In The Politics of Autism, I discuss the day-to-day challenges facing autistic people and their families. In many states -- particularly those with large rural populations -- one problem is a shortage of high-quality behavior therapists.
Six years ago, the Behavior Analyst Certification Board, a nonprofit corporation that establishes professional credentialing standards for behavior analysts, created the RBT [registered behavior technician] qualification, largely, they say, to ensure uniform standards for the technicians who increasingly do much of the frontline care. Compared with higher levels of certification that call for at least a college degree, these paraprofessionals need only a high school diploma, a 40-hour course, a background check, an in-person assessment and, starting in 2016, a written test.
The new qualification was followed by a surge in the number of people certified to deliver ABA. Critics, however, have challenged the standards for being too lax. It takes hundreds of hours of training over months to qualify therapists to work independently with children, they say. “Forty hours? You’ve got to be kidding me. Put another zero behind that and maybe that would be closer,” says Jon Bailey, an ABA expert at Florida State University in Tallahassee.
And it’s not just the credentials that have come under scrutiny. On-the-job coaching and supervision are supposed to make up for gaps in the training, but some RBTs find that the agencies they work for do not provide much of either. Technicians describe checked-out or overworked supervisors, little guidance and high turnover, which harms clients along with ABA’s reputation. “The RBT is the hands-on person,” Bailey says. “They should have a lot of training, because if they mess up, you’re messing with people’s lives. This is not like somebody burned a hamburger or something.”
