Why Do So Many First Time BCBA Test Takers Fail: What’s Going On?

There are (at least!) two overriding concerns across the current BCBA testing and certification process. One is that first time pass rates for the BCBA exam continue poor. Not only is that frustrating but retakes get expensive. And more than one retake not only gets even more expensive but can also harm the start of a career. Another macro issue is the wide variability in skill sets often seen among active BCBAs. Considering both, a hypothesized correlation likely exists.

Of the about 75 programs listed by the BACB in 2013, only about 21 had pass rates over 70% and, of those, just 14 schools had pass rates at 85% or better for first time test takers (seven schools had a pass rate of 100%). Sixteen listed schools with a total of 171 students among them had pass rates at less than 40%. Eight schools had pass rates of less than 30% representing 83 total students. According to the BACB, the overall pass rate for the 3,006 first-time candidates who took the BCBA examination in 2013 was 58%

(http://www.bacb.com/Downloadfiles/PassRates/BCBA_ACS_pass_rates_percent.pdf).

Why is this happening and why are the differences so dramatic?

Is it the academic programs; differential priorities; student engagement; support given to students and/or faculty; faculty and/or student backgrounds; curriculum design; professional perspectives; systems for BCBA supervision; lack of adequate application/practice; a combination of these or something else entirely?

Most probably, the answers lie in a combination of these factors.

The other side of this closely related coin is the often wide variability in BCBA competencies by those who pass their exam. And the training priorities and perspectives of BCBA eligible academic programs are very likely and mutually related to both, the persistent high first time test taking failure rates and subsequent professional variability.

Allow me a short anecdote.

A few years ago, I was talking to a smart young woman with a BCBA earned through her completion of a known and strong university program. As we talked, she told me she simply wouldn't know what to do; who to serve were autism to be (hypothetically) eliminated. And even though this hardly represented the first time I'd heard such a comment, it depresses me each time.

Needless to say, I started to offer a very long list with regards to who might still be left to serve ranging from children to adults.

I've been practicing Applied Behavior Analysis for – well – a long time now and have watched cycles come and go. The BCBA was initially intended to prioritize autism based on the fundamental framework of Applied Behavior Analysis. While the BCBA specifically for ‘autism’ was neutralized in concept, the original intent has long since won in practice.

I also think that it is this very dynamic, at least in part, which is very closely connected to the low first time BCBA pass rates and the subsequent variability in professional competencies among practicing BCBAs.

A BCBA should be as prepared and able to provide behavioral services to a young, high strung child with a developmental behavioral disability like autism or adults in long term residential treatment as they are to persons experiencing a wider range of environmental and/or socially based behavioral challenges.

The BCBA should see themselves, first, as a Clinical Behavior Analyst Generalist and be able to effectively assess for and generate behavioral interventions across a range of behavioral need to include, but hardly limited to, Intellectual & Developmental and Developmental Behavioral disabilities, academic underachievement/learning problems, transitional issues like parental divorce and other family stressors, medical needs and resistance to medical care, individualized and resistant ‘normative’ adaptive targets, psychiatric issues and dual diagnoses, early onset dementia, feeding/eating disorders, domestic violence & conduct disorders.

With its increasing focus on autism services, the field of Applied Behavior Analysis often ignores the power and depth it contains to help and support much broader populations. ‘ABA’ is not a strategy; it’s not an intervention and it is not population specific but a deep and comprehensive field and clinical discipline much of which has been lessened from within and by the field itself.

In 1991, Stephen Fawcett said that since behavior analysis takes the view that individual and social problems are directly represented by the behavior of key individuals and existing environmental structures, Behavior Analysts are much better able to respond to and be effective with issues often perceived as intractable by other disciplines. And Fawcett is absolutely correct but only so long as Behavior Analysts fully know their field.

When a competent BCBA tells me that he or she wouldn’t know who or how to serve other than those with autism, I often wonder what Fawcett would think. I wonder what Baer, Wolf and Risley would think, too. (But that will be for another blog entry!)

