ABA is under pressure—and a lot of it is deserved.

In this episode of Rad N Bad, Sean and Mike break down the real impact of North Carolina’s recent Medicaid policy changes and what they signal for the future of the field. This isn’t speculation. This is a direct response to rising costs, federal audits, and growing questions about how ABA services are delivered and justified.

For years, the industry has been highly effective at getting services authorized—but far less consistent at proving meaningful, real-world outcomes. Now, states are starting to ask better questions:

• Why this many hours?

• What is actually changing outside the session?

• Can caregivers implement the intervention independently?

• Where is the plan to fade services?

North Carolina didn’t eliminate ABA.

They challenged it.

And in doing so, they introduced a new reality:

• Telehealth is being restricted

• Supervision is being defined and enforced

• Parent training is no longer optional

• High-intensity services must be justified—monthly

• Exceptions for rural and underserved areas must be proven, not assumed

This episode goes beyond the policy language and gets into what it actually means for providers, BCBAs, and organizations trying to navigate the shift.

Sean and Mike also call out the uncomfortable truth:

At some point, hours became the product.

Instead of focusing on independence, generalization, and caregiver competency, parts of the field leaned into volume—and now the system is correcting it.

But this isn’t just criticism.

They break down what a defensible, outcome-driven model actually looks like, including:

• Lower direct hours with higher impact

• Parent-Mediated Intervention (PMI)

• Caregivers as the primary agents of change

• Measuring outcomes through adaptive functioning and real-world performance

• Building models that lead to titration and discharge—not dependency

The takeaway is simple:

This isn’t the end of ABA.

It’s a filter.

And the field is being asked one question:

Does what you do actually create independence?

Because the future of ABA won’t be defined by how many hours are provided…

It will be defined by what changes because of them.

Here is the policy if you would like to read it:

https://webservices.ncleg.gov/ViewBillDocument/2025/7815/0/H696-PCCS10584-LUXR-3

In this episode, Mike Carrero sits down with Dr. Nick Green, a behavior analyst who traded the clinic for the gym. As the founder of BehaviorFit, Dr. Green is on a mission to prove that ABA isn't just for autism—it's the secret weapon for human performance. They dissect the "Autism Industrial Complex," explore why only 20% of adults worldwide meet physical activity guidelines, and reveal why your "lack of motivation" is actually an environmental design flaw. Whether you're a "reconditioning athlete" chasing former glory or a professional trying to find time for a treadmill, this conversation reframes fitness as a sustainable behavioral contingency.

In this episode of the Rad N Bad Podcast, Sean Yocum and Mike Carrero sit down with Dr. Cheryl Tierney, Chief Medical Officer at EarlyPoint, to discuss a technological seismic shift in the world of autism evaluations.

For decades, the diagnostic process has been a subjective, "bottlenecked mess" relying on antiquated tools (some still asking if kids can use a VCR!). Dr. Tierney introduces EarlyPoint, the first FDA-cleared eye-tracking biomarker designed to provide an objective "yes/no" diagnostic aid for children aged 16 to 95 months.

Sean, Mike, and Dr. Tierney dive deep into how 12 minutes of passive video watching can capture tens of thousands of data points, comparing a child's social visual engagement to a normative sample with clinical precision.

Key highlights include:

• Beyond the "Wait and See" Trap: How EarlyPoint helps pediatricians in rural America skip the two-year waitlist and diagnose within the medical home.

• The "Subjective-Objective" Problem: A critical look at why traditional tools like the ADOS can be influenced by clinician bias or cultural/language barriers.

• Proactive vs. Reactive: Using eye-tracking to identify neurodivergent learning patterns before "outward symptoms" even fully emerge, allowing for intervention during peak neuroplasticity.

• The "Billion-Dollar Fridge": The story of how this tech shrunk from the size of a refrigerator to a portable, handheld device.

• Neurodiversity & Eye Gaze: Clarifying that the goal isn't "training eye contact," but ensuring children don't miss vital social learning opportunities.

Is technology finally catching up to the science of behavior? Join the guys as they vet the innovators turning the "Autism Industrial Complex" on its head.

To better understand how EarlyPoint works, it tracks where a child focuses during social interactions. While neurotypical children often focus on "social anchors" like eyes and mouths to gather information, children with autism may focus on non-social or peripheral details, leading to different data clusters.

https://earlipointhealth.com/

We need to talk about the "copy-paste" problem in our field. Across the industry, too many of us have become "milestone chasers"—clicking and dragging generic goals from standardized assessments into plans without ever considering the messy, beautiful reality of the family living them. An assessment is not a curriculum, and a milestone is not a program. If your intervention plan ignores the individual, you aren’t doing behavior analysis; you’re running an assembly line.

