Symptom Severity and Treatment Dosages: Understanding Medical Necessity & Bridging the Gap Between Diagnostics & Clinical Recommendations is the kind of topic that looks straightforward until it collides with the speed, ambiguity, and competing demands of clinic sessions and day-to-day service delivery. In Symptom Severity and Treatment Dosages: Understanding Medical Necessity & Bridging the Gap Between Diagnostics & Clinical Recommendations, for this course, the practical stakes show up in service continuity, accurate reporting, and defensible clinical decisions, not in abstract discussion alone.
Provider: BehaviorLive — via Council of Autism Service Providers
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Join Free →In the field of evaluation and diagnostics, there is currently no objective guide or decision-making tool that incorporates the DSM-5 available for a clinician to determine the diagnostic severity of Autism Spectrum Disorder (ASD) (i.e., levels 1, 2, 3) across raters. Similarly, in the field of Applied Behavior Analysis (ABA), there is no wide-scale industry standard for practitioners when recommending a treatment dosage for ABA therapy. Treatment dosages are typically informed by a summation of subjective and objective assessments of the recipients of the ABA services with the ultimate determination being the clinical opinion of the practitioner. This lack of standardization across both diagnostics and treatment is a significant practice gap across both fields and leads to flawed diagnoses and medically necessary dosage recommendations. The presenters will discuss the definition of medical necessity in relation to insurance funders, industry guidelines, and the severity of diagnostic symptoms, particularly ASD, while drawing parallels to the broader healthcare industry. Content of the presentation will also highlight the importance of training practitioners on how to recommend initial treatment dosages, as well as understanding the need for progress monitoring throughout a recipient's time in ABA services.
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Nicole McMillan, BCBA-D received her PhD in Cognitive and Behavioral Sciences with an emphasis in ABA from Auburn University. Over the past 15 years, she has gained clinical experience across skill acquisition and challenging behavior in settings, such as clinics, schools, in-home, and early intervention preschools. Those settings have included several populations, including caregivers, teachers, RBTs/BCaBAs/BCBAs, and individuals with ASD and other developmental disabilities. She has served in executive and senior leadership roles across multi-state ABA agencies with a focus on quality assurance and clinical systems, training, community outreach, research, and university program partnerships. Her interests include patient outcome measurement, clinical decision-making, and early intervention. She has presented at regional and national conferences, as well as published studies in several peer-reviewed journals including the Journal of Applied Behavior Analysis. She has also co-authored two book chapters in Children and Youth with Autism Spectrum Disorder (ASD): Recent Advances and Innovations in Assessment, Education, and Intervention and Handbook of ABA for Children with Autism: Clinical Guide to Assessment and Treatment.
Dig into the research behind this topic — plain-English summaries written for BCBAs.
279 research articles with practitioner takeaways
258 research articles with practitioner takeaways
252 research articles with practitioner takeaways
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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.