A Risk-Driven Approach to Applied Behavior Analysis Across Ages: Implications for "Medical Necessity"
Rachel Taylor (Center for Applied Behavior Analysis )
Biography:Dr. Rachel Taylor (formerly Dr. Tarbox) has supported individuals diagnosed with neurodevelopmental
disorders for more than 20 years. She started her career working in several prestigious institutions
including the New England Center for Children and the Kennedy Krieger Institute at Johns Hopkins
Hospital. She is the former Co-Director of Research and Development for the Center for Autism and
Related Disorders (CARD) and the former Chief Clinical Offer for Intercare Therapy, Inc.. Dr. Taylor has
also held several academic positions including founding Department Chair for the ABA Masters and PhD
programs at The Chicago School of professional Psychology Los Angeles, and Faculty member in
Psychology at the California State University Los Angeles and Channel Islands. Dr. Taylor is as an
Advisor to the Cambridge Center for Behavioral Studies, Scientific Council member for the Organization
for Autism Research, and former Executive Council member for the International Association for
Behavior Analysis (ABAI), in addition to her longstanding service on the Board of Directors for the
California Association for Behavior Analysis (CalABA), most recently as the 2020 Conference Chair. Her
interests include 1) protecting against a potential divide between science and practice and 2)
demonstrating how ABA produces socially significant improvements regardless of age or diagnosis.
Applied behavior analysis (ABA) is the “gold standard” for service provision aimed at helping young children diagnosed with autism spectrum disorders (ASD). However, the increased attention to this population may be detracting from the value associated with taking an ABA approach to support individuals of all ages, across a range of diagnoses. Further, the shift to define ABA as medically necessary for individuals diagnosed with ASD (APBA, April 10, 2020) requires effective patient, provider, and payor collaboration, and recent publications have highlighted the need for structured approaches to decision-making based in analytical ethics to support this transition. Accordingly, APBA released guidelines directing practitioners to provide services based on individualized risk exposure requiring a more patient-informed approach to care. The purpose of the current presentation is to outline a collaborative risk-driven approach designed to help guide practitioners to make ethically informed decisions regarding ABA service delivery, regardless of setting, age, or severity. Considerations regarding a potential divide between science and ABA-based service delivery will be addressed, including misconceptions about that which defines our professional and ethical obligations; specifically, how our related responsibilities extend far beyond particular ABA-based clinical programming procedures, necessitating constant empirical evaluation of the overall continuity of care for a given individual (e.g., placement, transition, community-based activities, and more).