As do other clinical professionals, BCBAs most often ultimately specialize. After all, parents would not take their sick child to a Cardiologist no matter how skilled that MD in the same way parents wouldn't routinely place a young child with more significant and persistent behavioral concerns in a more general day care facility no matter how well it might be run.

But just as an MD specialist is first trained as a medical 'Generalist' and is therefore able to provide services to persons outside of his/her specialty area, a BCBA must similarly be as thoroughly versed in the principles, foundations, theories, clinical applications and practice of Applied Behavior Analysis before choosing an area of specialization.

Such a lack of depth in the field and understanding of ‘Clinical Behavior Analysis’ is a reason, I strongly believe, that so many struggle to pass the BCBA exam and that those who do can often wind up more narrow in their behavioral analytic applications and knowledge. Applied Behavior Analysis is an incredibly positive and powerful service framework which is, in some ways, short selling itself.

Both undergraduate and graduate academic training programs must prioritize the training of Clinical Behavior Analyst 'Generalists' who are first thoroughly versed in the field of Applied Behavior Analysts.

In this way, too, BCBA Supervision should insist that student supervisees provide behavior analytic services to at least 3 or 4 wholly different populations who can directly benefit. The BCBA student could even list these as their first through third or fourth ‘specialty’ in the same way new teachers are often asked to identify in which grades they taught during their student teaching and new MDs select a specialty during their residency.

Graduate programs in Applied Behavior Analysis often have multiple courses in autism but not cross applications of clinical behavioral research and treatment; graduate programs in Applied Behavior Analysis have explicit courses in the

VB MAPP, for instance, but not in the cross applications of behavioral/environmental assessment.

The new BCBA should also be seen as a clinical ‘entry level’ position rather than a terminal professional clinical certification in the exact same way as are brand new medical or law school graduates. With their graduation from medical school, newly minted MDs are typically only starting the intensity of their training as clinical providers. Newly certified lawyers move into practices where they then also specialize over time.

But far too many new BCBAs no longer prioritize direct clinical services and, instead, are too often told that they are now ready to manage and provide primary supervision of the development and implementation of complex behavioral treatment plans across a range of individual needs and conditions.

And, again, this often focuses on the provision of services to persons – children – with autism. While children with autism absolutely and strongly benefit from well-trained Behavior Analysts and programming framed by Applied Behavior Analysis, so, too, do many others.

Such a distinct focus is often related to the reality that professional academic training is more focused, itself, on a sliver of the field of Applied Behavior Analysis; often a piece of verbal behavior rather than even that full domain. While the new BCBA may be able to help a smaller cross section of children following such training, it is training which also may not represent the field of Applied Behavior Analysis thereby minimizing the very strength of the field as referenced by Fawcett.

It also very likely leads to the higher first time (and, sometimes, second and third time) BCBA exam failure rates since a percentage of students have been trained in a piece of Applied Behavior Analysis rather than the field of Applied Behavior Analysis and may not be ready for the broader range of questions properly tested for in the BCBA exam.

Another reason for higher rates of first time BCBA test failure is likely related to a lack of student 'automaticity' with regards to the foundational knowledge (now positively identified by the BACB's 4th Edition Task List), language, broader principles, terminology and definitions relevant to Applied Behavior Analysis.

I have done a lot of BCBA supervision and training and could not even venture a guess how many of my BCBA supervisees to absolutely include those almost or, even, finished their graduate degree in Applied Behavior Analysis who cannot provide even the most basic, foundational definitions when asked. And I won’t even get started with regards to what often happens when I ask about and/or present more advanced behavioral analytic concepts.

Not only does this lack of foundational knowledge greatly increase fail rates for first time – and second time, too – BCBA test takers, it also greatly impedes application, clinical capacity and the ability to use and integrate the concepts of Behavior Analysis rather than memorize two or three relevant strategies.

