Why Is Autism Increasing?

Explore the potential factors, from genetics to environment and awareness.

Why Is Autism Increasing?

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition that affects individuals in unique ways. In recent years, there has been a notable increase in the prevalence of autism, leaving many wondering about the causes behind this rise.

Understanding Autism Spectrum Disorder

Autism Spectrum Disorder is a range of conditions characterized by challenges in social interaction, communication, and the presence of restricted and repetitive behaviors. It is a lifelong condition that affects individuals differently, with varying degrees of severity.

ASD is typically diagnosed in early childhood, although some individuals may not receive a diagnosis until later in life. It is important to note that autism is not a disease or a result of bad parenting. Rather, it is a neurological difference that shapes an individual's perception and experience of the world.

Exploring the Increase in Autism Rates

The increase in autism rates has been a topic of great interest and concern. It is crucial to understand that the rise in reported cases does not necessarily mean there has been an actual increase in the occurrence of autism. Instead, it can be attributed to a combination of several factors, including improved diagnostic criteria, increased awareness, and changes in data collection methods.

Over the years, there have been significant advancements in the identification and diagnosis of autism. Diagnostic criteria have expanded to encompass a broader range of symptoms and behaviors, leading to more accurate and earlier diagnoses. This has contributed to the observed increase in reported cases.

Furthermore, there has been a notable increase in awareness and understanding of autism among healthcare professionals, educators, and the general public. This heightened awareness has led to improved identification and access to services for individuals with autism. As a result, more cases are being recognized and reported.

While it is evident that diagnostic changes and increased awareness have played a role in the rise of reported autism cases, it is important to consider other factors as well. Ongoing research suggests that a combination of genetic and environmental factors may contribute to the development of autism. Factors such as advanced parental age, prenatal infections, maternal smoking, and exposure to environmental toxins have been explored in relation to the increased prevalence of autism.

Understanding the rise in autism rates requires a multifaceted approach, considering both genetic and environmental factors. By continuing to research and gain a deeper understanding of autism, we can work towards a better future for individuals on the autism spectrum.

Genetic Factors

While the exact causes of autism spectrum disorder (ASD) are still being researched, there is evidence to suggest that genetic factors play a significant role in the development of autism. In this section, we will explore two genetic factors that have been linked to the increased prevalence of autism: genetic predisposition and advanced parental age.

Genetic Predisposition

Research has shown that individuals with a family history of autism are more likely to have children with ASD. Genetic predisposition refers to the presence of certain genetic variations or mutations that increase the likelihood of developing autism. These genetic factors can be inherited from either one or both parents.

Several genes have been identified as potential contributors to autism. However, it's important to note that autism is a complex disorder with a range of genetic variations involved. The interplay between these genetic factors and environmental influences is still being studied to better understand the development of autism.

Advanced Parental Age

Advanced parental age, especially in fathers, has been associated with an increased risk of autism in children. As individuals age, the risk of genetic mutations during the formation of sperm and eggs also increases. These mutations can potentially affect the development and function of the brain, contributing to the development of autism.

While the overall risk is still relatively low, studies have found a higher prevalence of autism in children born to older parents. The specific mechanisms through which advanced parental age influences autism risk are complex and require further investigation.

To better understand the role of genetics in autism, it is essential to continue research in this field. By studying the genetic variations and mutations associated with autism, scientists aim to unravel the intricate genetic factors involved in the development of this complex disorder.

Understanding the genetic factors contributing to autism is just one piece of the puzzle. Environmental factors also play a crucial role in the rising rates of autism. In the next section, we will explore the impact of prenatal and early childhood factors on the development of autism.

Environmental Factors

In the quest to understand the increasing rates of autism, researchers have identified that environmental factors may play a role in the development of autism spectrum disorder (ASD). These factors encompass both prenatal and early childhood influences, which we will explore in this section.