In this episode, we’re tearing down the template. We discuss why we’ve become so obsessed with checking boxes that we’ve forgotten how to engineer behaviors that actually grant our clients their freedom.

We’re diving into the "Three Pillars of Better Programming":

1. The Roadmap: Why your goals must be justified 3, 5, and 10 years down the road, and how to build a roadmap that actually captures family buy-in.

2. Domains vs. Targets: Why a score going up doesn't mean life is getting easier, and how to stop treating targets like ends rather than means.

3. Generalization as a Design Constraint: Why generalization should never be an afterthought, and how to define "mastery" by how a skill survives after the therapist leaves the room.

We’re done apologizing for how powerful this science is. It’s time to stop performing "circus tricks" in ideal conditions and start programming for the real world.

In this hard-hitting episode of the Rad N Bad Podcast, Sean Yocum and Mike Carrero dissect the explosive Wall Street Journal investigation that has sent shockwaves through the ABA industry: "The Boom in Autism Therapy Is Medicaid’s Fastest-Growing Jackpot."

Sean and Mike pull back the curtain on a system they’ve long warned was "hollowing out." They tackle the "Gold Rush" in North Carolina and beyond, where private equity firms have allegedly traded clinical rigor for "capacity utilization" and "frozen marathons." From the $340,000-per-child billing scandals in Indiana to the "ghost supervision" of bloated caseloads, this is a "clinical autopsy" of a field at a breaking point.

The duo doesn't stop at the headlines. They also analyze the Council of Autism Service Providers (CASP)'s defensive response, questioning whether proposed "policy guardrails" are a genuine fix or a silent admission of systemic failure.

Key highlights include:

• The 40-Year-Old Ghost: Why a 1987 study is still being used to justify 40-hour work weeks for toddlers.

• EBITDA vs. Outcomes: How the "strip and flip" private equity model creates "RBT factories."

• The Documentation Crisis: Why 99% of billing in some states is being flagged as "improper."

• The Exit Strategy: Why Sean and Mike believe a quality ABA model should plan for its own ending from Day 1.

It’s time to stop chasing ghosts and start building a model that empowers families instead of billing for seat time. Let’s get radical.

Welcome to the kickoff of our new series, Beyond the Clinic Walls, where we explore the raw, unpolished reality of applying ABA outside of traditional autism care.

In this episode, we’re joined by Matt Harrington, BCBA and the engine behind an ABA-focused Digital Marketing Agency. Matt has taken our most lethal clinical tools—reinforcement schedules, stimulus control, and motivating operations—and turned them into a blueprint for shaping consumer behavior and scaling brands.

We’re diving deep into:

• The Science of the Click: How to identify the "function" of why your customers are actually hitting that button.

• The Marketing SD: How to craft the perfect "call out" to ensure your audience raises their hand.

• Reinforcement Loops: Why marketing doesn’t end when the customer buys—it’s where the real behavior change begins.

• The "Florida Man" Factor: How understanding deprivation and environmental context (even during a hurricane) explains why people buy what they buy.

If you’ve ever wondered how your clinical background translates to the digital marketplace, listen up. We’re done apologizing for how powerful this science actually is.

Find Matt on Linkedin at: https://www.linkedin.com/in/matthew-harrington-bcba-8157b11b9/

Welcome back to the Rad and Bad Podcast, the only show in ABA where we willingly jump into the wood chipper of industry nonsense to see what comes out the other side. Today, we’re asking the question: Who the hell is Attend Behavior?

Sean Yocum is joined by Alan Fullbright, BCBA, to discuss why the field has spent the last decade tuning the "cup holders" of clinical data while the "engine" of caregiver support has been left to rot. For too long, parent training has been the "side dish" of ABA—a series of dry PDFs and awkward Tuesday-at-3-PM meetings that families are too burnt out to attend.

Attend Behavior is the "hold my beer" response to that status quo. By digitizing the gold-standard Rubi parent training program, they’ve created a life raft for families drowning in behavioral chaos.

In this episode, we kick open the hood on:

• The "Manual" vs. The "App": How Attend turned decades of research into bite-sized, "weaponized" modules that parents can actually use at 8:00 PM on a school night.

• The Scalability Crisis: Why the field can't produce enough clinicians to meet the demand, and why caregiver empowerment is the only way out.

• Monocles and Gatekeeping: A blunt look at the "BCBA superiority complex" and why we need to stop treating parents like they’re incompetent.

