Disability-Affirming Supervision: Future Directions in Applied Behavior Analytic Supervision

Abstract

Various disciplines have undergone a shift towards increasing diversity, multiculturalism, and cultural humility in the past few years. In 2019, a Behavior Analysis in Practice special issue raised a collective call to action for increased diversity and representation within the field at both organizational and individual levels. Since that time, articles, discussions, and reports have been published providing heightened attention to cultural humility toward clients, stakeholders, and practitioners. However, little attention has been directed toward the diversity of individuals supervised by behavior analysts. In particular, effective and compassionate supervision of people with disabilities has not been addressed in the field. Practitioners and supervisors need to have the necessary knowledge and skills to be able to inclusively and effectively train and shape the behavior of supervisees with disabilities. The present article reviews the literature, research, and practices from the field of psychology and makes recommendations of tools to create a disability-affirming environment for supervision in the field of applied behavior analysis.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40617-023-00846-5.

The demand for behavior analytic practitioners who hold certification from the Behavior Analysis Certification Board (BACB) continues to grow in the United States. According to the latest report from the BACB (2020a, b), as of July 1, 2021, there were 48,124 board certified behavior analysts (BCBAs), 5,014 board certified assistant behavior analysts (BCaBA), and 102,937 registered behavior technicians (RBT). In the field of applied behavior analysis (ABA), supervision is a central activity for most BCBAs as they supervise BCaBAs and RBTs (Turner et al., 2016). Behavior analysts also supervise individuals who do not hold BACB credentials or certification, such as behavior therapists and direct care staff. The supervisor's behavior has a crucial impact on the supervisee's behavior. The quality of supervision contributes to the development of ethical behavior analysis practitioners and ensures the protection of clients (Turner et al., 2016). The BACB's supervision standards were minimal until 2011 when the Supervision Task Force was established by the BACB to develop supervision guidelines and training standards for behavior analysts (BACB, 2011). The task force set up minimal requirements and competencies for prospective and practicing certificants. Important additions to the requirements included a supervisory contract, the use of behavior skills training (BST), and frequent performance feedback to supervisees (BACB, 2012). In 2020, the BACB updated its supervisor training curriculum and requirements (BACB, 2020a, b). According to the new requirements, BACB supervisors must be able to complete the following: (1) state the purpose of supervision; (2) describe the strategies and potential outcomes of ineffective supervision; (3) prepare for the supervisory relationship; (4) establish a plan for structured supervision content and continued evaluation of the supervisee competence; (5) create a committed and positive relationship; (6) use BST to improve supervisee performance; (7) comply with relevant BACB fieldwork requirements; (8) evaluate the effectiveness of supervision; and (9) incorporate ethics and professional development (BACB, 2020a, b). These skills form the basis of supervisory skills required of supervisors to shape the behavior of direct care staff.

High-quality supervision is critical to shaping the behavior of direct care staff and this includes supporting the development of skills to work with clients of diverse backgrounds. Whereas courses in some behavior analysis programs have emphasized cultural humility and respect for individual differences, many may not because this is not part of the required BACB task list content. Both coursework and supervision are needed to teach cultural humility and respect for individual differences (Fong et al., 2016). An additional consideration is also needed for practitioners accruing hours under the BACB-supervised fieldwork model. Further, supervision and coursework that emphasizes respect for diversity includes not just racial, ethnic, and gender diversity, but also humility related to able-bodied and disabled individuals. The BACB, however, does not have specific requirements for including cultural humility with supervisees and clearly has not recognized how disabilities might affect the supervisees. Other fields, such as psychology, have developed research and guidelines for working with trainees with disabilities (Andrews et al., 2013; Lund et al., 2016, 2020; Olkin, 2009). Given that the field of ABA is sensitive to individual differences (i.e., the field is based on individual behavior), it would benefit from practical guidelines for working with supervisees with disabilities to create a more inclusive and individualized environment.

The purpose of the current article was twofold. First, to review the literature and guidelines established by other fields, such as psychology, for working with supervisees with disabilities. Reviewing guidelines from other fields can provide the field of behavior analysis with examples of practices that could be adapted in a conceptually systematic manner. Second, to propose a conceptually systematic framework of guidelines for behavior analytic supervision of supervisees with disabilities. In addition, examples of tools for supervisors and clinicians are presented to create a disability-affirming training environment for supervisees in clinical and educational settings, including the beneficial outcomes of such an environment.

