Association for Behavior Analysis International

The Association for Behavior Analysis International® (ABAI) is a nonprofit membership organization with the mission to contribute to the well-being of society by developing, enhancing, and supporting the growth and vitality of the science of behavior analysis through research, education, and practice.


50th Annual Convention; Philadelphia, PA; 2024

Event Details

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Symposium #133
CE Offered: BACB
The Evolution of Standards for Start of Care: A Clinically Informed Process for Intake, Caseload Composition, and Assent Driven Care
Saturday, May 25, 2024
4:00 PM–4:50 PM
Convention Center, 100 Level, 113 A
Area: AUT/OBM; Domain: Service Delivery
Chair: Emily Callahan (Centria Healthcare)
CE Instructor: Emily Callahan, Ph.D.

Problem: ASD presents unique challenges with early and comprehensive services being crucial for long term outcomes. Inefficiencies in the process from intake to intervention can result in delays, inequalities, and potential safety concerns for families (Arabi et al., 2021). Innovative approaches to initial discussions with families can provide enough information to set up clients and staff for success before they start care. By promoting a uniform intake process, decision makers can then appropriately match clients to service setting, staffing and resources needed, and ensure clarity with family expectations, as well as prepare for the start of care to ensure a safe environment aligned to assent. This symposium includes three presentations which will outline solutions to the barriers to start care quickly and effectively for the clients we serve. In the first presentation, we will describe the evolution of an intake process from a checklist of eligibility criteria to a clinically informed parent interview which enables a deeper understanding of client needs and supports needed before start of care. In the second presentation, we will outline considerations, based on the intake guidance, used to standardize a system to develop a balanced caseload composition for supervising clinicians. In the final presentation, we will describe a tier one intervention which builds upon the information gathered through the intake and client assignment process, to provide a start of care model that prioritizes therapeutic alliance and ensures that all services are aligned to client centered assent-based practice.The discussant will highlight the benefits of standardizing intake processes that include both alignment with intervention and clinician responsibilities and review how data produced from this process can inform organizational decisions.

Instruction Level: Intermediate
Keyword(s): autism, change management, Intake, SBT
Target Audience:


Learning Objectives: 1. Define how ABA providers can utilize the intake process to gather information that can inform the supports needed to provide effective services for clients. 2. Define how information gathered during the intake process can be utilized to assign and distribute caseloads. 3. Define how the assent process can be incorporated into service delivery from intake to start of care.

It’s More Than Just Confirmation and Verification: How a Large Scale Organization Updated the Intake Process to Inform Acuity and Case Conceptualization

EMILY CALLAHAN (Centria Healthcare)

By definition Autism Spectrum Disorder (ASD) is a heterogeneous disorder. The symptoms and behavioral features associated with a diagnosis of ASD vary greatly across individuals. While applied behavior analysis (ABA) is considered the premier approach for helping individuals with ASD, there are a number of factors that should be considered when developing therapeutic interventions for individuals with ASD. These include but are not limited to: age, medical and psychological comorbidities, cognitive abilities, communication skills, and presence of interfering behavior. A diagnosis is not enough for determining the supports necessary for an organization to provide care to individuals with ASD. This presentation will outline an overhaul of the referral and intake process at a large scale organization. The process was updated from one that simply checked the boxes (e.g., diagnosis, insurance verification) from one that incorporated a clinically informed interview for the intake team that included questions related to factors known to impact ABA outcomes, a clinical review process to review higher risk behaviors, and an acuity scoring system that provided guidance on the complexity of supports that would be needed to provide care for clients.


Caseload Composition: Building a Balanced Caseload With a Focus on Clinician Skillset and Client Needs

ASHLEY ZINK (Centria Autism Services)

When clients come to an organization for services, there are often unknowns that may lead to inadequate resources to support client needs, and can create dangerous situations. Providing a thorough, standardized approach to identifying and evaluating client needs prior to the onset of care allows us to set the client and clinical team up for success. By having a scoring system that evaluates the complexities of each client, we can effectively pair each client with a clinician who will be best suited to support their needs, and ensure that we are creating an environment where each clinician can fully step into their strengths and best serve their clients. Developing balanced caseloads within a clinician’s scope of competence can reduce the potential for clinician burnout and foster productive learning environments. This presentation will describe how an acuity scoring system generated from the intake process was used to guide case assignment and support prior to the start of care.


The Foundational Plan: A Response to Intervention Approach to Support Assent and Client Needs at Start of Care

Edward Sanabria (Centria Autism), HILLARY LANEY (Centria Healthcare)

What is “pairing” anyway? A common term to describe a common problem. Many clients start care with unknown needs; additional resources, excesses of interfering behavior, and staffing competency are some of the risks that can arise in the first 30 days of starting care for new clients. Gathering relevant information prior to start of care can inform necessary resources for success. How can we move away from arbitrary “pairing”, often seen as an unnecessary evil to capture the MO of our learners? And instead, move towards an innovative approach that prioritizes therapeutic rapport, not just as a cherry on top of a well done session, but as the foundation for all services our clients receive. This presentation will outline a tier 1 intervention provided to all clients, which can mitigate many of the barriers to a successful start of care. This approach, called the Foundational Plan, effectively supports therapy sessions aligned to assent-based practice from the first day of services.




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Modifed by Eddie Soh