Prenatal Factors

During the prenatal period, certain factors have been linked to an increased risk of autism. These factors include:

Prenatal Infections

Various studies have suggested a potential association between prenatal infections and an increased risk of autism. Maternal infections during pregnancy, such as rubella, cytomegalovirus (CMV), and influenza, have been implicated in contributing to the development of ASD in some cases. However, it's important to note that the majority of children exposed to prenatal infections do not develop autism.

Maternal Smoking

Maternal smoking during pregnancy has also been identified as a potential environmental risk factor for autism. Research suggests that exposure to cigarette smoke in utero may increase the risk of developing ASD. However, it's crucial to highlight that smoking is just one of many factors that can contribute to the development of autism, and not all children exposed to maternal smoking will develop the condition.

Early Childhood Factors

After birth, environmental factors during early childhood can also impact the risk of developing autism. Some of these factors include:

Electromagnetic Fields

Exposure to electromagnetic fields (EMFs) has been suggested as a potential environmental factor associated with autism. EMFs are generated by various electronic devices and power lines. While studies have shown some links between EMF exposure and autism, more research is needed to establish a direct causal relationship.

It's important to note that genetic and other factors also contribute to the development of autism. Environmental influences, including prenatal and early childhood factors, may interact with a child's genetic predisposition to increase the risk of ASD.

By gaining insights into the impact of environmental factors on the rising rates of autism, we can work towards creating a more inclusive and supportive environment for individuals with ASD. It's important to continue research efforts to better understand the complex interplay between genetics and the environment in the development of autism.

Vaccines and Autism

The topic of vaccines and their potential link to autism has been a subject of much debate and concern among parents and the general public. However, extensive scientific research has consistently shown no evidence to support the claim that vaccines cause autism. In fact, multiple studies have debunked this myth, reassuring parents about the safety of vaccines.

Debunking the Vaccine Myth

Numerous scientific studies and investigations have thoroughly examined the alleged connection between vaccines and autism, and all have concluded that there is no causal relationship between the two. The initial concern arose from a now-discredited study published in 1998, which suggested a link between the MMR (measles, mumps, and rubella) vaccine and autism. However, this study was retracted due to serious methodological flaws and ethical issues.

Since then, extensive research involving large populations and rigorous scientific methods has consistently refuted the vaccine-autism myth. The Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), and numerous other reputable organizations have reaffirmed the safety and importance of vaccines. Vaccines are a crucial tool in preventing serious diseases and protecting public health.

Scientific Studies and Findings

Scientific studies have investigated the potential correlation between vaccines and autism, focusing on various aspects such as vaccine ingredients, vaccination schedules, and the overall prevalence of autism. The overwhelming consensus is that vaccines do not cause autism. Let's take a look at some key scientific findings:

Study Findings
Danish Cohort Study (2002) No increased risk of autism associated with MMR vaccine.
Vaccine Safety Datalink (2013) No increased risk of autism associated with MMR vaccine or thimerosal-containing vaccines.
A Population-Based Study in Japan (2015) No increased risk of autism associated with MMR vaccine.
A Large Study in Sweden (2019) No increased risk of autism associated with MMR vaccine.

These studies, along with numerous others, have consistently demonstrated the safety of vaccines and their lack of association with autism. It is important to rely on evidence-based information when making decisions about vaccination and to consult trusted healthcare professionals who can provide accurate and up-to-date information.

Understanding the scientific consensus on vaccines and autism is crucial to dispelling misconceptions and ensuring the well-being of individuals with autism and the broader community.

Diagnostic Changes and Awareness

As the prevalence of autism has increased over the years, it is important to consider the role of diagnostic changes and increased awareness in understanding the rising rates of autism. These factors have contributed significantly to the identification and reporting of individuals with autism spectrum disorder (ASD).

Improved Diagnostic Criteria

One key factor contributing to the increased rates of autism is the improvement in diagnostic criteria. In the past, autism was often misdiagnosed or underdiagnosed, leading to a lower reported prevalence. However, advancements in clinical knowledge and research have led to the development of more accurate and comprehensive diagnostic criteria.