Understanding Disability

Disability is defined across three dimensions: impairment, limitation in performing activities, and restricted participation in daily activities (Centers for Disease Control & Prevention [CDC], 2020). Disabilities related to an impairment affect an individual’s physical or mental functioning (e.g., amputation, memory loss), disabilities affecting a person’s activities include walking or vision difficulty. Disabilities related to restrictions in participation in daily living activities like working. Finally, according to the CDC (2020), disabilities can be caused by conditions diagnosed since birth (e.g., Down syndrome, muscular dystrophy), developmental conditions diagnosed in childhood (e.g., autism spectrum disorder, attention-deficit/hyperactivity disorder), caused by an injury (e.g. traumatic brain injury), related to a long-term condition (e.g., diabetes), or a progressive condition (e.g., Parkinson’s disease).

Barriers in the Workplace

The experience of individuals with disabilities (whether they have visible or invisible disabilities) in the workplace and in supervision often includes bias, stigma, and barriers (Lund et al., 2020). According to Davis (2005), individuals who do not conform to able-bodied standards are marginalized and rendered socially invisible. They must face barriers including prejudices and biases against individuals with disabilities in the workplace and education settings (Crewe, 1994). Lund et al. (2020) identified two types of barriers individuals with disabilities face: attitudinal barriers, institutional barriers. An additional barriers related to the disability itself can also be considered.

Consider for example attitudinal barriers which can include invasive questions about a trainee’s disability, estimating the cost of accommodations to be too expensive, and a lack of information on laws and regulations on disability (Andrews et al., 2013; Olkin, 1999). Attitudinal biases include the assumption that even if reasonable accommodations are provided, the supervisee or trainee will not develop the required competencies and skills or that an accommodation is not needed, the trainee must work harder (Lund et al., 2016; Olkin, 2009). For example, a supervisor working with a behavior therapist with a vision impairment who asks for data sheets printed ahead of time in a larger font might view the accommodation as unreasonable because the behavior therapist can print the data sheets in larger font themselves. Employers may also view requesting accommodations as a way to avoid work or to allow lower-quality work because of the accommodations (Davis, 2005; Olkin, 2009). Such biases show a lack of understanding of the purpose of accommodations: the purpose of the accommodation is to create an opportunity for the trainee to demonstrate their ability to learn, perform a skill, and develop within their role (Lund et al., 2020). Indeed, accommodations need only alter the means of completing a task, not the task itself (Lund et al., 2020).

Trainees may also face institutional barriers when organizations fail to provide adequate training to supervisors regarding how to address requests for accommodations, fail to promote inclusive workplace practices that reduce the need to request accommodations (e.g., flexible scheduling, breaks) or lack clear policies regarding how the organization supports individuals with disabilities. For example, consider a supervisee working at a clinical organization providing services for clients with autism in the home. The supervisee suffers from a physical disability, requiring them to use private transportation between clients because they are unable to take public transportation. The organization, however, does not allow the supervisee to work with clients within the same small geographical area to minimize expenses from ride-hailing services. In this case, the clinical organization is failing to foster an inclusive workplace.

Finally, supervisees face barriers to the nature of their disability. As behavior analysts, we are particularly equipped to individualize treatments to target socially significant behaviors and improve the quality of life of supervisees. For example, a supervisor is working with a behavior therapist with a vision impairment. The behavior therapist has some vision and requires materials to be sent ahead of time for review. They also require printed materials, including data sheets, to be printed in a large font size to use with clients and collect data or on a tablet with font adjustments. Such a simple accommodation would allow the behavior therapist to comfortably complete their required job tasks.

Legal Rights and Responsibilities

Although employees have often faced both attitudinal barriers and institutional barriers in the workplace, organizations have legal responsibilities toward employees with disabilities. The Americans with Disabilities Act ([ADA] 1990) explicitly prohibits discrimination based on a person’s disability and prohibits employers from asking questions about an applicant or employee’s disability unless directly related to the job requirements. The ADA (1990) includes five titles, only Titles I, II, and V are relevant for ABA employers. ADA Title I (1990) concerns employers with 15 or more employees and requires employers to provide equal opportunities to individuals with disabilities; this includes hiring, promotion, training, pay, and organizational activities. Title II discusses the inclusion of individuals with disabilities in state and local government, which for ABA providers would apply to public schools. Title V prohibits retaliation against individuals asserting their rights, and provides flexibility for individuals with disabilities; it also states that they are not obligated to accept an accommodation.

