Autism law would help families and move Pennsylvania forward opinion

Through Amanda Fischer

In a recent comment by Capital-Star (Autism Legislation Before Pa. Senate offers families false promises, 10/18/22), former Speaker of the Pennsylvania House of Representatives Dennis M. O’Brien wrote about the legislation currently in the Pennsylvania Senate. This answer is an attempt to correct what I believe to be inaccuracies found in this article.

The article had some specific points worth repeating. And O’Brien deserves much credit for his years of service and advocacy for the autism community.

It is undeniable that serving those with autism spectrum disorders (ASD) and behavioral health needs is a complex challenge, as the commentary notes. It is also recognized that the research literature supports the use of principles and interventions based on applied behavior analysis (ABA) as highly effective in assisting individuals within this population to achieve their individual goals.

ABA is often considered the “gold standard”. It is also true that ABA is not just a treatment measure and has many uses outside of the autism-related area.

Let’s start with a precise definition of applied behavior analysis (ABA). ABA is a science (not a treatment or intervention, but a complete scientific approach) focused on the development of behavior change technology by discovering and analyzing environmental events that reliably influence behaviors of importance to individuals and society as a whole.

Autism Legislation Before Pa. Senate offers false promises to families

This means it is a data-driven problem-solving process that helps individuals achieve their behavior change goals, rooted in behavioral science. It is not any principle or intervention. It is also a professional field, not simply an approach that anyone can say they use simply because they are familiar with the above definition or some of the principles within the field.

As a professional field (such as Nursing, Speech Language Pathology, Medicine), ABA has national professional organizations that have been codifying ethical guidelines, training and experience standards, national body examinations, national body certificates, etc. for decades.

The American Medical Association (AMA) has a similar definition of ABA, defining a qualified healthcare professional in ABA as one who holds the nationally recognized Board Certified Behavior Analyst (BCBA) qualification. The ABA area has CPT billing codes and taxonomy approved by the American Medical Association (as is common in other healthcare areas). Therefore, ABA cannot be summed up as merely an approach followed by many professionals.

There are hundreds (more than 20 in the Commonwealth) graduate schools offering masters and doctoral programs in applied behavior analysis, which require years of training covering only part of the decades of research and many sub-specialties in the field.

I believe it is critically important to correct the charge that legislation sponsored by Rep. Thomas Mehaffie, R-Dauphin, (HB19) would threaten Act 62 of 2008, the Autism Insurance Act, and reduce the number of professionals who can provide ABA services, disrupting services for many children and adults with ASD in the Commonwealth.

That’s wrong.

Mehaffie’s bill simply establishes a behavior analyst license in Pennsylvania, which includes 36 other states, including four of Pennsylvania’s neighboring states. This is completely independent of Law 62 of 2008 and does not change anything in that law. The goal of Mehaffie’s bill is to license behavior analysts as a nationally recognized profession, thereby improving access to ABA services and patient safety.

It also explained that HB19 would increase the cost for people seeking the credentials as they “have to pay the costs and fees that are required by a California-based board.”

This is also a false statement. Mehaffie’s bill defines a certifying entity as “a board-approved non-profit organization that offers programs for recognized professional practitioners of applied behavior analysis who are accredited by the NCCA or the American National Standards Institute or successor institute.”

However, it is true that there is primarily one (although others have recently emerged) international certification body that is widely recognized for ABA (similar to other fields). That entity is the Behavior Analyst Certification Board (“BACB”), headquartered in Denver, not California.

The BACB is a non-profit certification agency accredited by the National Commission for Certifying Entities (which accredits certification programs in nursing, counseling, emergency technicians, etc.).

The BACB is the nationally recognized certification body in the field of ABA because it has been able to devote decades and immeasurable resources to creating and continuously updating a code of ethics, training and experience standards, content and task competencies, and a board exam informed by a job task -Analysis process involving hundreds of subject matter experts and frequent revisions to keep in touch with changes in the field.

National standards and national certification bodies are standard in all legitimately recognized areas, and HB 19 gives the State Board of Medicine authority to recognize BACB or any other certification body that meets the board’s standards – not “a California resident board.”

In summary, Mehaffie’s bill does not harm families, consumers, providers or professionals. Why wouldn’t Pennsylvania want to join the 36 (and counting) other states with a behavior analyst license so we can expand access to providers and protect consumers?

Finally, the ABA in PA initiative would like to thank the professional bodies of our colleagues who came to the table to negotiate the language surrounding Mehaffie’s proposal.

We hope this bill will pass and be signed by Governor-elect Josh Shapiro at the next session of the Pennsylvania General Assembly.

dr Amanda Fisher is a Board-Certified Doctoral-Level Behavior Analyst and Associate Professor at the Philadelphia College of Osteopathic Medicine. She is also President of the Pennsylvania For ABA Association. She can be reached at [email protected]