This comparison draws in part from “**Co-occurring Autism Spectrum and Mental Health Disorders: What Practitioners should Know, Do, and Say, when it comes to Prevalence, Risk factors, Screening, Referral, and Care Coordination” by Allyson Moore, M.S., BCBA, LMFT (BehaviorLive), and extends it with peer-reviewed research from our library of 27,900+ ABA research articles. The decision framework, BACB ethics code references, and cross-links below are synthesized by Behaviorist Book Club.
View the original presentation →One of the most consequential decisions a behavior analyst makes is not just what intervention to use, but how to approach the clinical question in the first place. For **co-occurring autism spectrum and mental health disorders: what practitioners should know, do, and say, when it comes to prevalence, risk factors, screening, referral, and care coordination, the difference between an evidence-based, individualized approach and a traditional, protocol-driven one can significantly impact outcomes.
This guide lays out the key factors side by side to support your clinical decision-making.
| Factor | Evidence-Based Approach | Traditional Approach |
|---|---|---|
| Increased Social Withdrawal | Behavioral: May reflect extinction of social behavior due to insufficient reinforcement in social contexts | Mental Health: May indicate depressive symptoms, social anxiety, or the onset of a mood disorder |
| Increased Repetitive Behavior | Behavioral: May represent automatic reinforcement or response to environmental changes | Mental Health: May reflect anxiety-driven compulsions or obsessive-compulsive symptoms |
| Refusal of Previously Tolerated Activities | Behavioral: May indicate changes in reinforcement value or establishing operations | Mental Health: May reflect anxiety-based avoidance or emerging phobia |
| Increased Aggression or Self-Injury | Behavioral: Functionally maintained by attention, escape, tangible, or automatic reinforcement | Mental Health: May indicate emotional dysregulation related to depression, anxiety, or PTSD |
| Sleep Disruption | Behavioral: May relate to environmental stimuli, schedule changes, or reinforcement contingencies | Mental Health: May be a symptom of anxiety, depression, or other mood disorders |
| Skill Regression | Behavioral: May indicate lack of maintenance contingencies or environmental disruption | Mental Health: May reflect cognitive and functional impact of depression, anxiety, or other conditions |
| Assessment Approach | Behavioral: Functional behavior assessment focused on antecedents, behavior, and consequences | Mental Health: Behavioral assessment supplemented by screening tools, caregiver interview, and referral for comprehensive evaluation |
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Use this framework when approaching **co-occurring autism spectrum and mental health disorders: what practitioners should know, do, and say, when it comes to prevalence, risk factors, screening, referral, and care coordination in your practice:
Does the data support a need for intervention? Is there a meaningful impact on the individual's quality of life, safety, or access to reinforcement?
YES → Proceed to assessment NO → Document reasoning, monitor
A functional assessment should guide intervention selection. Avoid defaulting to standard protocols without individual analysis. Consider environmental variables, setting events, and private events.
YES → Select evidence-based approach matched to function NO → Complete assessment first
Goals should be co-developed. Assent and informed consent are ethical requirements. The individual's preferences and values matter in selecting both goals and methods.
YES → Proceed with collaborative plan NO → Engage in shared decision-making
This course covers the clinical and ethical dimensions in detail with structured learning objectives and CEU credit.
**Co-occurring Autism Spectrum and Mental Health Disorders: What Practitioners should Know, Do, and Say, when it comes to Prevalence, Risk factors, Screening, Referral, and Care Coordination — Allyson Moore · 1 BACB Ethics CEUs · $30
Take This Course →We extended this decision guide with research from our library — dig into the peer-reviewed studies behind each approach, in plain-English summaries written for BCBAs.
280 research articles with practitioner takeaways
258 research articles with practitioner takeaways
244 research articles with practitioner takeaways
1 BACB Ethics CEUs · $30 · BehaviorLive
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All behavior-analytic intervention is individualized. The information on this page is for educational purposes and does not constitute clinical advice. Treatment decisions should be informed by the best available published research, individualized assessment, and obtained with the informed consent of the client or their legal guardian. Behavior analysts are responsible for practicing within the boundaries of their competence and adhering to the BACB Ethics Code for Behavior Analysts.