Under the ADA (1990), it is the responsibility of the employer to provide reasonable and acceptable accommodations to employees. Useful accommodations include flexible scheduling, extended time for required tasks, assistive equipment, parking accommodations, and alterations to the physical environment. Creating a disability-inclusive environment is a shared responsibility between the organization, supervisors, and trainees (Andrews et al., 2013).

Supervision of Students with Disabilities

Ethical Standards in ABA

Training organizations in ABA must abide by federal law and comply with the ADA, but also ensure their compliance with behavior analytic training and ethical standards. The BACB (2020a, b) Ethics Code provides credentialed individuals with an ethical code to abide by when providing services, including service delivery, consultation, supervision, research, training, and management, among others. Section 1.07 specifically refers to cultural responsiveness and diversity:

Behavior analysts actively engage in professional development activities to acquire knowledge and skills related to cultural responsiveness and diversity. They evaluate their own biases and ability to address the needs of individuals with diverse needs/ backgrounds (e.g., age, disability, ethnicity, gender expression/identity, immigration status, marital/relationship status, national origin, race, religion, sexual orientation, socioeconomic status). Behavior analysts also evaluate the biases of their supervisees and trainees, as well as their supervisees’ and trainees’ ability to address the needs of individuals with diverse needs/backgrounds. (BACB, 2020a, b, p. 9)

Although section 1.07 does not specifically refer to supervising trainees with disabilities, sections 4.06 and 4.07 refer to the individualization and diversity of supervisory duties respectively. Section 4.06 specifies that behavior analysts must provide supervision and training that is evidence-based and individualized to each supervisee (BACB, 2020b). The reference to the individualization of supervision suggests that accommodation for disabilities would be included. Section 4.07 mentions that behavior analysts must address diversity, and though it does not mention the diversity of supervisees and trainees, nor that the supervisor must be trained on diversity in general (BACB, 2020b), synthesizing sections 1.07, 4.06, and 4.07 suggests that cultural responsiveness to the disabilities of supervisees and trainees is part of the ethical code.

Cultural Humility

Many terms have been used across time to refer to cultural responsiveness, in this article, cultural humility will be used. Cultural humility is a framework recognizing that clinicians need to develop specific skills to work with diverse populations (Fisher-Borne et al., 2015). The model recognizes power imbalances certain cultural groups face and the work that must be accomplished by individuals and institutions through continuous learning and self-reflection. The cultural humility model relies on a practitioner’s commitment to lifelong self-evaluation to address power imbalances related to individual cultural differences (Wright, 2019).

Although the cultural humility model was developed in the field of social work (Fisher-Borne et al., 2015), it is applicable to the field of ABA as behavior analysts seek to improve socially significant behaviors and meaningfully improve the quality of life of clients (Wright, 2019). The cultural humility approach provides a useful framework, however, additional research evaluating the effectiveness of the framework in interventions, service delivery, graduate training, and supervision of students is needed.

Research in behavior analysis has evaluated the inclusion of cultural humility into graduate training. Conners et al. (2019) conducted a survey of BACB credentialed professionals on their graduate training and fieldwork experiences on multiculturalism and diversity issues. The authors found that survey respondents perceived their training and supervision as lacking in cultural competency. A consistent application and training for multiculturalism and diversity would benefit the supervisory environment for students. Najdowski et al. (2021) proposed antiracist strategies for a graduate program in behavior analysis to be implemented at the organizational level. For example, the authors proposed the use of behavioral approaches to tackle bias and racism during coursework, including behavior assessment, and intervention. They also suggested that instructors offer flexible submission or presentation styles. Fong and Tanaka (2013) proposed seven standards for cultural competence related to ethics and values, self-awareness, cross-cultural application, diverse workforce, language diversity, professional education, and referrals (Fong & Tanaka, 2013). Behavior analysts can contribute relevant research on the effectiveness of cultural humility, the individualization of supervision as related to culture, including disability, and the outcomes of supervision.

