Do Better Pod Live - Feb 2025: Determining Treatment Intensity

In this episode of the Do Better Podcast, Dr. Megan and Joe discuss considerations around determining treatment intensity. ARTICLE about POP-CAI SUMMARY FROM FATHOMMeeting PurposeLive recording of the Do Better Podcast discussing how to determine appropriate service intensity for ABA therapy clients.Key Takeaways - There's a lack of standardized training/processes for determining ABA therapy hours - New tools like POP-C (Patient Outcome Planning Calculator) are emerging to help guide decisions - Many factors impact appropriate service intensity beyond just client needs (e.g. family capacity, funding constraints) - More research is needed to determine optimal ways to prescribe treatment intensityTopicsCurrent State of Service Intensity Decision-Making - Historically, funding limitations often dictated hours (e.g. 6-10 hrs/week) - Many BCBAs receive no formal training on how to determine appropriate hours - Some organizations developing internal tools/processes, but no industry standard - New research-based tools like POPC starting to emergePOP-C (Patient Outcome Planning Calculator) - New tool published in 2023 to help determine service intensity - 33-question assessment placing clients into high (30-40 hrs), medium (20-30 hrs) or low (up to 20 hrs) tiers - Considers factors like diagnosis, behavior severity, communication skills, social avoidance - Still in early stages - authors seeking beta testersChallenges in Determining Appropriate Hours - Balancing clinical recommendations vs. family/logistical constraints - Insurance requirements may not align with clinical judgment - Difficulty measuring impact of prescribed vs. actual hours received - Varying capacity of families to supplement therapy hours - Considering opportunity costs (e.g. school time) of intensive 1:1 therapyFunding and Industry Trends - Some providers only accepting clients who can meet minimum hour thresholds - Medicaid/insurance cutting back on covered services in some areas - Potential for very limited covered hours (e.g. 4 hrs/month) in future - Need for efficiency and prioritization if hours become more constrainedNext Steps - Interested BCBAs can reach out to POP-C authors about beta testing - Continue monitoring emerging research and tools for determining service intensity - Consider how to adapt practices if funding becomes more limited in future