An Essential Service Decision Model for ABA Providers During Crisis
Score each case on urgency, client risk, and staff skill; the total tells you if the session must be face-to-face.
01Research in Context
What this study did
Colombo et al. (2020) built a triage matrix for ABA clinics.
The matrix mixes three questions: How urgent is the goal? How vulnerable is the client? How skilled is the provider?
Providers score each item low, medium, or high. The total tells them if the session stays in-person, goes remote, or pauses.
What they found
The paper is a position piece, not an experiment.
It gives a ready-to-use worksheet and sample cases.
No data on outcomes are reported.
How this fits with other research
Wine et al. (2022) kept 168 autistic students infection-free with a school-wide safety program. Their data show the matrix can work in real life when paired with strict health rules.
Neely et al. (2021) found telehealth works for assessments and skill building, but not yet for severe behavior reduction. Their review fills the “remote” boxes of the matrix with evidence-based options.
Ausenhus et al. (2019) and Zhu et al. (2020) both showed staff can learn and keep high fidelity through remote feedback. These studies give providers ready tools when the matrix says “go virtual.”
Why it matters
You now have a one-page sheet to justify in-person visits to funders and families. Use it when weather, strikes, or new waves hit. Pair it with telehealth tricks from the neighbor papers to keep lower-risk clients moving forward without pause.
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02At a glance
03Original abstract
In the United States, applied behavior analysis (ABA) is broadly recognized as a medically necessary treatment for individuals diagnosed with autism and related disorders (Association of Professional Behavior Analysts, 2020, Guidelines for practicing applied behavior analysis during COVID-19 pandemic, Retrieved from https://cdn.ymaws.com/www.apbahome.net/resource/collection/1FDDBDD2-5CAF-4B2A-AB3F-DAE5E72111BF/APBA_Guidelines_-_Practicing_During_COVID-19_Pandemic_040920.pdf). We argue that this designation should not be called into question in light of a particular disaster and that it is critical to consider that an interruption of services can have long-lasting effects on the treatment of the individual (practitioners are ethically obligated to uphold the continuity of services while doing no harm). This dilemma might be ameliorated by a decision model that considers the prioritization of immediate needs, the vulnerability of clients, and the competency of service providers. Just as the medical field prioritizes immediate needs during crisis situations and defers routine appointments (e.g., physicals, checkups), the ABA field can make similar evidence-based decisions. The purpose of the current article is to provide a decision model for ABA practitioners who find themselves questioning the need for essential service delivery during the current COVID-19 pandemic. The impact of this model goes beyond the needs of this crisis and can be applied to any emergency situation where services are at risk of interruption.
Behavior Analysis in Practice, 2020 · doi:10.1007/s40617-020-00432-z