Culture

Skinner (1953) first defined culture as a set of variables arranged and reinforced by the community. Human beings arrange and control contingencies of reinforcement and punishment influencing behavior, learned reinforcers, and punishers for an individual or group of individuals (Fong et al., 2016). Culture can also be defined as the overt and covert behavior of people with shared learning histories, to differentiate the group from others, and reliably influence the behavior of individuals within the group (Sugai et al., 2012). Culture includes an individual’s interaction with their environment, thus creating unique cultural subsets, from disability to culture centered around a specific ethnic heritage, gender experience, or socioeconomic status (Fong & Tanaka, 2013). Developing an understanding of another person’s culture opens the door to developing an awareness and understanding of a person’s cultural values, circumstances, and preferences (Skinner, 1981). Understanding the culture of supervisees and staff can help develop a better relationship with supervisees (Fong et al., 2016).

Disability Culture

According to Gill (1995), disability culture is often unknown to individuals outside of it. Disability culture centers around core values: using humor, appreciating disability as part of human diversity, accepting interdependence as natural, developing the skill to manage various systems, technology, and assistants, using a shared language, developing changing symbols and art, and developing a collective sociopolitical stance (e.g., encouraging independent living). The field of disability has developed the emergence of people first language, shifting from disability first language (e.g., “individual with a disability”). The experience of disability is individual to each person, therefore, supervisors should seek the input of their supervisees regarding their self-identification language as it varies from one person to another (Andrews et al., 2013). Understanding disability culture can help supervisors in their role of supervisor-advocate, and develop a better understanding of the role disability plays in the life of their supervisees. In addition, it would reduce the burden for supervisees with disabilities in educating their supervisor (Andrews et al., 2013).

Examples of Recommendations from Psychology

Diversity also includes working with supervisees who have disabilities. Other human service fields have addressed recommended practices for supporting supervisees with disabilities. Researchers in psychology have conducted research with trainees with disabilities asking them what advice they would give to other psychology trainees with disabilities. Lund et al. (2016) evaluated the responses to one survey question asking trainees what advice they would give to a trainee with a disability like theirs. Appendix A displays a summary of recommendations for supervisors from the psychology research (Lund et al., 2016, 2020; Olkin, 2009; Wilbur et al., 2019) in addition to a summary of recommendations from trainees with disabilities to other trainees with disabilities taken from Lund et al. (2016). Respondents from the study conducted by Lund et al. (2016) suggested that trainees find support, identify resources within and outside their own organizations, and seek mentorship from other professionals with disabilities. Respondents also recommended that trainees advocate for their own rights during training, and can discuss their own disabilities. Survey respondents recommended trainees ask for accommodations with professors or with the on-campus disability office, as well as becoming proficient in useful technology. Survey respondents further recommended documenting contact with their supervisor, and creating an accommodation record in case of a dispute. Finally, some respondents encouraged trainees to disclose their disability at the beginning of training to take charge of their disability and experiences. However, other respondents recommended being careful around disclosure, disclosing only if necessary, and carefully selecting to whom they disclosed information (Lund et al., 2016). Supervisors should take into the perspective of individuals with disabilities to provide the adequate support direct care staff and supervisees will need.

Lund et al. (2020) emphasized the significant role of supervisors as advocates for supervisees with disabilities. The authors defined a supervisor-advocate as an individual who speaks in support of their trainees with disabilities, searches for solutions, educates others on problem-solving in supporting disabled trainees, provides accommodations, and helps their supervisees develop problem-solving skills to address barriers related to their disability. A supervisor-advocate first acquires competence in supervising trainees with disabilities through formal training or by seeking continuing education and research on supervising students with disabilities (e.g., Andrews et al., 2013; Lund et al., 2016, 2020; Olkin, 1999, 2009; Wilbur et al., 2019). Second, they  review important resources, including APA webinars on supervision and disability (Wilbur et al., 2017), or the Job Accommodation website (Job Accommodation Network, 2018). Appendix B displays a nonexhaustive summary of resources for supervisors looking for initial resources across organizational, political, technological, online, and educational sources. Third, the supervisor-advocates follows up on requested accommodations from their supervisees (Lund et al., 2020). Fourth, are proactive, reminding colleagues and the organization that supervisors are responsible for supporting trainees in requesting accommodations. Fifth, the supervisor-advocate speaks out and addresses disability biases in colleagues and their workplace (Lund et al., 2020). Finally, they contribute to creating a disability-affirming training environment by advocating for the hire of supervisors and supervisees with disabilities, by supporting the inclusion of disabilities in diversity statements and policies, by pushing for the inclusion of disabilities in cultural competency training, by advocating for hiring trainees with disabilities, and by communicating the availability of disability accommodations to new hires (Lund et al., 2020). Supervisors must also consider that their behavior occurs within the large environment of society's view of disability and the stigma attached to it.

