By Matt Harrington, BCBA · Behaviorist Book Club · April 2026 · 12 min read

Be the Change: Advocating for State-Level Regulation and Ethical Reform in ABA Practice

Overview & Clinical Significance

Applied behavior analysis exists in a regulatory landscape that varies dramatically across states and jurisdictions. Some states have comprehensive licensing laws that establish clear scopes of practice, accountability mechanisms, and consumer protections for ABA services. Others have minimal or no state-level regulation, meaning that the quality and safety of ABA services depend primarily on voluntary certification and the ethical commitments of individual practitioners. This course equips behavior analysts with the knowledge and skills to advocate for meaningful state-level regulation that ensures ethical, high-quality ABA practice.

The clinical significance of regulation is direct and consequential. In the absence of effective regulation, consumers have limited recourse when they receive substandard or harmful services. Without licensure requirements, individuals without appropriate training may provide services they call ABA, potentially causing harm to vulnerable populations. Without clear scopes of practice, role confusion and interprofessional conflicts may compromise service delivery. Without accountability mechanisms, practitioners who engage in unethical behavior may face no professional consequences beyond BACB disciplinary action, which has limited enforcement power at the state level.

Oswin Latimer's course brings a distinctive perspective to this topic by emphasizing the importance of building inclusive coalitions that bring together autistic individuals, BCBAs, parents, and related professionals. This approach reflects the understanding that regulation affects all stakeholders and that effective advocacy requires input from all of them. The inclusion of autistic voices in the regulatory process is particularly significant given the ongoing conversation about whether ABA practices adequately respect the autonomy and preferences of the people they serve.

The course challenges practitioners to move beyond passive acceptance of the regulatory status quo and to become active agents of change. This is not merely a professional development opportunity; it is an ethical imperative. When behavior analysts identify problems with how ABA is regulated or practiced in their state, they have an obligation under the Ethics Code to work toward solutions. Advocacy for better regulation is a form of professional service that benefits clients, practitioners, and the field as a whole.

The clinical stakes of regulation are evident in real-world consequences. In states without licensing laws, families seeking ABA services have no state-level mechanism for verifying a practitioner's qualifications. In states with weak regulatory frameworks, practitioners who cause harm may continue practicing after only receiving a voluntary certification sanction. In states where ABA is poorly understood by legislators, insurance mandates and coverage requirements may not reflect the realities of evidence-based practice. Each of these situations has direct consequences for the individuals and families who rely on ABA services.

Background & Context

The regulatory history of behavior analysis as a profession is relatively short compared to longer-established disciplines like psychology, medicine, and social work. The BACB was established in 1998 and began offering the BCBA credential in 2000. State licensing of behavior analysts began in the late 2000s and has progressed unevenly, with some states establishing comprehensive licensing laws early and others still lacking any state-level regulation.

The push for state-level regulation has been driven by several factors. The growth of insurance coverage for ABA services, particularly through state autism insurance mandates, created a need for regulatory frameworks that define who can provide these services, what qualifications are required, and how quality is monitored. The expansion of ABA into new service settings (schools, hospitals, community programs, telehealth) created intersections with existing regulatory frameworks that require clarification. And reports of harmful practices by unqualified or unethical practitioners created pressure for consumer protection mechanisms.

The regulatory landscape is complicated by the fact that behavior analysis does not fit neatly into existing healthcare regulatory categories. It is not medicine, psychology, counseling, or social work, though it intersects with all of these. This uniqueness means that behavior analysis often needs its own licensing category, with its own scope of practice, educational requirements, and supervisory standards. Creating this category requires legislative action, which requires advocacy, coalition building, and political engagement.

The current regulatory conversation is also shaped by legitimate disagreements within the field about what regulation should look like. Some advocate for strict licensing with comprehensive scope-of-practice definitions. Others argue that overly restrictive regulation could limit access to services, particularly in underserved areas where qualified practitioners are scarce. Some emphasize the importance of regulatory independence for behavior analysis. Others advocate for regulatory models that facilitate interdisciplinary collaboration.

The participation of autistic individuals in the regulatory conversation represents a significant development. The autistic self-advocacy movement has raised important questions about what ABA practices should be regulated, how consumer complaints should be handled, and whether regulatory frameworks should include protections against practices that autistic individuals report as harmful. Including these perspectives in the advocacy process is both ethically important and strategically valuable, as legislation that reflects diverse stakeholder input is more likely to be comprehensive and effective.

