. They strive to empower newly diagnosed individuals and provide support to those looking to enhance their quality of life.

Easterseals provides valuable services for adults with autism to overcome barriers in their lives, such as job placement, college enrollment, and independent living options [2]. Their residential services help individuals find suitable living arrangements within their communities, ensuring they have access to necessary support and social engagement.

Establishing connections within a supportive community can greatly enhance the lives of adults with autism. Finding "a tribe" of understanding peers, whether through colleagues or other neurodiverse individuals, can reduce feelings of loneliness and foster a sense of belonging [3]. Resources that promote community engagement, along with autism resources for parents, can play an essential role in helping families support their adult children effectively.

Challenges Faced by Autistic Adults

Autistic adults often encounter various challenges that can impact their daily lives. Understanding these difficulties is essential for parents and caregivers in providing appropriate support. This section explores three prominent challenges: social communication difficulties, sensory challenges, and health conditions and barriers.

Social Communication Difficulties

Many autistic individuals experience significant challenges in social communication. They may struggle with understanding social norms, personal boundaries, and appropriate personal space [4]. These difficulties can lead to misunderstandings in social situations, making it harder for autistic adults to connect with others and build relationships.

Social communication issues can manifest in various ways, including:

Challenge Description
Understanding cues Difficulty interpreting facial expressions, tone of voice, and body language
Initiating conversations Hesitance or uncertainty when starting interactions with others
Maintaining dialogue Struggles with back-and-forth conversation and topic changes

By addressing these challenges, parents can help their autistic children develop vital social skills. Resources such as autism resources for parents can provide effective strategies.

Sensory Challenges

Heightened sensory sensitivities are common among autistic individuals. They may experience discomfort or distress related to touch, sound, light, smell, or taste. Because of these sensitivities, autistic adults often require accommodations in environments that minimize sensory overstimulation.

Sensory challenges can vary in intensity; some individuals may avoid specific stimuli, while others might seek them out. Common sensory challenges include:

Sensory Type Potential Impact
Touch Discomfort from certain fabrics or textures
Sound Overwhelm in noisy environments
Light Sensitivity to bright lights or flashing effects

Creating a safe space for autism at home can help manage these sensory challenges, allowing autistic individuals to feel more comfortable and secure.

Health Conditions and Barriers

Autistic adults are likely to face a range of co-occurring health conditions, leading to various struggles throughout their lives. These challenges can include mental health issues, barriers to employment, and difficulties navigating a world designed for neurotypical individuals.

Specific health conditions and barriers that autistic adults may encounter are:

Condition/Barrier Description
Mental health challenges Higher rates of anxiety, depression, and stress
Negative social attitudes Discrimination from non-autistic people
Executive function struggles Difficulty with planning, organizing tasks, and managing time

Understanding these complex challenges is essential for parents. Strategies such as overcoming common autism challenges can provide effective measures to improve the quality of life for autistic adults and help them thrive in their environments.

Supporting Autistic Adults

Finding ways to support autistic adults is essential for nurturing their independence and enhancing their quality of life. This includes employment opportunities, housing options, and community engagement resources.

Employment and Career Opportunities

Employment plays a pivotal role in fostering self-determination and financial independence for adults on the autism spectrum. Organizations such as Easterseals offer vital services that help individuals assess their skills, identify potential career paths, and develop training to achieve their employment goals. Additionally, these organizations work closely with businesses to provide resources to recruit and hire autistic individuals.

Employment Service Description
Skill Assessment Help individuals understand their strengths and suitable job roles.
Employment Training Offer training sessions to hone job-specific skills.
Employer Resources Provide businesses with information on the benefits of hiring autistic employees.

Housing and Residential Options

Adults with autism have various choices regarding living arrangements, which can significantly impact their quality of life. Easterseals offers residential services that empower individuals to choose appropriate living situations tailored to their needs. Options can include supported living arrangements, group homes, or independent living with assistance.

Housing Options Description
Supported Living Offers assistance with daily living in a communal or independent setting.
Group Homes Provides shared housing with support staff available.
Independent Living Allows individuals to live alone with minimal support, fostering autonomy.

Community Engagement and Resources

Community engagement is crucial for individuals with autism to develop social skills and participate in meaningful activities. Easterseals provides resources that encourage participation in community life, enhancing social interactions and recreational opportunities. From day programs to recreational activities, these resources foster a sense of belonging and promote inclusive experiences.

Community Resource Description
Day Programs Structured activities during the day, focusing on social skills and engagement.
Recreational Activities Opportunities for socialization through sports, arts, and other hobbies.
Social Skills Workshops Sessions designed to enhance communication and interaction abilities.

Understanding autism in adulthood necessitates a multifaceted approach that includes employment support, housing choices, and community resources. Engaging families with information and assistance can lead to a more enriching life for autistic adults. For additional resources, parents can explore our article on autism resources for parents or learn about how to build a support network.

Transitioning to Adulthood with Autism

Transitioning to adulthood is a significant milestone for anyone, and for individuals on the autism spectrum, this period can come with unique experiences and challenges. It is essential for parents to be aware of these changes to provide the necessary support and understanding.

Changes in Social Interactions

As young adults with autism enter adulthood, they often face shifts in their social interactions. Unlike childhood, where social environments may be more structured, adult socialization can be unpredictable and less defined. Autistic individuals may develop coping mechanisms to navigate these varied situations and manage their symptoms. However, they still retain the core traits of autism, which may manifest differently in adult interactions, leading to communication and social hurdles. Understanding the evolving nature of autism spectrum disorder (ASD) across life stages emphasizes the need for tailored support.

