BCBA Initial Assessment Process
Conducting the Assessment
The development of an Applied Behavior Analysis (ABA) treatment plan by a Board Certified Behavior Analyst (BCBA) is a detailed, client-centered process. It follows a 30 day comprehensive assessment of the individual's skills, needs, and the functions of their behaviors. The ultimate goal is to create a personalized, effective plan that promotes learning, development, and improved quality of life. An assessment from a BCBA is also what determines the medical necessity of the ABA services, something that all insurance companies require initially and ongoing to continue funding ABA services. Here’s a step-by-step overview of how this plan is developed:
1. Comprehensive Assessment
The process begins with a thorough assessment, which includes:
Direct Observations: Observing the individual in various settings to understand their behavior and skills in different contexts.
Standardized Assessments: Utilizing tools like the Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP),the Assessment of Basic Language and Learning Skills-Revised (ABLLS-R), the Essentials for Living (EFL), or the PEAK Comprehensive Assessment, to evaluate communication, social, academic, and daily living skills.
Interviews: Speaking with caregivers, family members, or teachers to gather information about the individual’s behavior, history, strengths, and areas of highest need.
Functional Behavior Assessment (FBA): Identifying the antecedents, behaviors, and consequences to understand the function of challenging/problem behaviors.
2. Identification of Goals
Based on the comprehensive assessment, the BCBA identifies specific, measurable goals tailored to the individual’s needs and based on the Standardized Assessment Tools. Goals are prioritized based on several factors, including:
Importance to the individual person, family and/or caregivers: Goals that will have the most immediate and significant impact on the persons quality of life, well-being, and preference. Developmental Appropriateness: Goals that are aligned with the person’s developmental level.
Pre-requisite Skills: Building on existing skills and addressing gaps that are prerequisites for more complex skills.
3. Treatment Plan Development
With goals identified, the BCBA develops a detailed treatment plan that includes:
Skill Acquisition Programs: These are strategies designed to teach new skills, such as communication, social interactions, self-care, and academic abilities. Programs are chosen based on the individual’s learning style and the goals identified.
Behavior Intervention Plans (BIPs): For challenging behaviors, the BCBA designs interventions based on the functions of those behaviors, identified during the FBA. BIPs include strategies for preventing problem behavior, teaching alternative skills/behaviors, and managing consequences to reduce the occurrence of these behaviors.
Generalization and Maintenance Strategies: The plan outlines how skills and behaviors that are being targeted will be generalized to various settings and people as well as maintained over time.
Data Collection Methods: Detailed plans for how progress towards goals will be measured via the Goal Attainment Score (GAS).
Parent and Caregiver Training: Since generalization across settings and people are crucial, the plan includes training for parents, caregivers, and other relevant individuals to ensure they can effectively support the individual’s learning and use of new skills in everyday situations.
4. Review and Approval
Before implementation, the treatment plan is reviewed with the person and/or the caregivers. This step ensures that everyone involved understands the plan and agrees with the goals and strategies. The BCBA addresses any questions or concerns and makes adjustments as needed prior to submitting the report to the insurance for approval of continued services. This report unlocks further and ongoing services, which are reported on every 6 months and reauthorized based on the progress.
5. Implementation
The treatment plan is put into action by the BCBA and a team of trained behavior technicians. Implementation of the plan with fidelity is crucial, so the BCBA provides ongoing supervision and training to ensure the plan is executed as designed with meaningful progress.
6. Monitoring Progress and Making Adjustments
The BCBA continuously monitors the individual’s progress towards their goals, analyzing data collected during therapy sessions and reporting on it to receive ongoing authorization of medically necessitated services. Based on this analysis, the BCBA may adjust the treatment plan, adapting goals and strategies as the individual learns and grows. This iterative process ensures that the ABA therapy remains effective and responsive to the individual’s evolving needs and that progress is being made, a requirement of the BACB and most funding sources to continue to justify the medically necessitates services.
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