Service Delivery

The expanding role of behavior analysis and support: current status and future directions.

Lutzker et al. (2005) · Behavior modification 2005
★ The Verdict

ABA has outgrown the clinic—use systems tools and policy advocacy to take on public-health problems now.

✓ Read this if BCBAs who want to move from direct therapy to systems-level or policy work.
✗ Skip if Clinicians happy staying at the individual-client level with no expansion plans.

01Research in Context

01

What this study did

Saunders et al. (2005) wrote a position paper. They asked behavior analysts to stop thinking small.

The authors said one-to-one clinic projects are not enough. They urged the field to tackle public-health-sized problems like smoking, obesity, and unsafe schools.

02

What they found

The paper is a call to action, not an experiment. It claims ABA tools are ready for population-level use.

No new data are shown. The message: if we can shape one child’s behavior, we can shape a whole city’s.

03

How this fits with other research

Hobson (1987) made the same plea almost twenty years earlier. Both papers say behavior analysis should leave the clinic and fix big social problems.

Malott (2004) gave a world-map version. It told funded pioneers to plant ABA programs overseas first, then grow. Saunders et al. (2005) widened the lens to any public-health target, anywhere.

de la Cruz et al. (2025) show the idea is now real. Their 2025 review lists wins: licensure laws, insurance mandates, and bigger service capacity secured through analyst-led advocacy.

McGee et al. (2019) add the "how." They pair the 2005 dream with behavioral systems analysis, a tool that maps staff roles, funding flows, and feedback loops so large autism agencies can scale without crumbling.

04

Why it matters

You no longer have to wonder if ABA can work at scale. The roadmap is on the shelf: use behavioral systems analysis inside your agency, teach legislators the economic and client benefits, and diversify services beyond autism. Start small—maybe one school district or one maternal-health contract—then measure, publish, and let the data pull you wider.

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Map your agency with a behavioral-systems diagram: list inputs, throughputs, outputs, and feedback loops, then pick one bottleneck to fix this quarter.

02At a glance

Intervention
not applicable
Design
narrative review
Finding
not reported

03Original abstract

Although many of the pioneers of behavior analysis thought on a large scale and encouraged others to do so, most behavior analytic projects have remained small scale. The intent of this article is to urge the application of behavior analytic principles on a large scale. This article begins with a brief history of applied behavior analysis. It then describes some early behavior analysts who thought big and describes several examples of large-scale behavioral projects. It then shows how behavior analysis fits well with the public health model and describes how behavior analytic principles can be implemented broadly to combat public health problems. The article ends with some practical advice for behavior analysts on how to think big and speculates on the future of behavior analysis.

Behavior modification, 2005 · doi:10.1177/0145445504273289