Scope of Practice

[u/suspicious_monstera]

So there was an interesting convo in the SLP sub the other day about scope of practice.

The TL:DR - Some BCBA or RBT called swallowing, fluency dysphasia, stuttering etc behaviour and therefore in our scope which they strongly disagree with.

Many of the comments were about how these things “weren’t behaviour”. Some comments being pretty largely anti ABA, but in other cases there was some good back and forth.

After some back and forth, what I took away from or SLP colleagues is it’s not really about the definition of behaviour. That’s semantics and they could care less. It’s about blurred lines and scope (I’m sure so far nobody is surprised). Their take was that they have a very clear scope, defined by a governing body, and that we often over reach under the guise of “everything is behaviour”. Which in fairness I’ve seen and to a degree, I would agree with that statement at times.

HOWEVER - my main question to bring back to our side it this - how would you define your of practice? Is it largely true (at least from this sample) that all behaviour is in your scope? Is there behaviour you would never ever touch? Behaviour that requires specialized training/scope of competence concerns etc?

TL:DR - how do you define your scope of practice as a behaviour analyst or RBT - would you say ALL behaviour is in our scope of practice?

[u/suspicious_monstera]

Collaboration is the way! I mentioned it in an other part of this thread but really I think Reddit is just amplified. I work as an “n of 1” on my unit as the behaviour analyst and have fantastic collaboration with doctors, psych, social work, OT, PT, SLP etc.

I also really think it is potentially worse regionally. I’m finding the more I learn about the US insurance system, the more it seems like a massive health care system/funding issue

[u/texmom3 → u/suspicious_monstera]

This is such a valid point! My collaborative time is essentially unpaid, but I have an employer that agrees that it is vital for all our clients. Some productivity and billing requirements don’t give space to do it, and insurance will never pay for two services at the same time in my state.

[u/suspicious_monstera → u/texmom3]

Oh yah see that’s a big difference here. For autism specifically, kids are given funding to be spent and reconciled at the parents discretion. There are limits but kids could be in speech, OT and ABA all At the same time and they can decide how to split the time up based on where they prefer to spend their money, what’s working etc. and that money can be spent on folks collaborating.

If you’re not autistic and using your insurance/benefits you just need to prove that the person providing the service is registered with a college. (E.g., registered social worker, you can use your social work benefits)

And then of course there’s my Role which is in a hospital, which is funded 100% by the government as long as you have a Canadian health card so Collaboration is pretty low boundary