In this episode of the Do Better Podcast, Dr. Megan and Joe discuss considerations around determining treatment intensity.
ARTICLE about POP-C
AI SUMMARY FROM FATHOM
Meeting Purpose
Live recording of the Do Better Podcast discussing how to determine appropriate service intensity for ABA therapy clients.
Key Takeaways
- There's a lack of standardized training/processes for determining ABA therapy hours
- New tools like POP-C (Patient Outcome Planning Calculator) are emerging to help guide decisions
- Many factors impact appropriate service intensity beyond just client needs (e.g. family capacity, funding constraints)
- More research is needed to determine optimal ways to prescribe treatment intensity
Topics
Current State of Service Intensity Decision-Making
- Historically, funding limitations often dictated hours (e.g. 6-10 hrs/week)
- Many BCBAs receive no formal training on how to determine appropriate hours
- Some organizations developing internal tools/processes, but no industry standard
- New research-based tools like POPC starting to emergePOP-C (Patient Outcome Planning Calculator)
- New tool published in 2023 to help determine service intensity
- 33-question assessment placing clients into high (30-40 hrs), medium (20-30 hrs) or low (up to 20 hrs) tiers
- Considers factors like diagnosis, behavior severity, communication skills, social avoidance
- Still in early stages
- authors seeking beta testers
Challenges in Determining Appropriate Hours
- Balancing clinical recommendations vs. family/logistical constraints
- Insurance requirements may not align with clinical judgment
- Difficulty measuring impact of prescribed vs. actual hours received
- Varying capacity of families to supplement therapy hours
- Considering opportunity costs (e.g. school time) of intensive 1:1 therapyFunding and Industry Trends
- Some providers only accepting clients who can meet minimum hour thresholds - Medicaid/insurance cutting back on covered services in some areas
- Potential for very limited covered hours (e.g. 4 hrs/month) in future
- Need for efficiency and prioritization if hours become more constrained
Next Steps
- Interested BCBAs can reach out to POP-C authors about beta testing
- Continue monitoring emerging research and tools for determining service intensity
- Consider how to adapt practices if funding becomes more limited in future