Tag: ABA

5 Tips for Navigating Autism Treatment for Your Multilingual Child

Author: Clinical Development Manager Maia Jackson, M.S., BCBA | Updated On
Clinically Reviewed By: Geneviève Marshall, PhD, BCBA-D, LBA

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Language development is a critical component of the day-to-day lives of young children. It is used within a variety of contexts, including playing with peers, building relationships, functionally communicating needs, etc. As such, there is a heavy emphasis on language and communication built into most applied behavior analysis (ABA) programs. Because such a heavy emphasis is placed on language, it is important that practitioners are mindful of the specific language or languages that are incorporated in the therapeutic setting. The Association for Science in Autism Treatment recommends supporting  bilingualism for children with autism by encouraging family-centered, culturally sensitive language choices.

By promoting the use of the family’s native language, children have an increased likelihood of communication opportunities with their immediate and extended families, friends, and community. In addition to having more opportunities to communicate, the quality of the interactions will be more meaningful as caregivers are more likely to effectively express their own emotions, hold their child’s attention, and more thoroughly discuss topics of interest when using their native language (Zhou, et al., 2019). There are also benefits to multilingualism outside of the familial unit. Research has shown that children who are raised in multilingual homes tend to demonstrate higher perspective talking skills than children who do not (Zhou, et al., 2019). Despite all of the benefi ts to speaking one’s native language, families often face a number of barriers, especially when seeking out autism-related services.

While we live in a culturally diverse country, English remains the dominant language in most regions of the U.S. When children turn on the TV, chances are the shows they watch are in English. When they go to school, they will receive a primarily English education and their peers will speak primarily English. Autistic individuals who receive behavior analytic treatment in the U.S. are likely receiving those services in English. Despite all of these barriers, there are ways for parents and caregivers to advocate for their bilingual children and family.

1. Look for providers who speak your native language. 

One of the first measures to take when selecting a service provider is to request clinicians who speak your native language. Bilingual service providers can be hard to find and it may take time, but let your provider know your preference so they can attempt to hire and/or pair you with appropriate staff members.

2. Request translation services.

In cases where there are no staff members available to provide services in your native language, consider asking for translation services. Even if you are proficient in English, it may be easier or feel more comfortable for you to communicate in your native language. Per the Behavior Analyst Certification Board’s (BACB) Ethics Code for Behavior Analysts, the clinician you are working with should make every effort to effectively communicate with you and provide you with the opportunity to ask questions and participate in the development and implementation of your child’s program.

3. Consider the assessment language.

If your child speaks a language other than English, it is important to discuss the benefits of your child being assessed in that language. Providers use assessment results as a tool to guide the clinical program and decision making. Having the results of the assessment in your child’s primary or dominant languages will give a more accurate picture of your child’s strengths and areas of need. The starting point of the program will be more representative of your child’s language abilities.


4. Ensure the program is visually representative of your child and your family.

Visual tools and stimuli are often used as prompts, supports, and/or reinforcement systems within many ABA programs. These visual supports may serve to outline a schedule for the day, visuals might accompany a short narrative or story describing a social scenario your child might encounter, or you might see visual images used as reminders or prompts of what steps come next in routine with multiple steps, such as hand washing.  These visual items should be representative of your child and your family. Discuss incorporating your native language and culture into these items in order to promote their use and acceptance by your child. If your child accepts the stimuli and is motivated to use them, effectiveness of their intended purpose will likely increase. 

5. Discuss your language and other cultural values with your team.

Per the Ethical Code for Behavior Analysts, your cultural norms, traditions, and expectations should be extended through all aspects of the ABA program. Social interactions, communication, play activities, and activities of daily living are areas that are addressed in many ABA programs and are going to be affected by language, culture, and traditions. Discussing the ways your language and culture impact your day-to-day routines and expectations will help the clinical team develop and implement a program that is best suited to your child and your family.  

Serving as the navigator and advocator of your child’s services is a huge role. Advocating for language will often be just as important as advocating for hours, goals, or other supports.  Use your team to provide support and to feel empowered to be the advocate your child and your family need.

What is Contemporary ABA?

