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