[PDF] SECTION 5: TIERED SERVICE-DELIVERY MODELS AND





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SECTION 5: TIERED SERVICE-DELIVERY MODELS AND

Most ABA treatment programs involve a tiered service-delivery model in which the Behavior. Analyst designs and supervises a treatment program delivered by 



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A Proposed Tiered Model of Assessment in Writing Instruction: Supporting All Student-Writers Zoi A Traga Philippakos University of Tennessee Erin FitzPatrick University of North Carolina at Charlotte Writing is an essential skill and outcome for academic and professional success but the call for evidence-based practices and instructional di˜er-

What is a tiered model?

And being that this is a tiered model, it also means there are three or more bundled package levels, with three or more pricing levels. They usually get labeled as “Gold, Silver, and Bronze” or “Basic, Standard, and Premium.”

What is tiered instruction?

Tiered instruction is an educational practice that involves grouping students and teaching a tailored lesson to fit each group's skill level. Tailored instruction is carried out by varying the level of assignments and products to fit each group's needs. The objective is that tiered lessons are appropriately challenging for all students.

What are tiered assignments?

Tiered assignments are structured such that all students have the same workload. There are many different ways that lessons can be tiered including by learning style and outcome, amongst others. To implement tiered instruction, teachers can create a standard lesson based on the learning goals they have for the lesson.

What are the advantages of the five-tiered model?

26 The five-tiered model facilitates reciprocity; uses a build-upon, but not duplicative investigative principle; and facilitates the use of automation. Each successively higher level of investigation builds upon the levels below.

26
BCBA

BCBA-D

RBTRBTRBTRBT

SECTION 5:

TIERED SERVICE-DELIVERY MODELS

AND BEHAVIOR TECHNICIANS

Most ABA treatment programs involve a tiered service-delivery model in which the Behavior Analyst designs and supervises a treatment program delivered by Assistant Behavior Analysts and Behavior Technicians.

Description of a Tiered Service-Delivery Model

Behavior Analyst's clinical, supervisory, and case management activities are often supported by other

staff such as Assistant Behavior Analysts working within the scope of their training, practice, and competence. Following are two examples of tiered service-delivery models (among others), an organizational approach to treatment delivery considered cost-effective in delivering desired outcomes.

In the first example (below), the Behavior Analyst oversees a treatment team of Behavior Technicians.

1

BOARD CERTIFIED BEHAVIOR ANALYST

provides clinical direction, supervision, and case management

REGISTERED

BEHAVIOR

TECHNICIAN A

delivers treatment protocol

REGISTERED

BEHAVIOR

TECHNICIAN B

delivers treatment protocol

REGISTERED

BEHAVIOR

TECHNICIAN C

delivers treatment protocol

REGISTERED

BEHAVIOR

TECHNICIAN D

delivers treatment protocol 27
BCBA

BCBA-D

RBTRBTRBTRBTRBTRBT

Such models assume the following:

1. The BCBA or BCBA-D is responsible for all aspects of clinical direction, supervision, and case

management, including activities of the support staff (for example, a BCaBA) and Behavior Technicians.

2. The BCBA or BCBA-D must have knowledge of each member of the treatment team's ability to

effectively carry out clinical activities before assigning them.

3. The BCBA and BCBA-D must be familiar with the client's needs and treatment plan and regularly

observe the Behavior Technician implementing the plan, regardless of whether or not there is clinical

support provided by a BCaBA. BCaBA

BOARD CERTIFIED BEHAVIOR ANALYST

BOARD CERTIFIED ASSISTANT

BEHAVIOR ANALYST

provides clinical direction, supervision, and case management provides clinical and case management support under supervision of Behavior Analyst In the second example (below), the Behavior Analyst is supported by an Assistant Behavior Analyst; the two of them jointly oversee a treatment team of Behavior Technicians.

REGISTERED

BEHAVIOR

TECHNICIAN A

delivers treatment protocol

REGISTERED

BEHAVIOR

TECHNICIAN B

delivers treatment protocol

REGISTERED

BEHAVIOR

TECHNICIAN C

delivers treatment protocol

REGISTERED

BEHAVIOR

TECHNICIAN D

delivers treatment protocol

REGISTERED

BEHAVIOR

TECHNICIAN E

delivers treatment protocol

REGISTERED

BEHAVIOR

TECHNICIAN F

delivers treatment protocol 26
BCBA

BCBA-D

RBTRBTRBTRBT

SECTION 5:

TIERED SERVICE-DELIVERY MODELS

AND BEHAVIOR TECHNICIANS

Most ABA treatment programs involve a tiered service-delivery model in which the Behavior Analyst designs and supervises a treatment program delivered by Assistant Behavior Analysts and Behavior Technicians.