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Clinically Reviewed By: Geneviève Marshall, PhD, BCBA-D, LBA

People often say that history is written by the victors. When the colonists won the American Revolution, they described the war as a noble struggle to escape tyranny. Had the British won, history books might have called it a heroic effort to save the empire from ungrateful rebels. 

In the same way, most people in America are able-bodied, so they decide what is “normal.” For example, we might see an autistic brain or someone with poor eyesight (but stronger other senses) as less valuable. But really, these are just different ways of thinking and living. 

For more than 60 million Americans with disabilities, this can be a challenge. They have to fit their lives into a world designed for able-bodied people, even though it would be easy to make the world work for everyone.  

Ableism and Ableist Misconceptions

Contemporary treatments include the individual in planning when possible. Contemporary practices change in response to the voices of those who have received therapy in the past. 

Ableism is when able-bodied people assume everyone is like them and fail to see the challenges people with disabilities face.  

Ableism includes unfair ideas, such as thinking people with disabilities always need help, even if they don’t ask for it. Not all disabilities are visible, which can lead to wrong assumptions about mental illnesses being different from physical ones. These false beliefs make it harder for people with disabilities to be treated equally and included in society.  

ABA Intervention

Applied behavior analysis (ABA) is widely regarded as the most effective treatment for autism, supported by decades of research. It isn’t a single therapy method. Instead, it’s a flexible approach that uses different techniques to help children build the skills they need to thrive at school and in daily life. 

Recently, ABA has increasingly become the target of much controversy as self-advocates are speaking up about their experiences. They reject the idea that teaching people with autism the skills deemed necessary without their input or choice. Some advocates say independence is meaningless without happiness and that people with autism should choose their own goals, which might not include fitting in with others.  

ABA, which is essentially the science of good teaching, has a long history and was originally developed in the 1960s by a group of researchers at the University of Washington. ABA was used to treat individuals with developmental disabilities and initially was a rigid, highly structured and teacher-directed program, which led to some of the negative experiences and associations with ABA. Historically, for example, ABA was used to reduce or eliminate “stimming” – repetitive physical movements and sounds that may soothe and reduce anxiety. We now better understand that stimming helps people with autism manage their sensory processing and their environments. 

Just like in other areas of medicine and science, the field of ABA has advanced in a significant and meaningful way to become a play-based, naturalistic, family-focused and individualized, contemporary treatment that is tailored to the unique needs and goals of everyone. A good ABA program collects and reports data to show effectiveness. Providers must demonstrate success, validated by parents, through goals set with the family. If your provider doesn’t follow this approach, they may not be using best practices.  

ABA now adapts to individual needs by learning from adults. While negative experiences must be addressed, dismissing ABA entirely overlooks its success for many. Good programs focus on the client, seek consent, and value input. Research and ask key questions when choosing a provider.  

What to Look for in an ABA Program 

  • Will I participate in determining the goals of treatment for myself/my child? 
  • How are your staff trained? 
  • How is my child’s program developed? Do all clients receive the same program or are they individualized? 
  • Will there be parent goals as part of my child’s program? 
  • How often is my child’s program modified or revised? 
  • How is data collected and reported? 
  • How often will I see data on my child’s progress? 

Your child’s program should be client-centered and future looking, which means that your family and relevant caregivers are providing input into your child’s strengths and challenges, and that you and your child are helping to guide the goals of his/her program based on your preferences and needs. 

The science of ABA has a long history with decades of research to support its development and evolution. While ABA is most widely known in its application to autism, ABA was developed, and has been applied, to address many circumstances regarding behavior that matter to society. ABA is applied in many different areas, including mental health, animal training, organizational behavior management, marketing, forensics, sports, and physical health, to name a few. Just as other areas of science and medicine advance and application of treatments change, so has the field of ABA. Many lives have been impacted by ABA for the better. It is incumbent upon the professional community to listen, learn, and evolve its practice so that their services are as relevant and effective as possible. After all, the purpose of ABA is to help children with autism achieve the goals that matter most to them and their families — goals that foster growth, independence, and joy in their everyday lives.  

Big Moments & New Beginnings: LEARN Behavioral Learning Center Openings!

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We are thrilled to announce that we have expanded our reach by opening several new Learning Centers over the past year! This has been an incredible year of growth and excitement for LEARN Behavioral, allowing us to help even more children and families find success in school and life. Check out some of the exciting highlights below, and browse our newest locations here.