The political dimensions of regulatory advocacy cannot be ignored. Behavior analysts seeking to influence state legislation must understand how the legislative process works, how to engage with legislators and their staff, how to build relationships with key political figures, and how to navigate the competing interests that shape policy outcomes. These are skills that most BCBA training programs do not teach but that are essential for effective advocacy.

Clinical Implications

The presence or absence of effective state-level regulation has direct implications for clinical practice. In well-regulated states, practitioners operate within a clear framework that defines their scope of practice, establishes standards for education and supervision, creates accountability mechanisms for ethical violations, and provides consumers with a formal complaint process. This framework supports quality practice by establishing clear expectations and consequences.

In states with weak or absent regulation, the clinical implications are less favorable. Practitioners may face scope-of-practice conflicts with other professionals when there is no clear legal definition of what behavior analysts are authorized to do. Consumers may be unable to distinguish between qualified and unqualified practitioners. Insurance companies may impose arbitrary requirements in the absence of state standards. And the profession may lack the legal standing needed to advocate effectively for client access to services.

Regulation also has clinical implications for how ABA practices evolve over time. Regulatory frameworks can be designed to promote evidence-based practice, require continuing education, mandate ethical oversight, and create mechanisms for updating practice standards as the evidence base evolves. Without these mechanisms, practice evolution depends entirely on voluntary professional development, which is inconsistent across practitioners.

The clinical implications extend to interdisciplinary relationships. Clear scope-of-practice definitions established through regulation reduce conflicts between behavior analysts and other professionals by establishing what each discipline is authorized to do. This clarity supports collaboration by reducing territorial disputes and creating a shared understanding of each profession's role in the service delivery system.

Coalition building has clinical implications because the perspectives that inform regulation directly shape what regulated practice looks like. When autistic individuals participate in the regulatory process, they bring perspectives on what practices are helpful versus harmful, what consumer protections are needed, and what outcomes regulation should promote. When parents participate, they bring perspectives on access, quality, and family experience. When BCBAs participate, they bring perspectives on clinical standards, supervisory requirements, and professional development. When related professionals participate, they bring perspectives on interdisciplinary coordination and scope-of-practice boundaries. Comprehensive regulation requires all of these perspectives.

The clinical implications also include the potential for regulation to address practices that the field has identified as problematic. If research and clinical experience indicate that certain practices are outdated, harmful, or insufficiently evidence-based, regulatory frameworks can create mechanisms for restricting or eliminating those practices. This is a more powerful lever for practice improvement than professional consensus alone, because regulatory requirements carry legal force.

Ethical Considerations

The BACB Ethics Code (2022) addresses professional advocacy and regulatory compliance in ways that are directly relevant to this course. Code 1.02 (Conforming with Legal and Professional Requirements) establishes the baseline obligation to comply with existing regulations. But the ethical dimensions of advocacy go beyond compliance with current law to encompass the proactive pursuit of better regulation.

Code 3.12 (Advocating for Appropriate Services) explicitly calls for behavior analysts to advocate for appropriate services and service delivery systems. While this standard is most often applied to advocating for individual clients, it also supports systemic advocacy for regulatory frameworks that ensure appropriate services at the population level. A behavior analyst who identifies that their state's lack of regulation is allowing unqualified individuals to provide harmful services has an ethical basis for advocating for regulatory reform.

Code 1.07 (Cultural Responsiveness and Diversity) is relevant to how coalitions are built and whose voices are included in the advocacy process. Effective advocacy for regulation must include the perspectives of the diverse communities affected by ABA services. Building coalitions that include autistic individuals, family members, practitioners from diverse backgrounds, and professionals from related disciplines ensures that the resulting regulation reflects a comprehensive understanding of stakeholder needs.

Code 2.01 (Providing Effective Treatment) connects to regulation through the understanding that regulatory frameworks can either support or hinder the delivery of effective services. Regulation that establishes appropriate qualifications for practitioners, requires evidence-based practices, and creates accountability for service quality supports effective treatment at a systemic level. Regulation that is poorly designed (overly restrictive, poorly enforced, or misaligned with clinical realities) can actually hinder effective treatment by creating barriers to practice or imposing requirements that do not reflect evidence-based standards.

Code 1.04 (Integrity) applies to how behavior analysts conduct advocacy activities. Advocacy should be grounded in honest representations of the evidence, transparent about the interests being served, and conducted through legitimate political and professional channels. Misrepresenting data, making unsupported claims about the necessity or effects of regulation, or engaging in deceptive political tactics would violate this standard regardless of how worthy the advocacy goal might be.