Description of a Tiered Service-Delivery Model

Behavior Analyst's clinical, supervisory, and case management activities are often supported by other

staff such as Assistant Behavior Analysts working within the scope of their training, practice, and competence. Following are two examples of tiered service-delivery models (among others), an organizational approach to treatment delivery considered cost-effective in delivering desired outcomes.

In the first example (below), the Behavior Analyst oversees a treatment team of Behavior Technicians.

1

BOARD CERTIFIED BEHAVIOR ANALYST

provides clinical direction, supervision, and case management

REGISTERED

BEHAVIOR

TECHNICIAN A

delivers treatment protocol

REGISTERED

BEHAVIOR

TECHNICIAN B

delivers treatment protocol

REGISTERED

BEHAVIOR

TECHNICIAN C

delivers treatment protocol

REGISTERED

BEHAVIOR

TECHNICIAN D

delivers treatment protocol 27
BCBA

BCBA-D

RBTRBTRBTRBTRBTRBT

Such models assume the following:

1. The BCBA or BCBA-D is responsible for all aspects of clinical direction, supervision, and case

management, including activities of the support staff (for example, a BCaBA) and Behavior Technicians.

2. The BCBA or BCBA-D must have knowledge of each member of the treatment team's ability to

effectively carry out clinical activities before assigning them.

3. The BCBA and BCBA-D must be familiar with the client's needs and treatment plan and regularly

observe the Behavior Technician implementing the plan, regardless of whether or not there is clinical

support provided by a BCaBA. BCaBA

BOARD CERTIFIED BEHAVIOR ANALYST

BOARD CERTIFIED ASSISTANT

BEHAVIOR ANALYST

provides clinical direction, supervision, and case management provides clinical and case management support under supervision of Behavior Analyst In the second example (below), the Behavior Analyst is supported by an Assistant Behavior Analyst; the two of them jointly oversee a treatment team of Behavior Technicians.

REGISTERED

BEHAVIOR

TECHNICIAN A

delivers treatment protocol

REGISTERED

BEHAVIOR

TECHNICIAN B

delivers treatment protocol

REGISTERED

BEHAVIOR

TECHNICIAN C

delivers treatment protocol

REGISTERED

BEHAVIOR

TECHNICIAN D

delivers treatment protocol

REGISTERED

BEHAVIOR

TECHNICIAN E

delivers treatment protocol

REGISTERED

BEHAVIOR

TECHNICIAN F

delivers treatment protocol 27
BCBA

BCBA-D

RBTRBTRBTRBTRBTRBT

Such models assume the following:

1. The BCBA or BCBA-D is responsible for all aspects of clinical direction, supervision, and case

management, including activities of the support staff (for example, a BCaBA) and Behavior Technicians.

2. The BCBA or BCBA-D must have knowledge of each member of the treatment team's ability to

effectively carry out clinical activities before assigning them.

3. The BCBA and BCBA-D must be familiar with the client's needs and treatment plan and regularly

observe the Behavior Technician implementing the plan, regardless of whether or not there is clinical

support provided by a BCaBA. BCaBA

BOARD CERTIFIED BEHAVIOR ANALYST

BOARD CERTIFIED ASSISTANT

BEHAVIOR ANALYST

provides clinical direction, supervision, and case management provides clinical and case management support under supervision of Behavior Analyst In the second example (below), the Behavior Analyst is supported by an Assistant Behavior Analyst; the two of them jointly oversee a treatment team of Behavior Technicians.

REGISTERED

BEHAVIOR

TECHNICIAN A

delivers treatment protocol

REGISTERED

BEHAVIOR

TECHNICIAN B

delivers treatment protocol

REGISTERED

BEHAVIOR

TECHNICIAN C

delivers treatment protocol

REGISTERED

BEHAVIOR

TECHNICIAN D

delivers treatment protocol

REGISTERED

BEHAVIOR

TECHNICIAN E

delivers treatment protocol

REGISTERED

BEHAVIOR

TECHNICIAN F

delivers treatment protocol 28

Rationales for a Tiered

Service-Delivery Model

Tiered service-delivery models that rely on the use of Assistant Behavior Analysts and Behavior Technicians have been the primary mechanism for achieving many of the significant improvements in cognitive, language, social, behavioral, and adaptive domains that have been documented in the peer-reviewed literature. 4 The use of carefully trained and well-supervised Assistant Behavior Analysts and Behavior Technicians is a common practice in ABA treatment. 5,6 Their use produces more cost-effective levels of service for the duration of treatment. The use of tiered service-delivery model enables healthcare funders and managers to ensure adequate provider networks and deliver medically necessary treatment. It additionally permits sufficient expertise to be delivered to each client at the level needed to reach treatment goals. This is critical as the level of supervision required may shift rapidly in response to client progress or need. Tiered service-delivery models can also help with treatment delivery to families in rural and underserved areas, as well as clients and families who have complex needs. 2quotesdbs_dbs22.pdfusesText_28
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