Q&A About ABA Therapy for Children with Autism: FAQ for Caregivers

Author: Senior Clinical Director Dr. Ashley Williams, PhD, LABA, BCBA-D, | Updated On
Clinically Reviewed By: Geneviève Marshall, PhD, BCBA-D, LBA

Was your child recently diagnosed with autism? Are you beginning to navigate treatment for your child? Before you get started, check out these seven FAQs about ABA therapy.

What is the goal of ABA therapy?

ABA therapy is designed to support autistic individuals and their families, achieve their identified goals, and improve their quality of life. ABA-based interventions are supported by decades of research and enhance social, communication, play, and adaptive skills. Services incorporate the needs and interests of the autistic individual and their caregiver(s). A behavior analyst delivers the ABA services with the help of behavior technicians, who often provide direct care to the autistic individual. Services are tailored to the individual’s unique needs, with their feedback, and evolve over time. Services for children may look quite different than services for adults, given the individuals’ needs differ over time.

What is “contemporary ABA therapy”?

At LEARN, we refer to our approach as “contemporary ABA.” It is an evolved approach to ABA therapy that promotes individualized treatment, naturalistic and play-based teaching, and is person-centered. LEARN provides a contemporary approach that acknowledges the evolution of ABA, values the individual and their family, and creates space for individuality. Practicing contemporary ABA means that our behavior analysts deeply understand their responsibility to positively and meaningfully impact the lives of the individuals served.

How many hours of ABA therapy will my child receive?

Your child’s hours will be determined between you and your behavior analyst. Your behavior analyst recommends hours based on assessing your child’s needs, other therapies received, and your feedback as the parent/caregiver. Focused programs range from 10-25 hours per week, and comprehensive programs range from 30-40 hours weekly. At LEARN, we provide home-based, center-based, and community-based services, and you can reach out to your local clinical director to find out which services are available in your area.

Are your ABA therapy services individualized?

Absolutely! Each autistic person we serve is unique, and we believe that should be celebrated. Our goal is to promote individual interests and incorporate those into ABA therapy. Behavior analysts make individualized recommendations for services, including hours based on the child and customized goals that fit their needs. Behavior therapists receive training on how to understand the preferences of their clients and include those in sessions to make them fun, rewarding, and engaging.

How is neurodiversity integrated into your approach to ABA therapy?

Listening to the perspective of autistic folks has informed our approach to ABA therapy and led us to incorporate neurodiversity into our practice. Our goal is to elevate the autistic voices in our community, including the individuals we serve, our neurodivergent employees, and the greater neurodivergent community. We’re deeply committed to person-centered ABA therapy practices and promote assent-based care, meaning we validate the identities and experiences of neurodivergent folks and create space for autistic voices to be heard and upheld.

Will my child be required to do discrete trials and sit at a table?

Not all autistic folks benefi t from discrete trials or tabletop work. For example, a two-year-old child with lots of energy may benefit more from a play-based approach with the therapist sitting on the floor and embedding learning opportunities in play with their favorite toy. Behavior analysts overseeing the treatment plan take time to assess the individual’s needs and work collaboratively with the family to identify an approach to treatment that will work best for the child.

What if someone doesn’t want ABA therapy?

We understand that not everyone seeks ABA therapy, feels it’s the best fit, or perhaps, thinks it’s the right time to try. As with other medical services, the patient (along with their caregiver, if a child) has the right to decide when, if, and what treatment is right for them. Not all ABA therapy providers have the same approach, either, and LEARN supports a family’s right to choose a provider that meets their needs and is a good match for their treatment goals. We want families and our clients to be excited about services and encourage collaboration on our journey together.

Meet Michael Maloney, Founder and CEO of LEARN Behavioral

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Michael Maloney, Founder and CEO of LEARN Behavioral, joins us to share about his early career in education and how a small consulting company grew into an organization that now provides autism services in over 17 states (23 with LEARN Academy). In this conversation, we also explore his insights about the changing landscape of services for families. Michael shares, “In the last ten to twelve years, there has been an absolute sea change. When we started, four states covered services, and now all 50 do. Parents often had to pay out of pocket, and few could afford to. The financial burden has lessened so significantly because of the growing awareness and advocacy.”

