Behav Analysis Practice (2017) 10:164–166 DOI 10.1007/s40617-017-0172-1
DISCUSSION AND REVIEW PAPER
The Registered Behavior Technician™ Credential: A Response to Leaf et al. (2017) James E. Carr 1 & Melissa R. Nosik 1 & Iser G. DeLeon 2
Published online: 13 February 2017 # Association for Behavior Analysis International 2017
Keywords BACB . Behavior analyst certification board . Behavior technician . Certification . Credential . Registered behavior technician . RBT
The authors of Leaf et al. (2017) have requested a response from the Behavior Analyst Certification Board® (BACB®) to their concerns about the Registered Behavior Technician™ (RBT®) credential. Leaf et al. (2017) is the latest in a series of public and private communications from these authors expressing a general dissatisfaction with the BACB’s credentialing activities. Their primary concern—again—is the BACB’s adherence to national and international standards for developing credentialing requirements rather than using an alternative approach to generate requirements that better correspond to their worldview. The discontent expressed in Leaf et al. (2017) is fundamentally a restatement of the arguments first appearing in the book chapter titled To BACB or not to B? by Leaf, Taubman, Bondy, and McEachin (2008). In fact, their thesis about the Board Certified Behavior Analyst® (BCBA®) credential at that time was as follows: BWe are concerned that the BCBA credential is not the ‘Gold Standard’ that everyone has been longing for. In fact we think that the cure might be even worse than the illness!^ (p. 49). Representatives of the BACB have communicated with these authors multiple times over the years, but it has become clear that there are simply fundamental disagreements between the
* James E. Carr [email protected]
parties about the nature and structure of professional credentials. Although the prior approach of communicating directly with the BACB about their concerns was ostensibly the most efficient and direct way to correspond, apparently this dialogue is now to occur within the scholarly literature. The BACB was established from its onset to follow procedures for developing standards that (a) align with best practices in the credentialing industry and (b) are legally defensible (American National Standards Institute, 2016; Institute for Credentialing Excellence, 2016). Any credentialing standard that is not legally defensible (e.g., consistent with antitrust laws) is likely to be quickly reversed after the inevitable legal action by applicants who do not meet the standard. The recommendations by Leaf et al. (2017) appear uninformed by legally defensible credential development, which would render unproductive a point-by-point response to each of their concerns about the RBT credential. In addition, several contradictions and misinformation are found within their comments. An example of the former is the authors’ concern that the RBT credential might increase the cost of intervention, although their recommendations would undoubtedly result in a considerably more expensive certification program—consider the logistics and expense associated with the review by trained behavior analysts of over 1000 submitted video samples per month. Examples of the latter include the assertions that the RBT credential was created to address a shortage of frontline staff (it was not1) and that Board Certified Assistant Behavior Analysts® (BCaBAs®) should meet the same supervision standards as BCBAs (they do2). We will, however, focus our remaining comments on the authors’ core argument 1
1
Behavior Analyst Certification Board, 7950 Shaffer Parkway, Littleton, CO 80127, USA
2
University of Florida, Gainesville, FL 32611, USA
The RBT credential was developed in response to various stakeholders (e.g., funders, legislators) who sought a credential for the individuals who actually make direct contact with clients. 2 BCBA and BCaBA supervisors must both meet identical BACB requirements for supervision of RBTs.
