ASU's Department of Psychology helps close autism-treatment gap

In 2008 Arizona became the fourth state to allow for the treatment of autism to be covered by insurance. As a result, families of children afflicted with the developmental disorder began relocating to the state at an alarming rate.

Alarming because, at that time, the number of Arizona practitioners capable of providing the sort of specialized treatment required – called applied behavior analysis (ABA) – was dismally low compared with the growing number of individuals in need of it.

“The data out there at the time indicated that there was only one licensed behavior analyst per every 400 kids with autism,” said Sara Pennak, director of program development and clinical initiatives for Arizona State University’s Department of Psychology.

Most programs available to students looking to become licensed in ABA did not include a real-world clinical training component.

“One of the hurdles for people becoming licensed is that they have to have supervised hours by a licensed practitioner. So you’ve got licensed practitioners who are spread really thin anyway because they’re seeing all of their clients, and so what would happen with many of these other programs across the country, across North America, is that the students would get their degree and then they’d be stuck trying to find a way to get 1,500 hours of licensed supervision,” Pennak said.

Meaning that even though students had completed a program, they would still find it difficult to become licensed even after they became certified. Adding to the problem was the fact that many of the available programs just weren’t up to par when it came to teaching the science behind ABA, resulting in less-prepared graduates.

It was clear to many professionals in the field that something had to be done to produce not just more behavior analysts, but more well-trained licensed behavior analysts.

Taking action

So around 2012, a group of five ABA professionals from the Phoenix metro area decided to take action and contacted ASU with an idea. The group (endearingly referred to by members of the psychology department as “the gang of five”) wanted the university to develop a doctoral program to help meet the growing demand for licensed behavior analysts.

Abby Twyman, clinical director for Trumpet Behavioral Health and one of the “gang of five,” was the then-president of the Arizona Association for Behavioral Analysis, the local chapter for the international organization.

“All the people coming to us had focused on the practice of behavioral analysis, but not on the science behind it,” she said. “So, due to the high need for services in this state, we felt as an organization that it would be really important for a university to start an in-person program so that when people are done, they will have had a really high-quality education and clinical experience.”

Amy Kenzer, clinical services director for the Southwest Autism Research and Resource Center, said the group chose to approach ASU’s Department of Psychology because of its “rich history in behavioral analysis” and because “a lot of us had some association with ASU already, whether teaching courses as associate faculty or having students who did undergrad internships with us … it made sense to continue to grow that relationship.”

Foundation Professor and psychology department chair Keith Crnic agreed to meet with them.

“They were looking for people who would become well-trained clinically to be out there working. So I said to them, ‘Then you don’t want a doctoral program. What you want is a master’s program,’” Crnic said.

The reason being, he explained, is that doctoral programs in psychology are meant to train researchers, not practitioners.

“Master’s-level training is meant to be hands-on and in-the-field, working with existing professionals who are well-trained. You can give students the kind of intensive clinical experiential training that adds to the scientific background that it takes to really do this well,” Crnic said. “So we chatted about it for a while, and they quickly realized that that was what they needed. And then they said, ‘Can you guys do that?’”

As it turned out, the timing was just right for the university, which was looking to develop more health-related master’s programs.

“You know, what’s great about this development is that members of the community hear about these things and they say, ‘Hey, you can get access to ASU, and ASU will listen and try to respond to the community need.’ And that’s what happened in this situation,” Crnic said.

So Crnic recruited the help of Pennak to develop the program, and Adam Hahs, a licensed behavior analyst and current co-director of the program, to help implement it.

“One of the things we wanted to do with our program is to incorporate elements of the best medical-school teaching models so that, from day one, our students are going to be out in the field at a clinic, at an agency, at an organization, applying what they’re learning in the classroom to the real world,” Pennak said. “We want them to hit the ground running.”

The program begins

On Aug. 18, the Department of Psychology welcomed its first cohort of students to the inaugural semester for the Master of Science program in Applied Behavior Analysis (MS ABA) at an orientation on ASU’s Tempe campus.

“They really are excited about this program, it being affiliated with ASU, all the history, and being able to walk away with a degree that’s as powerful as this one,” Hahs said.

“It was pretty amazing how quickly and with such high integrity this program was put together,” Twyman said.

One of the students, Reyna Rivera, has worked as a therapist for children with autism and eventually wants to become a board-certified behavior analyst and “serve as a pillar in the autism community.”

“I look forward to growing as an individual and learning more about myself as a practitioner throughout the MS ABA program,” Rivera said.

Behavior analysis is a science of the principles of learning and behavior, and its focus is the study of the environment on behavior. Applied behavior analysis is concerned with the development and application of a technology for improving behavior based on those principles of learning and behavior.

It’s important to note that ABA techniques are not only used for the treatment of autism. ABA also has utility for dealing with addiction, traumatic brain injury, weight-related issues, educational systems, disease prevention and control, business management and more. The goal of the new master’s program is to provide its students with as many diverse opportunities as possible within the broad field that is ABA.

Special-education teacher and student in the program Johanna Emershaw was already utilizing ABA techniques in her classes but realized she could use more training to meet her students’ needs.

“All the programs that were available were online programs, a format that did not meet my learning style,” she said. “I had begun a program with NAU, a few years back, but found that it was a struggle for me to express my knowledge through an online format. I needed an in-class program where I could interact face to face with like-minded people.”

According to Hahs, as of 2015, the ratio of licensed behavior analysts to children with autism is closer to one to 144 in the state of Arizona.

With the help of this new program, which will be accepting applications for the fall 2016 cohort in September, it’s likely that ratio will only get better.