If, for instance, a BCBA student largely only understands reinforcement as a scheduled 1:1 exchange or persistently prioritizes the use of edibles, they become not only much more likely to fail their first attempt at the BCBA exam but will also be poorly prepared to support the range of diversity and unique needs among their clients. Reinforcement is a principal of and a concept in Applied Behavior Analysis; it is not a strategy.

A thorough knowledge of the Principles of Reinforcement Theory will not only better prepare the student for their BCBA exam but, more importantly still, they will be that much more adept in the design of individualized systems that reinforce,

motivate and support success while remaining adaptable and flexible.

BCBA supervision must simultaneously focus on foundational knowledge and the principles of human behavior along with individualized, assessment driven applications and foundational competencies framed by the BACB's 4th Edition Task List.

High quality behavioral analytic coursework and BCBA Supervision should first focus on the Clinical Behavior Analyst Generalist even while prioritizing sessions to target and meet the unique interests and real time professional needs of the student.

First time pass rates for the BCBA exam can be made much higher….

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In honor of this commentary at almost 17,000 views on LinkedIn. Thank you.

This 'postscript' was motivated by a comment I received and responded to on this string. It is material I've been planning to write about and, thanks to that prompt, decided to start this connected discussion by adding it to the end of this well read commentary.

An important reality and point of consideration is that a number of our top Behavior Analysts; those who have and do lead the field are not, still, BCBAs. At last check, such folks as Dave Wacker, Andy Bondy, Bob Koegel and Rob Horner...among many others...have yet to take their BCBA exam.

To the hard core programs and harder core agendas, these folks might not technically be considered as 'qualified' a Behavior Analyst as somebody who has been working with their BCBA for a few years. Even tho huge numbers of us know this to be crap; it is a held to notion by some.

Now, don't get me wrong.

The BCBA is a helluva good and important concept. But it is also a concept which still needs a great deal more thought and professional development. While it should reflect baseline clinical behavioral analytic knowledge and competencies at a professional level, it has largely morphed into an 'autism' training and 'certification.'

And for many new BCBA certificants; they no longer consider themselves practicing clinicians but, instead, apply as clinical managers, clinical supervisors...or just move right to opening still one more autism agency, become CEO and start supervising everybody. That I'm - well - lots older, have 40+ years of very active, very diverse and continuing clinical experience doesn't even process well anymore or in many places in our field.

Just one thing this all means is that we regularly lose the opportunity to train - correctly and clinically - many Behavior Analysts who could have been really good clinical providers across a number of populations. But we'll never know in that the BCBA has also, in many ways, become self limiting to the field of Applied Behavior Analysis....

Another thing it means is that there are huge numbers of extremely competent Behavior Analysts working right now without their BCBAs who can't even apply for many positions any more since they are not a 'BCBA with 1 - 3 years experience.'

We really do have a problem here, Houston....

I think a key is to reframe behavioral analytic degree work towards a degree in 'Clinical Behavior Analysis' and be sure it is designated as an entry level clinical certification with the demonstrated competence to serve wide ranging populations.

I have an idea and construct for this and will likely write more about it soon.

Newly graduated physicians, nurses, psychologists, clinical social workers, teachers...and others...do not step out of the testing room with full, primary practice and clinical rights.

New teachers don't apply to be Department Chairs and new physicians do not submit to be a hospital's new Chief of Medicine after passing their boards. In fact, not only could they not do that, but it then takes a number more years before a newly minted physician can even claim a specialization, private practice and 'board certify.'

I want to see the BCBA; at least the BCBA - D ultimately become first party reimbursable in the same way as are Master's level counseling degrees and LCSWs.

But to get there, we have a great deal of work yet to do.

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I provide online BCBA/BCaBA supervision and Telebehavior clinical behavioral services through my website:

http://www.drlousandler.com/

I will help you pass your BCBA/BCaBA exam.

I can help with challenging behavioral/structural needs in homes, community and classrooms towards positive and generalizable change; Qualify of Life outcomes.

I am open scheduling a conversation via phone, Skype or VSee to all inquiries.

#appliedbehavioranalysis #BCBA #BCaBA #Testplanning