Behav Analysis Practice (2017) 10:164–166
that credentialing standards be the product of empirical research. As we mentioned earlier, the BACB follows specific procedures for establishing and revising important credentialing standards (Johnston, Mellichamp, Shook, & Carr, 2014). The cornerstone of this process is the use of groups of carefully selected and representative subject matter experts (SMEs) from the profession to study specific standards and make recommendations to the BACB's Board of Directors after considerable deliberation. The Board of Directors, itself a body of SMEs, may then accept or deny (but not modify) the recommendations. The BACB currently uses over 100 SMEs each year for its standards and examination tasks, and critical standards are fully re-evaluated at least every 5 years. This process ensures that the BACB’s standards come from the profession and not from BACB staff. The initial RBT standards (BACB, 2013) were outcomes of established SME and job analysis procedures and these will be used again when the standards undergo periodic review. In contrast to the standard-setting process described above, Leaf et al. (2017) recommend that standards instead be the product of empirical research. Here is a sample of the research questions proposed by the authors: Have the BACB credentials been successful in resulting in more qualified providers and improved services? (p. 3); Are 40 h of RBT training enough to produce improved client outcomes? (p. 5)3; Is the age requirement for RBTs (18 years) appropriate to provide sufficient outcomes? (p. 4); Does mastery of skills on the RBT Task List produce better client outcomes? (p. 6); Do RBT credential components help protect consumers (p. 8); and Does RBT certification lead to improved outcomes as demonstrated in prospective randomized controlled studies? (p. 8). As scholars ourselves, we welcome additional research on all aspects of behavior analysis, including credentialing standards. However, there are unique challenges associated with the research necessary to appropriately and unambiguously answer questions about specific standards that are not evident in the Leaf et al. (2017) recommendations. The lowest effort approach would be correlational research in which a large body of practitioners are measured on two variables: a predictor variable (e.g., number of hours of training) and a criterion variable (e.g., quantification of a practitioner’s client outcomes). Setting aside the difficulty of operationalizing and measuring these variables, a single correlational study would be insufficient for establishing a professional standard because of important differences between practice areas (e.g., autism, 3 The authors provided examples of intervention studies (e.g., Lovaas, 1987) in which behavior technicians were trained for more than 40 h (the current minimum duration of RBT training). However, these studies were not conducted to determine a necessary training duration; they simply described the amount of training received by technicians. Consequently, the relation between treatment outcome and training duration cannot be ascertained from those studies.
165
general education, gerontology), practice settings (e.g., homes, schools, clinics), and countries. Numerous additional systematic replications across these variables would be necessary before any widely applicable standards could be distilled. Furthermore, this enterprise would need to be replicated for every professional standard; the RBT credential alone includes five core standards (i.e., education, age, training, competency assessment, written examination) that could serve as predictor variables. Of course, all of the aforementioned activity would need to be repeated periodically as the profession changes and grows. In the end, however, we doubt that correlational research, even at such a scale, would be convincing to the authors. Conducting these lines of research from an experimental, not correlational, approach would introduce the additional complications of randomized subject assignment, the unavailability of appropriate control groups, and obtaining group homogeneity. In addition, there is such considerable variability within specific practice areas (e.g., clinic-based early and intensive behavioral intervention for young children with autism) that the independent variables (e.g., training duration) would likely be rendered trivial. The aforementioned lines of research represent entire careers worth of scholarly activity, which would be incompatible with a profession’s immediate need to identify practitioners who meet specific entry-level standards. Indeed, it is likely that this discrepancy is why professional credentials—across professions—do not implement data-based standards. We do not disagree that exquisitely trained behavior technicians would be ideal, but it cannot come at the cost of impeding access to care while we wait for the outcomes of such largescale and long-term studies—especially for a group of paraprofessionals being supervised by a group of behavior analysts who have already met substantially more rigorous credentialing standards. However, we would value such research if it was conducted and we