The Diversity Is in the Details: Unintentional Language Discrimination in the Practice of Applied Behavior Analysis
ACA Section 1557 means BCBAs must give free language help to families with limited English or face civil suits.
01Research in Context
What this study did
Kornack and colleagues wrote a position paper. They looked at ACA Section 1557. This law says health care must give language help to families who speak little English. The authors asked: Are BCBAs following this rule? They reviewed what the law means for day-to-day ABA practice.
What they found
The paper says BCBAs must offer interpreters or translated forms to Limited English Proficient families. If we do not, families can sue. The authors show that ABA has no clear plan for this yet. They urge the field to act fast.
How this fits with other research
Friedman (2016) found Medicaid waivers still used the old term "mental retardation" years after Rosa's Law banned it. Both papers flag slow adoption of new language rules.
Luckasson et al. (2013) and Matson et al. (2013) gave naming and classification guidance for intellectual disability. Like Kornack et al. (2019), they are practitioner-facing position papers that tell BCBAs how to speak and write.
Esbensen (2016) pushed medical schools to add IDD health training. Kornack et al. (2019) pushes ABA to add language-access training. Both papers spot a training gap and call for systemic change.
Why it matters
You may already have Spanish-speaking or Mandarin-speaking families on your caseload. Check your intake packet today. If forms are only in English, you are out of compliance. Add a line to your consent that says, "Free interpreter available on request." This one change keeps you legal and welcomes every family.
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02At a glance
03Original abstract
Individuals with limited English proficiency face more challenges accessing applied behavior analysis (ABA) than their English-speaking counterparts. Many federal and state laws have been enacted to ensure the civil rights of protected classes, and Section 1557 of the Affordable Care Act (ACA, 2010) builds on those laws and explicitly establishes a cause of action (i.e., a basis to sue) against health care providers, including ABA providers, who discriminate against patients on the basis of race, color, national origin, sex, age, or disability. A patient’s language falls under the scope of national origin, and most health care providers, including behavior analysts who deliver ABA as medically necessary treatment, have a duty to ensure that patients who are Limited English Proficient (LEP) have the same access to the provider’s services as English-speaking patients. Knowledge of this provision of the ACA is critical to its compliance and, more importantly, to ensuring that behavior analysts rise to the challenge that the goal of true diversity represents. Note: Many terms are used interchangeably to describe insurance carriers, insurance issuers, health plans, and managed care organizations, as well as practitioners of applied behavior analysis. In this article, insurance carriers, insurance issuers, health plans, and managed care organizations are referred to as payors, and practitioners of applied behavior analysis are referred to as behavior analysts or ABA providers.
Behavior Analysis in Practice, 2019 · doi:10.1007/s40617-019-00377-y