Addressing Stigma

Disability can be stigmatizing in our current society, and anyone who does not fit the able-bodied mold may often be marginalized (Davis, 2005). Supervisors thus face the added challenge of confronting bias and stigma against individuals with disabilities. Lund et al. (2020) recommended supervisors self-reflect and evaluate their own beliefs on disability and how their beliefs on disability affect their interactions with disabled supervisees. The authors emphasize the supervisor is responsible for creating a disability-inclusive environment where able-bodied and disabled trainees can thrive and develop critical clinical skills. Supervisor advocates should support and contribute to the inclusion of disability in supervisory education to ensure future supervisors have the tools necessary to supervise trainees with disabilities and address their own internal biases (Lund et al., 2020). Supervisors should seek to normalize discussions about disabilities by encouraging colleagues to communicate to every trainee their own role in establishing reasonable and necessary accommodations (Lund et al., 2020).

Addressing Reasonable Accommodations

Under the ADA, employees are legally allowed to request accommodations if they are otherwise qualified for the position and the accommodations do not put an undue financial burden on the organization (ADA, 1990). Requesting accommodations during training may expose disabled supervisees to stigma and bias. It is critical for supervisors to understand the purpose of accommodations in the workplace or in educational settings (Lund et al., 2020). To request an accommodation, an employee must already meet the required qualifications to perform the skill or task. Reasonable accommodations change how a standard is achieved but should not change the standard itself or the essential functions of the task; accommodations recognize the difference between job tasks and essential functions (Lund et al., 2020).

Supervisory Advocates as Trainers

According to Lund et al. (2020), supervisor-advocates create a supervisory environment where they teach and share knowledge on supervising trainees with disabilities with colleagues and other supervisees. Supervisors take on the role of educating supervisees on disability and reasonable accommodations (Lund et al., 2020). It is the supervisor’s responsibility to create a safe environment for supervisees to evaluate and remedy their own biases related to disability, so once they become supervisors, they can also become advocates for supervisees and direct care staff with disabilities (Lund et al., 2020).

Disability-Affirming Training Environment Model

The disability-affirming training environment (DATE) was developed by Wilbur et al. (2019) as a model to create an environment where individuals with disabilities can thrive and access resources within their organization. In the DATE model, supervisors first develop an understanding of disabled individuals as part of a minority group, subject to discrimination and biases, and disability as an aspect of diversity. Second, according to the authors, supervisors educate themselves on disability through training or reading literature. Third, supervisors are responsible for setting accommodations for trainees with disabilities and asking if trainees need accommodations. Lastly, supervisors advocate for their trainees needing accommodations (Wilbur et al., 2019).

Overall, the field of psychology has developed useful practices and recommendations for the supervision of trainees with disabilities. However, empirical evaluation to evaluate the efficacy of the recommendations and their effect on the outcome of supervision is needed. It is necessary to consider the perspective of trainees with disabilities who are navigating completing their supervision and training requirements while also navigating a workplace with a disability. Behavior analysis can contribute to empirical research to test recommendations and their outcomes on students.

Behavior Analytic Perspective

Research from the field of ABA, although not focused on the supervision of individuals with disabilities, has provided resources and research for practicing cultural humility and setting organizational goals at different levels.

Organizational Level

Organizational behavior management (OBM) is a behavior analytic approach applied to improving workplace performance (Dickinson, 2001). Specific OBM interventions often include analyses of organizational systems (Brethower, 2000) to foster behavior change within all levels of an organization (Sigurdsson & Austin, 2006). For sustainable changes made within an organization to last the intervention should be programmed for generalization from the training setting across time, employees, and organizational settings (Sigurdsson & Austin, 2006). Strategic planning is a comprehensive approach allowing organizations to plan and prepare for the future by (1) setting clear vision and mission statements; (2) evaluating the current social, community, and business climate around the organization; and (3) defining organizational, departmental, and individual objectives and plans for employee training (Chase & Smith, 1994). Developing a specific strategic plan to create a disability-affirming environment could provide the structure to develop disability-related goals and measure their outcomes during supervision and training.