would ensure that it be made available to relevant groups of SMEs in their deliberations about standards revisions in the future. Leaf et al. (2017) called for a response from the BACB to three specific points: B… the BACB® needs to state that (a) [RBTs] might not be knowledgeable of all ABA-based procedures, (b) that the RBT® designation does not ensure that a person has received any training in ASD, and (c) that [an] RBT® should never implement ABA-based programs independently without ongoing supervision^ (p. 9). In actuality, these statements have already appeared in official BACB text, although we will reiterate them now. First, the RBT Task List (BACB, 2016) was content validated based on what behavior technicians actually do and their required training is based on the task list. The preamble to the RBT Task List specifically states that it Bincludes core tasks that are likely to be performed by behavior technicians … It is acknowledged that there might be other tasks not listed here that a behavior technician would be expected to perform by a
166
supervisor^ (p.1). Second, the RBT credential is not population-specific, although the vast majority of RBTs work with individuals with autism spectrum disorders and are trained and assessed in that context. The RBT credential was purposely kept population-neutral to reflect the diverse populations served in applied behavior analysis. Finally, the BACB Newsletter issue that introduced the RBT credential, as well as BACB.com, makes it quite clear that BRegistered Behavior Technicians may not practice independently^ (BACB, 2013, p. 3). Indeed, the first line of text describing the credential at BACB.com states that RBTs practice under Bclose, ongoing supervision.^ As we previously stated, the primary authors of Leaf et al. (2017) have long expressed dissatisfaction with the BACB’s credentialing activities (e.g., Leaf et al., 2008). It is evident that the processes the BACB follows and the outcomes they generate do not conform to their view of appropriate credentialing standards. From their comments, it appears that Leaf et al. (2017) envision behavior technicians operating with greater independence and at a level of expertise more akin to a BCaBA. However, professional credentialing programs must meet established psychometric and legal standards if they are to withstand challenges. Because the BACB’s credentialing programs were designed based on lessons learned from earlier credentialing efforts in behavior analysis, as well as established credentialing standards, they have endured for almost 20 years and have been recognized in hundreds of laws and funding systems around the world. The RBT credential—the BACB’s newest—was launched just over 2 years ago and there are now over 25,000 RBTs worldwide (and approximately the same number of BCBAs and BCaBAs combined). This means that consumers and other stakeholders (e.g., funders) have a clear mechanism for identifying behavior technicians who have a defined set of behavior-analytic experiences. The BACB will periodically convene SME workgroups to further evaluate and refine
Behav Analysis Practice (2017) 10:164–166
RBT standards. If these outcomes are consistent with those of our other credentials, we might expect successively higher RBT standards in years to come depending on SME input and the state of the profession. In the meantime, the BACB will continue to implement its existing SME-derived standards and hold RBTs and their mandated supervisors accountable under the BACB’s ethics and disciplinary system. Compliance with Ethical Standards Conflict of Interest The authors are affiliated with the BACB, the organization that offers the RBT credential, which is the subject of Leaf et al. (2017).
References American National Standards Institute. (2016). Accreditation program for personnel certification bodies under ANSI/ISO/IEC 17024. Retrieved from https://www.ansi.org/Accreditation/credentialing/ personnel-certification/Default.aspx Behavior Analyst Certification Board. (December, 2013). BACB newsletter - Special issue on the RBT credential. Retrieved from http://bacb. com/wpcontent/uploads/2015/07/BACB_Newsletter_12-13.pdf Behavior Analyst Certification Board. (2016). Registered behavior technicianTM (RBT®) task list. Retrieved from http://bacb.com/wpcontent/uploads/2016/03/160321-RBT-task-list.pdf Institute for Credentialing Excellence. (2016). National commission for certifying agencies (NCCA) standards. Retrieved from http://www. credentialingexcellence.org/p/cm/ld/fid=66 Johnston, J. M., Mellichamp, F. H., Shook, G. L., & Carr, J. E. (2014). Determining BACB examination content and standards. Behavior Analysis in Practice, 7, 3–9. doi:10.1007/s40617-014-0003-6. Leaf, J. B., Leaf, R., McEachin, J., Taubman, M., Smith, T., Harris, S. L., et al. (2017). Concerns about the Registered Behavior Technician™ in relation to effective autism intervention. Behavior Analysis in Practice. doi:10.1007/s40617-016-0145-9. Leaf, R., Taubman, M., Bondy, A., & McEachin, J. (2008). To BCBA or not to B? In R. Leaf, J. McEachin, & M. Taubman (Eds.), Sense and nonsense in the behavioral treatment of autism: it has to be said (pp. 47–54). New York: DRL Books Inc.