Watch the video interview at www.allautismtalk.com.

Planning Fun Summer Activities for Children with Autism

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Summertime offers opportunities and challenges for all parents. For parents of children with special needs, both may seem magnified. Here are some helpful tips to consider when planning your child’s summer break:

PLAN AND DISCUSS AHEAD OF TIME
As summer begins, discuss with your child any changes and plans that might occur. Give your child multiple opportunities to ask questions and to process what their summer might be like. Find out if there are activities that he or she might like to explore. Offer examples and be prepared to discuss details of what might be expected.

CONSIDER A DAILY SCHEDULE
Schedules are often difficult to create and maintain, but having one in place can be a huge stress reducer. During the school year your child may be used to a morning routine, a predictable school schedule and consistent after school activities. The summer can undo much of that, so having a schedule in place can give some comfort and predictability. It can also allow you to program important goals, such as practicing social skills, keeping up with academics, and reducing video game and TV time. Ideally, an outside activity such as sports would be on the schedule each day. Even if a child doesn’t participate on a team, a sports or exercise activity that can be performed in the yard, at a gym, or on a play date has obvious health benefits, and increased physical activity helps reduce repetitive behaviors and improve sleep.

KEEP UP THE HOMEWORK ROUTINE
It’s okay to have less of it, but keeping a homework routine in place can be valuable, since you’ve worked hard to develop and maintain this routine throughout the school year. A more casual approach over the summer can result in setbacks when school begins again. Plus, it’s a positive and productive routine in which you can insert more social skills related content. Consider buying a workbook on social and emotional skills that can be a focus of the summer homework routine.

WORK ON SOCIAL SKILLS
This is the biggest opportunity provided by the summer break. Working on social skills goals can take many forms—as a homework assignment, as mentioned above, or expanding involvement in the community, sports, and play dates. Some parents forget that activities like swim lessons, barbecues, and vacation trips can all be valuable new settings to prompt the use of social skills. A summer job, in any form, often provides social opportunities.

TURN OFF THE VIDEO GAMES AND TELEVISION
Many of us struggle with this, since video games and television provide a much-needed break for parents, providing easy and low-cost entertainment. While it’s easier said than done, limiting these activities is critical for social development and critical thinking. We all know that sitting in front of any machine for long periods is counterproductive, so, enough said!

REMEMBER THAT IT’S YOUR SUMMER TOO
Without the routine of the school year, summer can feel like an extra burden to parents as they try to keep their children occupied and happy. Remember that summer is for everyone, so try to include activities that are interesting to you, too, and can hopefully be enjoyed by the whole family. The beach, an outdoor festival or concert, a hike or sculpture garden— whatever you plan, it’s okay to create a few summer memories of your own.

Watch our Parent Video: Summer Activities for Kids with Autism in Your Community

Here are some additional resources to help make your season great for the whole family:

Prevalence of Autism Spectrum Disorder – What you should know

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On April 27, 2018, the Centers for Disease Control and Prevention (CDC) released a new report on the prevalence of autism spectrum disorder (ASD) in the United States. The prevalence estimates show an increase from 1 in 68 children from the previous report in 2016 (Christensen, Baio, Van Naarden, Braun, et al., 2016) to 1 in 59 children in the current report.  The CDC established the Autism and Developmental Disabilities Monitoring Network (ADDM) in 2000 to provide prevalence estimates of children diagnosed with ASD.  ADDM releases surveillance data every two years.  The data for the current surveillance were collected at sites in 11 different states using health and educational records of children 8 years of age.

The results of the ADDM report suggest the increase in prevalence of ASD may be due, in part, to the identification of ASD in children from diverse racial and ethnic backgrounds.  Previous ADDM reports noted a disparity in the prevalence of ASD with more Caucasian children identified with ASD than black or Hispanic children. The racial, ethnic, and socioeconomic disparities in children diagnosed with ASD has been highlighted in numerous empirical studies (e.g., Durkin, Maenner, Christensen, Daniels, Fitzgerald, Imm, Lee,…Yeargin-Allsopp, 2017; Mandell, Wiggin, Carpenter, Daniels, DiGuiseppi, Durkin,…Kirby, 2009; Tek & Landa, 2012).  Later identification of ASD results in a delay to accessing effective treatment.  Empirical research over the years consistently finds early intervention to be effective at increasing a variety of adaptive skills. It is important to remember that the American Academy of Pediatrics recommends that all children in the U.S. be screened for ASD at 18 and 24 months.