• The Death of "Train and Hope": Shifting the focus from clinical labor to caregiver leadership.

If you’re ready to stop treating symptoms and start empowering the real agents of change, it’s time to find out who the hell Attend Behavior really is.

https://home.attendbehavior.com/

Live from NCABA 2026 in Winston-Salem, NC, Sean Yocum and Mike Carrero take the stage for the first-ever live recording of the Rad n Bad podcast. In an industry that prides itself on data and behavior change, the guys ask the uncomfortable question: Why do we spend millions of dollars on conferences and return to the clinic on Monday without changing a single thing?

Sean and Mike strip away the "professional theater" and analyze the conference ecosystem through the lens of behavior analysis. They dive deep into:

• The Reinforcement Reality: Why the hallway is the "Super Bowl" of networking while the breakout rooms are just "intellectual cardio."

• Escape-Maintained Professionalism: Is your conference attendance a genuine pursuit of mastery, or just a high-end "escape from aversive stimuli" (like insurance paperwork and RBT call-outs)?

• The ROI of Vibes: Moving past participant satisfaction surveys to measure actual clinical outcomes and treatment integrity post-event.

• Hacking the System: How to shift from "Inspiration" to "Implementation" by redesigning CEUs around competency, follow-up, and measurable skill acquisition.

This isn't a "trash session"—it’s a call to action. If behavior follows reinforcement, it’s time to stop reinforcing attendance and start reinforcing outcomes. Grab a drink, pull up a chair at the bar, and let's get into the contingencies of why we do what we do.

In this episode of the Rad n’ Bad Podcast, Sean and Mike scrape off the "clinical veneer" to expose the "metallic stench" of a field currently governed by the path of least resistance. They are joined by a true industry heavy hitter, Rebecca Urbano Powell, CEO of Seven Dimensions Behavioral Health and a veteran with 25 years in the trenches.

The trio dives headfirst into the messy reality of 2026 ABA: where BCBAs have become "marionette puppets" for insurance funders and social media influencers. Rebecca breaks down why the "square peg, round hole" insurance model is failing families and why "good enough" data is actually a block of clinical sludge clogging client progress.

From her roots in old-school darkroom photography to picking apart Medicaid misinformation for fun, Rebecca brings the fire. She challenges every clinician to stop hiding behind "standardized packages" and start investing in their own mastery. This isn't just a podcast episode; it’s a call to arms for providers to stop being customer service reps and start being scientists again.

• The Photography Pivot: How the science of developing film mirrors the creativity needed in behavior analysis.

• Insurance vs. Reality: Why "medically necessary" boxes are strangling individualized care.

• The Power of Parents: Why grassroots family advocacy is the only reason the field still has a pulse.

• The Profit Problem: A candid look at why prioritizing bottom lines over patient outcomes is ruining the science's reputation.

• The Seven Dimensions or Bust: If you aren’t adhering to the dimensions, you aren’t doing ABA—you’re just billing for it.

"Learning shouldn't suck and punishment doesn't teach. I get to bring my fun and my humor into a scientific industry... why not?" — Rebecca Urbano Powell

Connect with Rebecca on Linkedin

https://www.linkedin.com/in/rebecca-urbano-powell-bcba-380b523/

The box of conversation is officially open. In this second installment of No-Man’s Land, Sean Yocum and Mike Carrero take on one of the most taboo subjects in ABA: Addressing and Treating Stereotypy.

As always, the rules are rigid—no "it depends" and no using "nuance" as a shield. The coin flip decides their fate, and this week, Mike is forced to argue for the treatment of stereotypic behaviors, while Sean defends the right to stim. From "Quiet Hands" to "Bodily Autonomy," the guys trade verbal nukes over whether reducing repetitive behavior is a violation of human rights or a necessary gateway to independence and safety. Can they find a middle ground that respects neurodivergent identity while still expanding a learner’s access to the world?

In this episode, we pressure test:

• Bodily Autonomy vs. Access to Learning: Is treating stereotypy "behavioral conversion therapy" or a prerequisite for functional communication?

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  The "Vending Machine" vs. The "Jumper Cables": How do we differentiate between aesthetic "normalizing" and clinical safety?

  
  

• Contingency Design over Behavior Reduction: Why the "Old Way" of suppression is failing and how to reframe treatment as expanding choices rather than constraining them.

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  Redefining Social Validity: Moving from "looking typical" to increasing the quality of life as defined by the learner and their community.

  
  

Stay edgy. Stay bad. Analyze that behavior.