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Speech Therapist Refusing To Do PECS

Scenario I am on a new team with a very involved young child with ASD and several other diagnoses. When meeting with the team, it was determined that PECS would be a great starting point for the child for functional communication. The speech therapist stated that she will just recommend a communication device because she hates doing PECS, implementing it and keeping up on the pictures. The family expressed concern about the child using a device as he doesn’t point…

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Resources for IRB Approval for Independent Researchers

Scenario I am looking for resources for IRB approval for independent researchers. I'm partnered with a university and have approval for a project but I have other projects unrelated to that project that I would like to get approval for. Any suggestions? Response The university s/he is partnering with may have its own IRB (I know ASU does), otherwise whoever their university contact is should have resources? I’m in the early stages of this process as well but I’m just…

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Family Doesn’t Want Details Released To Funding Source Without Permission

Scenario I am working with young child with ASD. The family has sought out numerous treatments for their son. They feel that the hyperbaric chamber, oxygen therapy, gluten free diet and supplements have been the most beneficial treatments for their son. The team feels that the evidence-based practice of ABA is making a great impact on the child with the therapist. He is able to perform a wide variety of skills in different areas of development for the provider. The…

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Parents Offering Token Items During Check Out/Transition

Scenario A team is looking for insight on how to handle parents offering dinner and other token items during check out/transition out of service session (especially how a BCBA would coach a RBT to handle this in the moment)? Response Explanation of appreciation but limitations that exist to accept   Make sure message is firm but respectful; establish mutual trust, prime the situation   Many of these families feel eternally indebted to us, we need to acknowledge their thankfulness and redirect this…

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Terminate Services Due To Parent Behavior

Scenario How does a BCBA terminate services when parent behavior is impeding patient services? Response Review expectations at onset of service Revisit tx plan goals and alignment with family values Reach out to supporting BCBAs for guidance Set discharge criteria in initial tx plan Refer to counseling for additional services if exp. avoidance is hypothesized

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BCBA Subpoenaed in Family Court

Scenario A BCBA is subpoenaed, court ordered and approached by one guardian(parent) lawyer for issues involving family court. What are the next steps for the BCBA? Response Outline at the onset of services (conditions of participation in such situations, must be judge-ordered etc.   Annually revisit conditions for participation in court   Address familial stressors at intake

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Changing Direction of Treatment from Previous BCBA

Scenario You are a new BCBA to an established case and go to meet your client and his family for the first time.  The client is a 12-year-old male evaluated using the VB-MAPP and has been a client of the company for 5 years.  You see the client run in and out of the meeting wearing only his underwear and holding up an iPad to his ear.   While meeting with the family, you learn that the previous BCBA has…

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Supervisee Slaps Child in School Setting

Scenario Dilemma: Supervisee slaps a child in the school setting. Response Mandatory reporters- DCS   Reach out to the BACB   Reach out to the state psych board   Look at supervision contract and what the criteria to terminate it is   Learning point- make sure you are writing your contracts accordingly to cover certain situations that require immediate action   How would we know if someone has a previous incident against them? – probably not known until it’s been…

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Client Pre-Authorization Denied For Much Needed Services

Scenario You receive an ABA referral from a pediatrician for a 3-year-old client; you call the parent listed and gather insurance details and enough background information to see if the client’s behaviors are within the scope of the practice. The client is severely impacted and engaging in high rates of SIB; your colleague that specializes in SIB has an opening on his caseload. When the team proceeds to obtain prior authorization from the client’s primary insurance, pre-auth is denied as…

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Parent Utilizing CBD & THC

Scenario You have been working with a family for 18 months. The father is consistent with parent training attendance, actively engages in sessions and follows through with protocol implementation. The client recently experienced an increase in aggression; the team has developed a modified protocol and you are prepared to share it at the next parent training session. At the parent training session, Dad mentions that he is trying CBD oil (with THC) with the child in hopes to reduce aggression…

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