Diagnostic criteria, such as those outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), have been refined to better capture the diverse range of symptoms and behaviors associated with autism. This has allowed for a more precise identification of individuals on the autism spectrum and has contributed to the increase in reported cases. The improved diagnostic criteria have helped clinicians and healthcare professionals better identify and support individuals with autism.

Increased Awareness and Screening

Another significant factor influencing the rising rates of autism is the increased awareness and screening efforts. As awareness about autism has grown, more parents, educators, and healthcare professionals have become knowledgeable about the signs and symptoms of autism. This increased awareness has led to a greater likelihood of individuals being referred for evaluation and diagnosis.

Furthermore, screening initiatives and programs have been implemented to identify autism in early childhood. Screening tools, such as the Modified Checklist for Autism in Toddlers (M-CHAT), have been widely used to identify potential signs of autism in young children. Early detection and intervention can lead to improved outcomes for individuals with autism.

The combination of improved diagnostic criteria and increased awareness and screening efforts has contributed to the rise in reported autism rates. It is important to note that while the increase in reported cases may be influenced by these factors, it does not necessarily indicate a true increase in the prevalence of autism. It is vital to continue research and understanding of the complex factors involved in the development of autism spectrum disorder.

The Role of Other Factors

In addition to genetic and environmental factors, other factors related to maternal health and lifestyle, as well as exposure to chemicals and pollution, have been explored as potential contributors to the increasing rates of autism.

Maternal Health and Lifestyle

Maternal health and lifestyle choices during pregnancy may play a role in the development of autism in some cases. Certain maternal health conditions, such as obesity, diabetes, and hypertension, have been associated with an increased risk of autism in offspring. It is believed that these conditions might affect fetal brain development and contribute to the risk of autism.

Additionally, certain lifestyle choices during pregnancy, such as smoking and alcohol consumption, have been linked to an increased risk of autism. Maternal smoking, in particular, has been found to be associated with a higher likelihood of autism in children. It is important for expectant mothers to prioritize their health and make informed choices that support the well-being of both themselves and their babies.

Exposure to Chemicals and Pollution

Exposure to certain chemicals and pollutants has also been suggested as a potential factor in the rising rates of autism. Research has shown that prenatal exposure to certain environmental toxins, such as air pollution and heavy metals, may increase the risk of autism in children.

Air pollution, including particulate matter and certain airborne chemicals, has been associated with adverse neurodevelopmental outcomes, including autism spectrum disorder (ASD). Exposure to heavy metals, such as lead and mercury, has also been linked to an increased risk of autism.

While the exact mechanisms by which these chemicals and pollutants contribute to the development of autism are not fully understood, it is important to be aware of potential environmental risks and take steps to minimize exposure, especially during pregnancy and early childhood.

Understanding the various factors that may contribute to the increasing rates of autism is an ongoing area of research. It is important to note that autism is a complex condition and likely involves a combination of genetic and environmental influences. By continuing to study and gain insights into these factors, researchers can further enhance our understanding of autism and potentially develop strategies for prevention and early intervention.

FAQs

Is there a cure for autism?

There is currently no known cure for autism, but early intervention and therapy can help children with autism develop important skills and improve their overall quality of life.

Are vaccines responsible for the increase in autism prevalence?

No. Numerous studies have shown that there is no link between vaccines and autism. The increase in autism prevalence is likely due to a combination of genetic and environmental factors.

Can adults be diagnosed with autism?

Yes. While many people are diagnosed with autism as children, it is possible to be diagnosed with autism as an adult. In fact, some individuals may not receive a diagnosis until later in life.

What resources are available for families affected by autism?

There are many resources available for families affected by autism, including support groups, therapy services, and educational programs. Organizations such as Autism Speaks and the Autism Society of America can provide information and assistance to families seeking support.

Summary

In conclusion, the increase in autism prevalence is a complex issue with no one answer. Genetics, environmental factors, and improved diagnosis and awareness may all be contributing to the rise in autism rates. It is important to continue research into the causes of autism and to provide support and resources to individuals and families affected by autism.

Our Resources

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