Understanding and Reacting to Relapse: Considerations for Practitioners

Neely et al. (2025) wrote a how-to guide for BCBAs. It shows step-by-step ways to spot, plan for, and stop relapse of severe problem behavior in kids with autism.

The paper is not an experiment. It is a position paper that pulls best practices into one checklist you can keep on your clipboard.

The authors say relapse is usually predictable. They give a three-part framework: list likely triggers, schedule booster sessions before they are needed, and watch for tiny early warning signs every day.

Colombo et al. (2021) surveyed BCBAs and found that almost half get their first severe-behavior case with zero supervision. Neely’s relapse guide fills that training gap by giving those same BCBAs a ready-made safety net.

Fuhrman et al. (2016) showed that multiple-schedule thinning during FCT can stop resurgence. Neely extends this idea by adding trigger lists and booster plans, turning a single-tactic fix into a full relapse-prevention routine.

Parrott (1984) warned that treatment drift causes failure long before relapse shows up. Neely’s 2025 paper answers that old warning with modern safeguards like pre-planned integrity checks and parent booster meetings.

You just helped a child cut head-banging from 40 to 2 hits a week. Without a relapse plan, the behavior can roar back when the flu, school break, or a medication change hits. Use Neely’s checklist: write the top three triggers you saw during assessment, schedule one booster session per month for the next three months, and pick one easy-to-graph warning sign (like first-request latency) to watch each day. Do it Monday and you may skip the crisis call next month.