Once goals have been developed for an organization, the relations between each system within an organization need to be evaluated (Chase & Smith, 1994). For an organization to meet its goal and fulfill its vision and mission, each organizational system (i.e., societal, organizational, departmental, individual) must align its goals and outcomes (Chase & Smith, 1994). If an organization wants to create a disability-affirming culture, then all levels within the organization must align with this goal. Conducting an initial vantage analysis would provide critical information on existing differences between specific organizational systems and organizational objectives and develop a plan to align organizational goals with current systems.

Fong et al. (2016) recommend developing cultural awareness at the organizational level by embedding cultural awareness training and supervision within an organization. First, Fong et al. (2016) recommend selecting an individual within the organization to be responsible for developing cultural awareness discussion points for supervised fieldwork and to serve as a point of contact on cultural awareness best practices within the organization. Second, organizations should seek to include cultural awareness training within individual and group supervision, in addition to companywide training (Fong et al., 2016). Cultural awareness training should be embedded in behavior analysis coursework. Although the BACB Fifth Edition Task List (2020a, b) does not specifically refer to supervising supervisees with disabilities, the general behavior analytic approach to understanding and producing behavior change allows for guidelines proposed in other fields such as psychology, to be evaluated for conceptual consistency, ethical merit, and effectiveness of outcomes.

Individual Level

The American Psychological Association ([APA] 2003) recommends practitioners evaluate how their own self-held beliefs and biases can influence how they interact with individuals from other cultural backgrounds and ethnicities. Behavior analysts are also subject to individual biases that can affect how they interact with supervisees and clients. Developing self-awareness aids in self-monitoring behavior toward others. In behavior-analytic terms, self-awareness can be described as verbal discrimination of one’s own behavior (Barnes-Holmes et al., 2001). Practitioners would benefit from discussing interactions with diverse clients and supervisees within professional group discussions, journals, mentorship meetings, or feedback sessions (Tervalon & Murray-García, 1998). Practitioners could further discuss interactions with diverse supervisees and trainees with other professionals. Discussing interactions with colleagues and supervisees may help behavior analysts develop better cross-cultural interactions (Fong et al., 2016).

Fong et al. (2016) further suggest that behavior analysts may also benefit from being mindful by engaging in active listening during client interactions to enhance skills of self-observation and self-monitoring of covert and overt behaviors. This recommendation can be extended to interactions with supervisees with disabilities. For example, during an interaction with a supervisee with disabilities asking for accommodations, the supervisor can engage in self-monitoring of their covert verbal behavior, as well as overt verbal behavior in how they respond to the request.

Ongoing self-assessment of behavior and its environment offers an avenue for behavior analysts to continually monitor their own behavior and identify observable and measurable goals for behavior change to align their behavior to specific goals and objectives (Fong et al., 2016). Leland and Stockwell (2019) developed the first self-assessment tool targeting observable and measurable behaviors for transgender, gender nonconforming (TGNC) affirming practices for the field of ABA. The TGNC-Affirming Clinical Skills Self-Assessment ([TGNC-ACSSA] Leland & Stockwell, 2019) is an ongoing self-assessment of individual skills around ethics, arranging the environment, and arranging behavior. This assessment is a great example of the use of an assessment to monitor ongoing behaviors and its impact on clients. A self-assessment developed to assess the behavior of practitioners for creating a disability-affirming environment could be beneficial for the field. Indeed, supervisors and clinicians working either at the clinical or educational and training level play a significant role in advocating for supervisees with disabilities and promoting equity and access to training, resources, and career growth.

Taking an OBM approach to disability would include first specifying organizational goals specific to creating a disability-affirming environment, then identifying specific employee goals aligned with organizational goals. Pinpointing, from the OBM literature, specifies behaviors and how they will be measured (Chase & Smith, 1994). Pinpointing adds value for an organization by identifying critical behavior, clarifying employee performance, facilitating the delivery of feedback and reinforcers for meeting or exceeding expectations, and implementing corrective changes for performance not meeting performance expectations (Daniels & Daniels, 2006). Pinpointing requires the description of important results or outcomes, and then the identification of measurable and observable employee behavior required to achieve the specified outcomes or results (Chase & Smith, 1994; Daniels & Daniels, 2006; Rodriguez et al., 2016). Specific pinpoints could be developed to further the organizational goals of creating a disability-affirming culture. For example, the following pinpoint could be developed for a supervisor: “The behavior analyst supervisor will inform every supervisee and direct care staff of their responsibility to arrange for accommodations, record the request for accommodations, and arrange for accommodations within two weeks of the request. If the supervisor requires more time to set up accommodations, they will inform their supervisee of the steps taken and the progress to securing accommodations. Once the accommodations have been secured, the supervisor will send a copy of the recommendations to the clinical director and the human resources department for recordkeeping. The clinical director will monitor the supervisor’s implementation of accommodations, contingent on implementing accommodations within 72 hours they will earn 5 points toward their total end-of-year bonus.”

