Azaba Ethics Scenario Archive

BCBA’s Performing Diagnostics

Ethics Scenario Archive
1. Approaching Former Adult Client
2. Medical Marijuana
3. Pro Bono Work
4. Supervision Has Multiple Relationships with Family Receiving Services
5. Parent Training Concerns
6. Parents Not Implementing Procedures
7. Soliciting Parent Testimonials
8. Retaliation Towards Mandated Reporting
9. Family Rejecting Safety Measures
10. Parental Collaboration
11. Hostile Work Enviornment
12. Creating Protocol to Prevent and Treat Trauma with Limited Functional Language
13. Parent ABA Practice Questions in OT & Speech
14. Potential Gifts From Clients on Social Media
15. Helping Close Relationships With ABA Tips
16. Parent Utilizing CBD & THC
17. Client Pre-Authorization Denied For Much Needed Services
18. Supervisee Slaps Child in School Setting
19. Changing Direction of Treatment from Previous BCBA
20. BCBA Subpoenaed in Family Court
21. Terminate Services Due To Parent Behavior
22. Parents Offering Token Items During Check Out/Transition
23. Family Doesn’t Want Details Released To Funding Source Without Permission
24. Resources for IRB Approval for Independent Researchers
25. Speech Therapist Refusing To Do PECS
26. BCBA Receives Cease & Desist
27. Unlicensed, Certified BCBA Provide Supervision
28. Rapid Prompting Method (RPM)
29. Parent as Witness to Accident
30. Website Testimonials
31. Student Using Social Media Inappropriately
32. Hiring Behavior Analyst Trainees at a School District
33. College Recommendation Letter for Client
34. Connecting Families That Are Clients
35. Employer Requiring Same Number of ABA Hours for All New Clients from New BCaBA
36. Do we have any ethical guidelines regarding shared work spaces among two companies that provide similar ABA services in a private property?
37. Client Assessment & Discontinuation
38. Caseload Concerns
39. Naptime
40. Systemic Supervision Concern – Clients & RBTs
41. BCBA’s Performing Diagnostics
42. Self-Reporting DUI to BACB
43. Multiple Relationship with RBT
44. Refusal to Provide Documentation
45. Telehealth Supervision
46. Role of a Lead RBT
47. Urgent – Unsupervised RBT
48. Clinic Owner Requesting Services
49. Inadequate Case Supervision
50. Language Barrier to Services
51. Withholding Fieldwork Hours
52. Reportable Trainee Behavior
53. Treating Others with Compassion, Dignity, and Respect
54. RBT Self-Reporting DUI

Scenario

“There has been an uptick in ABA agencies posting that they will diagnose children with Autism if the child does not already have a diagnosis. I’m concerned about the field confusing competence within a scope with receiving some continuing education in another area. There are only a few levels of physicians that can diagnose (normal pediatricians do not have this ability), so for a BCBA to go through a minimal training course and feel they are equipped to perform a diagnostic evaluation without a supervising (diagnosing) physician overseeing the entire process is unethical and does a great disservice to clients. I’ve seen reports from these agencies go out to non-contracted diagnosing physicians hoping for a stamp of approval, but without the diagnostician seeing the actual child, that would be unethical at best and a license revocation at worst. I think these agencies state their purpose as an aid to help alleviate the diagnosis delay, but by using BCBAs to do this, it’s doing nothing more than adding additional charges to clients on top of the diagnostician they will have to go to to get an actual diagnosis. Normal BCBA training does not cover child development, counseling families on receiving diagnoses or any training on diagnostic evaluations.”

Committee Input (e.g., considerations for pathways forward, potential barriers, potential solutions):

In accordance with Ethics Code 2.04, the committee recommends that the author reach out to the BCBA(s) sending out confidential test results to advocate for appropriate adherence to HIPAA and protection of clients.

In accordance with Ethics Codes 1.01, 1.05, 1.10, 2.06, 2.12, and 3.01, the committee recommends that the author reach out to the BCBA(s) testing for Autism to advocate for clients to receive only testing directly relevant to providing behavior analytic services that do not require medical and clinical training to perform.  The committee would encourage the author to explore the following steps as options; this should not be considered legal advice:

  1. Write a formal letter to the testing BCBA, educating them on and outlining our ethical codes of conduct surrounding client confidentiality, Behavior Analysts’ scope of competency, treatment biases, etc.  Consider providing suggestions to them on ways in which they can support clients getting appropriate diagnoses in the surrounding area to meet best practice standards.
    1. Documentation of concerns can provide a clear statement for follow-up.
  2. If meaningful change is not made to satisfy the ethical code of conduct, the BCBA could send their letter along to the Arizona Board of Psychologist Examiners for both Psychologists and BCBAs, the BACB and to state funders for auditing purposes.
    1. If the administration leaders are not behavior analysts, the correction process can still be sent to state licensing boards to ensure that only approved practitioners are providing diagnostic testing to clients.

Ethics Codes (specific standards that could apply to support/oppose):

  • 1.01 Being Truthful
  • 1.05 Practicing within Scope of Competence
  • 1.10 Awareness of Personal Biases and Challenges
  • 2.04 Disclosing Confidential Information
  • 2.06 Accuracy in Service Billing and Reporting
  • 2.12 Considering Medical Needs
  • 3.01 Responsibility to Clients
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