There is no cure for ASD. However, interventions based on the principles of applied behavior analysis (ABA) have been shown to have a beneficial impact on individuals with ASD.  Decades of research indicate that ABA-based interventions can increase communication and adaptive skills and decrease challenging behavior.  Although early intervention is critical, adolescents and adults benefit from ABA-based interventions.  The key is to identify a qualified professional (i.e., Board Certified Behavior Analyst or BCBA) with training and experience working with individuals ASD to work with your family.  A qualified BCBA will be able to develop a well-rounded program to meet the needs of your child and your family.

To access the 2018 ADDM report visit the website https://www.cdc.gov/ncbddd/autism/addm-community-report/index.html

To learn more about the Autism and Developmental Disabilities Monitoring (ADDM) Network visit the website https://www.cdc.gov/autism/

Reliable resources:

– Dr. Hanna Rue

Christensen DL, Baio J, Van Naarden Braun K, et al. Prevalence and characteristics of autism spectrum disorder among children aged 8 years—Autism and Developmental Disabilities Monitoring Network, 11 sites, United States, 2012. MMWR Surveill Summ 2016;65(No. SS-3): 1 -23.

Durkin, M.S., Maenner, M.J., Christensen, D., Daniels, J., Fitzgerald, R., Imm, P., Lee, L.C.,…Yeargin-Allsopp, M. (2017). Autism spectrum disorder among US children (2002-2010): Socioeconomic, racial, and ethnic disparities. American Journal of Public Health, 107, 1818-1826.

Mandell, D.S., Wiggin, L.D., Carpenter, L.A., Daniels J., DiGuiseppi, C., Durkin, M.S., …Kirby, R.S. (2009). Racial/Ethnic disparities in the identification of children with autism spectrum disorders.  American Journal of Public Health, 99, 493-498

Tek, S. & Landa, R.J. (2012) Differences in autism symptoms between minority and non-minority toddlers. Journal of Autism and Developmental Disorders, 42, 1967-1973.

Planning a Fun and Safe Summer for Kids with Autism

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Summer is officially here and along with the joy of concluding another school year, comes the challenge of navigating so many unscheduled, unpredictable and unexpected elements of the season.

Here are some helpful tips for planning your family’s summer activities that we hope will help create more fun and reduce the stress:

Maintain Some Structure
Try to maintain your child’s typical eating and sleeping schedule as much as possible. It’s not easy to stick to a schedule during summer, especially as this is a time when you want to let go a bit and relax. If you can maintain the basic structure of your child’s routine, you are less likely to have an overwhelmed child and the disruptive behavior that results.

Theme Park Programs
Visiting theme parks is a summertime family favorite but it also can bring a host of challenges for any child on the spectrum. Many parks offer Ride Accessibility Programs or Fast Pass programs for individuals with disabilities. If this is not an option for your family, there are other strategies such as planning your route ahead of time, splitting up (one parent goes with one child to an attraction while the other parent goes with another child to a different one), and bringing noise cancelling headphones to give your child a sensory break, etc.

Prepare in Advance
Travel requires specific preparation for children on the spectrum. It is important to familiarize your child ahead of time with the destination using photographs, videos etc. If your child has never flown or stayed in a hotel before, practicing these on a small scale (a one-hour flight first and a one-night stay at a local hotel are a really good idea).

Travel Safety
It is really important to understand a lot about where you will be staying during your vacation and the level of security of those locations. For example, if you are renting an apartment or home, it is critical that you check that each door has a lock and that the perimeter of the house is secure. Check whether your child can exit the location unassisted and be aware of what you need to do to secure the premises.

It Takes a Village
While vacationing, introduce your family.  Families who share with those around them, (especially in unfamiliar places like vacation destinations) about their child’s special needs tend to experience a more accommodating and supportive community. Helping others understand how they can help, can make your experience more relaxed and enjoyable.