DISCUSSION AND REVIEW PAPER
The Registered Behavior Technician™ Credential: A Response to Leaf et al. (2017) James E. Carr 1 & Melissa R. Nosik 1 & Iser G. DeLeon 2
Published online: 13 February 2017 # Association for Behavior Analysis International 2017
Keywords BACB . Behavior analyst certification board . Behavior technician . Certification . Credential . Registered behavior technician . RBT
The authors of Leaf et al. (2017) have requested a response from the Behavior Analyst Certification Board® (BACB®) to their concerns about the Registered Behavior Technician™ (RBT®) credential. Leaf et al. (2017) is the latest in a series of public and private communications from these authors expressing a general dissatisfaction with the BACB’s credentialing activities. Their primary concern—again—is the BACB’s adherence to national and international standards for developing credentialing requirements rather than using an alternative approach to generate requirements that better correspond to their worldview. The discontent expressed in Leaf et al. (2017) is fundamentally a restatement of the arguments first appearing in the book chapter titled To BACB or not to B? by Leaf, Taubman, Bondy, and McEachin (2008). In fact, their thesis about the Board Certified Behavior Analyst® (BCBA®) credential at that time was as follows: BWe are concerned that the BCBA credential is not the ‘Gold Standard’ that everyone has been longing for. In fact we think that the cure might be even worse than the illness!^ (p. 49). Representatives of the BACB have communicated with these authors multiple times over the years, but it has become clear that there are simply fundamental disagreements between the
* James E. Carr [email protected]
parties about the nature and structure of professional credentials. Although the prior approach of communicating directly with the BACB about their concerns was ostensibly the most efficient and direct way to correspond, apparently this dialogue is now to occur within the scholarly literature. The BACB was established from its onset to follow procedures for developing standards that (a) align with best practices in the credentialing industry and (b) are legally defensible (American National Standards Institute, 2016; Institute for Credentialing Excellence, 2016). Any credentialing standard that is not legally defensible (e.g., consistent with antitrust laws) is likely to be quickly reversed after the inevitable legal action by applicants who do not meet the standard. The recommendations by Leaf et al. (2017) appear uninformed by legally defensible credential development, which would render unproductive a point-by-point response to each of their concerns about the RBT credential. In addition, several contradictions and misinformation are found within their comments. An example of the former is the authors’ concern that the RBT credential might increase the cost of intervention, although their recommendations would undoubtedly result in a considerably more expensive certification program—consider the logistics and expense associated with the review by trained behavior analysts of over 1000 submitted video samples per month. Examples of the latter include the assertions that the RBT credential was created to address a shortage of frontline staff (it was not1) and that Board Certified Assistant Behavior Analysts® (BCaBAs®) should meet the same supervision standards as BCBAs (they do2). We will, however, focus our remaining comments on the authors’ core argument 1
1
Behavior Analyst Certification Board, 7950 Shaffer Parkway, Littleton, CO 80127, USA
2
University of Florida, Gainesville, FL 32611, USA
The RBT credential was developed in response to various stakeholders (e.g., funders, legislators) who sought a credential for the individuals who actually make direct contact with clients. 2 BCBA and BCaBA supervisors must both meet identical BACB requirements for supervision of RBTs.