Coping Mechanisms and Challenges

In adulthood, individuals on the spectrum often cultivate strategies to cope with social demands, whether through masking their symptoms or focusing on careers that align with their strengths. These coping mechanisms help them navigate a neurotypical world but can lead to stress and fatigue. Research shows that developing independent life skills is crucial, including grooming, shopping, cooking, and managing finances. Such skills enable autistic adults to thrive independently and should be prioritized.

Coping Mechanisms Description
Social Skills Training Learning and practicing communication techniques.
Role-Playing Scenarios Rehearsing social interactions in a controlled environment.
Time Management Techniques Using planners or apps to organize tasks and appointments.
Mindfulness Practices Engaging in relaxation techniques to reduce anxiety.

Adaptive Behaviors

Adaptive behavior is vital for helping autistic individuals fulfill their daily responsibilities and engage meaningfully in society. Effectively building this set of skills allows them to navigate their environments, such as managing their personal care, chores, and even social interactions. Identifying and practicing real-world skills is essential for growth and independence.

Key adaptive skills may include:

Adaptive Skills Importance
Grooming and Hygiene Necessary for personal care and social acceptance.
Cooking and Meal Preparation Encourages independence and healthy living.
Financial Management Crucial for sustaining daily life and independence.
Socializing and Building Relationships Essential for emotional well-being and support networks.

Parents can play an essential role in helping young adults with autism transition smoothly into adulthood by encouraging skill development through resources and support networks. Understanding these changes and challenges allows parents to provide appropriate guidance and foster confidence as their children navigate this new chapter.

Quality of Life for Autistic Adults

Improving the quality of life for autistic adults involves several factors, including sleep, work-life balance, active lifestyles, and effective stress management. By addressing these areas, parents can support their children in achieving a fulfilling and satisfactory life.

Importance of Sleep and Well-Being

Sleep plays a critical role in overall well-being and quality of life. Ongoing research shows that adequate rest is essential for preventing chronic illness and extending lifespan, as sleep allows the body to repair and heal cells in the brain [6]. Parents should encourage healthy sleep habits, such as:

Sleep Habit Description
Consistent Sleep Schedule Going to bed and waking up at the same time each day.
Calm Sleep Environment Creating a quiet and dark space free from distractions.
Limited Screen Time Reducing exposure to screens at least an hour before bedtime.

Achieving Work-Life Balance

A proper work-life balance significantly enhances the quality of life for autistic adults. This balance helps maintain mental and physical productivity and overall satisfaction. Without proper balance, individuals might experience fatigue and burnout, which can negatively impact personal relationships. Parents can support this balance by encouraging their children to:

Activity Purpose
Set Boundaries Establish clear limits between work and personal life.
Prioritize Downtime Schedule time for relaxation and hobbies.
Engage in Family Activities Foster connections through shared experiences.

Active Lifestyle and Stress Management

Living an active lifestyle is vital for boosting overall quality of life. Regular physical activity is associated with emotional and social benefits, motivating individuals to remain engaged and healthy. Encouraging participation in sports and other physical activities can promote both health and social interaction.

In addition, effective stress management skills are crucial for coping with the demands of daily life. Developing a personalized action plan for handling stress can enhance the overall quality of life. Parents can aid in this process by establishing activities that reduce stress, such as:

Stress Management Technique Description
Mindfulness and Meditation Practice techniques to focus on the present moment.
Physical Activity Engage in exercises like yoga or jogging to relieve tension.
Creative Outlets Encourage hobbies such as art, music, or writing to express feelings.

By focusing on sleep, work-life balance, active living, and stress management, parents can help their autistic children improve their quality of life. For further guidance, check out our resources on autism resources for parents and overcoming common autism challenges.

Autism in Gender Differences

Understanding autism in adulthood involves recognizing the distinct differences between males and females on the autism spectrum. These differences can affect diagnosis, the presence of co-occurring conditions, and how traits are expressed socially.

Disparity in Diagnosis

Research indicates that there is a noticeable disparity in the diagnosis rates of autism between genders. Typically, boys are diagnosed more frequently than girls. This is partly due to the differences in how traits manifest. A study across nine European nations showed that girls with autism often exhibit fewer stereotypical autism traits than boys at ages 4 to 5. Despite facing similar challenges with social cues, these challenges may not be as apparent in everyday social interactions [7].

The diagnostic criteria have been historically developed with male presentations in mind, potentially leading to an underdiagnosis of females. Continued awareness and adaptation of diagnostic methods are essential to ensure girls receive appropriate support and resources.

Co-occurring Conditions

Females on the autism spectrum are more likely to have co-occurring conditions such as anxiety and depression than their male counterparts. These additional challenges can complicate the management of autism and may affect support strategies and therapeutic interventions. Understanding the prevalence of these conditions in autistic girls and women is crucial for parents and caregivers seeking to provide the best support possible for their loved ones.

Gender Common Co-occurring Conditions
Males ADHD, learning disabilities
Females Anxiety, depression, eating disorders

Masking of Traits and Social Challenges

One significant aspect differentiating girls from boys on the autism spectrum is the tendency to engage in masking. Many girls learn to camouflage their autism traits in social settings, often by emulating the behaviors of their peers. This behavior allows them to blend in more easily but can lead to increased stress and emotional exhaustion over time.

Girls might appear socially adept but are often struggling internally to navigate the complexities of social interaction. In contrast, boys tend to display their differences more openly, often leading to more noticeable social challenges [7].

To support autistic girls effectively, it is important for parents to understand these dynamics. Resources like autism resources for parents can help in developing effective routines and support networks for their daughters. Equipping parents with knowledge about how girls may experience autism differently can lead to more tailored and beneficial support strategies.

References

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How To Find A Great BCBA Supervisor

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