Get Support From Your Team
Remember to use what works for your child while planning your family’s activities.  If you are working with an ABA provider, ask for assistance with goals that support a specific outing or trip.

Here are some additional resources to help make your season great for the whole family:

Watch our Parent Video: Summer Activities for Kids with Autism in Your Community

Structural Racism and its Impact on ABA: Disparities in Diagnosis and Treatment

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LEARN is committed to fostering a culture that embraces what makes us each unique—be it race, ethnicity, gender/gender identity, sexual orientation, religion, national origin, disabilities/abilities, or socioeconomic background. LEARN aims to acknowledge the lived experiences and diversity of perspectives of our staff and welcomes our teammates to share their stories to help foster conversations about diversity, equity, and inclusion in our communities.

By: Jasmine White, M.S., BCBA, Behavioral Concepts (BCI)

Today, the topics of diversity, equity, inclusion, and equality are at the forefront of many organizations. The long-standing impact of structural racism and its influence on society can no longer be disregarded. People of all creeds are speaking out against injustices and the need to promote inclusion. The dialogues on disparities have led me to reflect on the field of applied behavior analysis (ABA) and the community which it serves. To what extent has structural racism impacted ABA as a practice? Are ABA practitioners able to identify biases within the field? What is the impact on the provision of services? How does it influence diagnosis? The literature on structural racism has shown that even the most well-intended person can possess biases, we are not immune. Therefore, it is our time as a community to gain an understanding of how structural racism has affected the field of ABA.  

Here at LEARN, it is our goal to contribute to a brighter future for all, which means bringing to light sensitive topics that are impacting the communities we serve. While this may be an uncomfortable conversation, it is needed for the development of cultural humility in ABA practice. LEARN’s focus is twofold, call attention to and create a constructive conversation around disparities in diagnosis and treatment related to diversity, equity, and inclusion. As an organization that serves a diverse population, it is our responsibility to bring attention to the disparities experienced by those we serve and to be a part of the solution towards lasting change. 

Ethnicity is known as belonging to a specific racial, national, or cultural group and observance of that group’s customs, beliefs, and or language. Depending on ethnicity, one may have a life exposed to more inequalities. For racial and ethnic minorities in the United States, these inequalities include health disparities, such as higher rates of chronic disease, lower life expectancy, and decreased quality of life compared to the rates among non-ethnic minorities.

Ethnicity also has a direct impact on how early autism is identified, evaluated, and diagnosed. Research shows that not only do Black and Latino children with autism spectrum disorder (ASD) receive their diagnosis and start intervention at an older age than White children with ASD, but they also less frequently receive evidence-based interventions. For Black and Latino families, this directly impacts service opportunities, outcomes, and quality of life. According to the Center for Disease Control, studies have shown that implicit bias, lack of access to healthcare services, and non-English primary language are potential barriers to the identification of children with ASD. The research established that Black and Latino children receiving ABA services were more likely to score lower on caregiver reports of health care quality than their White counterparts, including areas of access to care, referral frequency, number of service hours, and proportion of unmet service needs.  

As a community, we must investigate ways to expand access and resources to those who so desperately need services. Identify areas of structural racism and work to reduce and eliminate them from ABA practice. Train our practitioners to identify and bracket implicit biases. Find communication methods so that all families can have a voice regardless of the primary language spoken. Explore ways to have open and honest networks of communication so that we can continue to have conversations that evoke change. Here at LEARN, we hope to be a part of the solution to these disparities so that we may create an environment where there is equity in access for those we serve.  

Discover more about LEARN Behavioral’s Diversity, Equity, and Inclusion initiatives. Let us find ways to work together to increase awareness and improve access to the communities we serve. Together, we can achieve more.

LEARN pledges to create a community centered around trust, respect, tolerance, and empathy. Read more about LEARN’s DEI journey in our 2021-22 DEI Annual Report and find out how we are investing in our clinicians’ cultural competence and increasing the diversity of our clinical team. Together, we’re better.

Jasmine is a BCBA and has worked with BCI for four years. She recently graduated Magna Cum Laude with a Master of Science in ABA from Bay Path University in Longmeadow, Massachusetts. Jasmine is currently conducting her thesis on Implicit Bias in ABA and is looking forward to expanding multiculturalism research in the field.