Behav Analysis Practice (2017) 10:164–166
that credentialing standards be the product of empirical research. As we mentioned earlier, the BACB follows specific procedures for establishing and revising important credentialing standards (Johnston, Mellichamp, Shook, & Carr, 2014). The cornerstone of this process is the use of groups of carefully selected and representative subject matter experts (SMEs) from the profession to study specific standards and make recommendations to the BACB's Board of Directors after considerable deliberation. The Board of Directors, itself a body of SMEs, may then accept or deny (but not modify) the recommendations. The BACB currently uses over 100 SMEs each year for its standards and examination tasks, and critical standards are fully re-evaluated at least every 5 years. This process ensures that the BACB’s standards come from the profession and not from BACB staff. The initial RBT standards (BACB, 2013) were outcomes of established SME and job analysis procedures and these will be used again when the standards undergo periodic review. In contrast to the standard-setting process described above, Leaf et al. (2017) recommend that standards instead be the product of empirical research. Here is a sample of the research questions proposed by the authors: Have the BACB credentials been successful in resulting in more qualified providers and improved services? (p. 3); Are 40 h of RBT training enough to produce improved client outcomes? (p. 5)3; Is the age requirement for RBTs (18 years) appropriate to provide sufficient outcomes? (p. 4); Does mastery of skills on the RBT Task List produce better client outcomes? (p. 6); Do RBT credential components help protect consumers (p. 8); and Does RBT certification lead to improved outcomes as demonstrated in prospective randomized controlled studies? (p. 8). As scholars ourselves, we welcome additional research on all aspects of behavior analysis, including credentialing standards. However, there are unique challenges associated with the research necessary to appropriately and unambiguously answer questions about specific standards that are not evident in the Leaf et al. (2017) recommendations. The lowest effort approach would be correlational research in which a large body of practitioners are measured on two variables: a predictor variable (e.g., number of hours of training) and a criterion variable (e.g., quantification of a practitioner’s client outcomes). Setting aside the difficulty of operationalizing and measuring these variables, a single correlational study would be insufficient for establishing a professional standard because of important differences between practice areas (e.g., autism, 3 The authors provided examples of intervention studies (e.g., Lovaas, 1987) in which behavior technicians were trained for more than 40 h (the current minimum duration of RBT training). However, these studies were not conducted to determine a necessary training duration; they simply described the amount of training received by technicians. Consequently, the relation between treatment outcome and training duration cannot be ascertained from those studies.
165
general education, gerontology), practice settings (e.g., homes, schools, clinics), and countries. Numerous additional systematic replications across these variables would be necessary before any widely applicable standards could be distilled. Furthermore, this enterprise would need to be replicated for every professional standard; the RBT credential alone includes five core standards (i.e., education, age, training, competency assessment, written examination) that could serve as predictor variables. Of course, all of the aforementioned activity would need to be repeated periodically as the profession changes and grows. In the end, however, we doubt that correlational research, even at such a scale, would be convincing to the authors. Conducting these lines of research from an experimental, not correlational, approach would introduce the additional complications of randomized subject assignment, the unavailability of appropriate control groups, and obtaining group homogeneity. In addition, there is such considerable variability within specific practice areas (e.g., clinic-based early and intensive behavioral intervention for young children with autism) that the independent variables (e.g., training duration) would likely be rendered trivial. The aforementioned lines of research represent entire careers worth of scholarly activity, which would be incompatible with a profession’s immediate need to identify practitioners who meet specific entry-level standards. Indeed, it is likely that this discrepancy is why professional credentials—across professions—do not implement data-based standards. We do not disagree that exquisitely trained behavior technicians would be ideal, but it cannot come at the cost of impeding access to care while we wait for the outcomes of such largescale and long-term studies—especially for a group of paraprofessionals being supervised by a group of behavior analysts who have already met substantially more rigorous credentialing standards. However, we would value such research if it was conducted and we