The ethical consideration of challenging outdated practices through regulatory mechanisms raises important questions about the evidence base. Code 2.01 requires evidence-based practice, but there can be legitimate disagreements about what the evidence supports. Advocacy for regulation that restricts specific practices should be grounded in a fair reading of the available evidence, not in ideological positions that go beyond what the evidence supports. This requires intellectual honesty and a willingness to distinguish between what is known, what is probable, and what is uncertain.

There is also an ethical dimension related to the potential unintended consequences of regulation. Well-intentioned regulation can sometimes produce harmful effects: restricting access to services in underserved areas, creating bureaucratic burdens that consume practitioner time without improving quality, or establishing standards that reflect one perspective at the expense of others. Ethical advocacy includes thoughtful consideration of these potential unintended consequences.

Assessment & Decision-Making

Engaging in effective regulatory advocacy requires assessing the current regulatory landscape in your state, identifying specific gaps or problems that need to be addressed, building coalitions that can support change, and developing strategies for engaging with the political process.

Begin by assessing your state's current regulatory framework for behavior analysis. Key questions include: Is there a state licensing law for behavior analysts? If so, what does it cover and what gaps exist? Who enforces it? What complaint mechanisms are available to consumers? How does the scope-of-practice definition compare to other states' definitions and to the BACB's scope? Are there insurance mandates that affect ABA services? How do these interact with the licensing framework?

Assess the political landscape. Who are the key legislators with jurisdiction over healthcare licensing? What are their positions on professional regulation generally? Are there existing relationships between the behavior analysis community and these legislators? Are there potential allies in related professions or advocacy organizations? Are there potential opponents whose concerns need to be understood and addressed?

Decision-making about coalition building requires careful thought about who should be included and how diverse perspectives will be integrated. A coalition that includes only BCBAs may be perceived as self-interested. A coalition that includes autistic self-advocates, parents, BCBAs, and related professionals demonstrates broad stakeholder support and is more likely to produce legislation that genuinely serves the public interest. However, coalition members may have different priorities and perspectives that require negotiation and compromise. Effective coalition leadership involves facilitating these conversations rather than imposing one perspective.

Decision-making about specific regulatory proposals requires balancing multiple factors. What level of regulation is appropriate given the state's existing framework? What requirements are feasible given the current supply of qualified practitioners? How will the proposed regulation interact with existing laws governing related professions? What consumer protection mechanisms should be included? How will the regulation be enforced, and what resources are needed for enforcement? What provisions should be included for updating the regulation as the evidence base evolves?

Assess your own readiness for advocacy. Effective advocacy requires skills in public speaking, writing, political engagement, coalition management, and negotiation that many behavior analysts have not been trained in. Consider seeking training in these skills, partnering with individuals or organizations that have advocacy experience, or starting with smaller advocacy activities (contacting legislators, participating in professional organization advocacy efforts) before taking on leadership roles in regulatory campaigns.

What This Means for Your Practice

Advocacy for regulation is a form of professional service that every behavior analyst can contribute to. You do not need to lead a legislative campaign to make a difference. Start by understanding your state's current regulatory framework. Know whether your state has a licensing law, what it covers, and what gaps exist. This knowledge is essential for your own practice and for any advocacy activities you undertake.

Connect with your state's behavior analysis association and their legislative or advocacy committee. These organizations typically coordinate regulatory advocacy efforts and can channel your energy effectively. If your state does not have an active advocacy effort, consider helping to start one.

When engaging in advocacy, prioritize coalition building over solo action. Seek out autistic self-advocates who are willing to participate in the process and ensure that their perspectives genuinely inform the regulatory proposals. Connect with parent organizations, related professional associations, and any other stakeholders who share an interest in quality ABA services.

Be prepared to engage with criticism of ABA practices as part of the regulatory conversation. Legislators and stakeholders will raise concerns about harmful practices, and responding with defensiveness or dismissal will undermine your credibility. Acknowledge legitimate concerns, demonstrate your commitment to client-centered practice, and show that the regulation you propose includes safeguards against the very practices that critics find concerning.

Remember that regulatory change is a long-term process. Legislative campaigns often take years and may require multiple attempts. Persistence, relationship building, and a willingness to compromise on details while maintaining core principles are essential for eventual success.