would ensure that it be made available to relevant groups of SMEs in their deliberations about standards revisions in the future. Leaf et al. (2017) called for a response from the BACB to three specific points: B… the BACB® needs to state that (a) [RBTs] might not be knowledgeable of all ABA-based procedures, (b) that the RBT® designation does not ensure that a person has received any training in ASD, and (c) that [an] RBT® should never implement ABA-based programs independently without ongoing supervision^ (p. 9). In actuality, these statements have already appeared in official BACB text, although we will reiterate them now. First, the RBT Task List (BACB, 2016) was content validated based on what behavior technicians actually do and their required training is based on the task list. The preamble to the RBT Task List specifically states that it Bincludes core tasks that are likely to be performed by behavior technicians … It is acknowledged that there might be other tasks not listed here that a behavior technician would be expected to perform by a
166
supervisor^ (p.1). Second, the RBT credential is not population-specific, although the vast majority of RBTs work with individuals with autism spectrum disorders and are trained and assessed in that context. The RBT credential was purposely kept population-neutral to reflect the diverse populations served in applied behavior analysis. Finally, the BACB Newsletter issue that introduced the RBT credential, as well as BACB.com, makes it quite clear that BRegistered Behavior Technicians may not practice independently^ (BACB, 2013, p. 3). Indeed, the first line of text describing the credential at BACB.com states that RBTs practice under Bclose, ongoing supervision.^ As we previously stated, the primary authors of Leaf et al. (2017) have long expressed dissatisfaction with the BACB’s credentialing activities (e.g., Leaf et al., 2008). It is evident that the processes the BACB follows and the outcomes they generate do not conform to their view of appropriate credentialing standards. From their comments, it appears that Leaf et al. (2017) envision behavior technicians operating with greater independence and at a level of expertise more akin to a BCaBA. However, professional credentialing programs must meet established psychometric and legal standards if they are to withstand challenges. Because the BACB’s credentialing programs were designed based on lessons learned from earlier credentialing efforts in behavior analysis, as well as established credentialing standards, they have endured for almost 20 years and have been recognized in hundreds of laws and funding systems around the world. The RBT credential—the BACB’s newest—was launched just over 2 years ago and there are now over 25,000 RBTs worldwide (and approximately the same number of BCBAs and BCaBAs combined). This means that consumers and other stakeholders (e.g., funders) have a clear mechanism for identifying behavior technicians who have a defined set of behavior-analytic experiences. The BACB will periodically convene SME workgroups to further evaluate and refine
Behav Analysis Practice (2017) 10:164–166
RBT standards. If these outcomes are consistent with those of our other credentials, we might expect successively higher RBT standards in years to come depending on SME input and the state of the profession. In the meantime, the BACB will continue to implement its existing SME-derived standards and hold RBTs and their mandated supervisors accountable under the BACB’s ethics and disciplinary system. Compliance with Ethical Standards Conflict of Interest The authors are affiliated with the BACB, the organization that offers the RBT credential, which is the subject of Leaf et al. (2017).
References American National Standards Institute. (2016). Accreditation program for personnel certification bodies under ANSI/ISO/IEC 17024. Retrieved from https://www.ansi.org/Accreditation/credentialing/ personnel-certification/Default.aspx Behavior Analyst Certification Board. (December, 2013). BACB newsletter - Special issue on the RBT credential. Retrieved from http://bacb. com/wpcontent/uploads/2015/07/BACB_Newsletter_12-13.pdf Behavior Analyst Certification Board. (2016). Registered behavior technicianTM (RBT®) task list. Retrieved from http://bacb.com/wpcontent/uploads/2016/03/160321-RBT-task-list.pdf Institute for Credentialing Excellence. (2016). National commission for certifying agencies (NCCA) standards. Retrieved from http://www. credentialingexcellence.org/p/cm/ld/fid=66 Johnston, J. M., Mellichamp, F. H., Shook, G. L., & Carr, J. E. (2014). Determining BACB examination content and standards. Behavior Analysis in Practice, 7, 3–9. doi:10.1007/s40617-014-0003-6. Leaf, J. B., Leaf, R., McEachin, J., Taubman, M., Smith, T., Harris, S. L., et al. (2017). Concerns about the Registered Behavior Technician™ in relation to effective autism intervention. Behavior Analysis in Practice. doi:10.1007/s40617-016-0145-9. Leaf, R., Taubman, M., Bondy, A., & McEachin, J. (2008). To BCBA or not to B? In R. Leaf, J. McEachin, & M. Taubman (Eds.), Sense and nonsense in the behavioral treatment of autism: it has to be said (pp. 47–54). New York: DRL Books Inc.