OBM has developed research across system-wide analysis, organizational, and individual behaviors that can offer an avenue for developing assessments for disability-affirming supervision. Conceptually systematic methods can be developed to assess and develop policies in organizations to promote the inclusion of employees and supervisees with disabilities.

Disability-Affirming Assessment Tools

OBM offers a variety of tools useful for the evaluation and assessment of an organization. It is imperative for the field to develop reliable and effective tools to promote and develop disability-affirming practices. In Appendix C and D are examples of untested disability-affirming tools derived from the work of Chase and Smith (1994) on strategic planning, performance systems analysis, and vantage analysis. Both the DASP and DAVA are informed by strategic planning, performance system analysis, pinpointing, and the vantage analysis developed in the field of OBM and described in detail in Chase and Smith (1994). Some questions are adapted from strategic planning questions and vantage analysis questions from Chase and Smith (1994). The original questions were changed to reflect a specific focus on disability-affirming practices. These example tools were developed to provide examples of tools meant to evaluate and assess measurable behavior and outcomes at every level of an organization. Although currently untested, these tools would go through primary review from individuals with disabilities by conducting a focus group with individuals with disabilities to collect their views and experiences on the survey questions. Completing a preliminary review of survey questions would ensure the inclusion of individuals with disabilities perspective and the relevance of the survey questions included (Kroll et al., 2007).

The first example depicted in Appendix C is Disability-Affirming Strategic Planning (DASP), a 15-item strategic planning assessment with subdomains for the environment, mission, vision, values, and organizational climate. The DASP is organized into three subdomains: environmental variables, mission, vision, and values, and organizational climate. Each subdomain contains binary questions with an accompanying unsure option if the assessor is not sure of the availability of the information.

The first subdomain explores environmental variables. It encourages organizations to evaluate the environmental stimuli related to strategic planning. For example, question 1 asks about the organization’s ability to track local, regional, and federal laws on disability in the workplace. The purpose of the question is to evaluate an organization’s compliance with disability laws. Question 3 addresses if the organization has a consistent manner of collecting data on technological trends affecting individuals with disabilities. For example, improvements in screen reader technology for blind or visually impaired employees. This question evaluates an organizational responsibility to provide reasonable accommodations to employees with disabilities.

The second subdomain includes two questions on the mission of the organization. For example, question 6 asks if the organization first has a defined mission statement. Question 7 asks if one of the objectives listed in the mission statement includes a stated commitment toward individuals with disabilities.

The third and final subdomain includes seven questions about the organizational climate to evaluate disability-affirming policies at the organizational level. For example, question 8 asks if the organization has clearly stated goals for disability inclusion. To measure outcomes of disability inclusion, organizations must first define specific behaviors and goals and subsequently measure their accomplishment.

The second example of a tool, depicted in Appendix D, is the Disability-Affirming Vantage Analysis (DAVA), a 16-item vantage analysis assessment with subdomains for evaluation at the social, organizational, departmental, and individual levels. The DAVA is organized into four subdomains: social, organizational, departmental, and individual levels. The four subdomains reflect the levels of vantage analysis described by Chase and Smith (1994).

The first subdomain contains four questions about the social level of an organization. At this level of vantage analysis, the purpose is to evaluate the values of the surrounding culture (Chase & Smith, 1994). For example, question 1 asks if the surrounding local and state environments offer resources to support a disability-inclusive organization. It aims to assess if resources are available to support organizations that want to implement a disability-inclusive environment.

The second subdomain includes five questions about the organizational environment. This level of analysis is aimed at evaluating the policies, values, and general objectives of an organization (Chase & Smith, 1994). For example, question 8 asks if the organization has specific policies on employee disability or disability in general. The purpose is to evaluate if an organization already has written policies around accommodations, recruiting, or promotion of employees with disabilities.

The third subdomain includes four questions at the departmental level of an organization. At this level of vantage analysis, the questions seek to evaluate the values, roles, and strategies of each department within the organization (Chase & Smith, 1994). For example, question 13 asks if a specific department within the organization is responsible for setting up accommodations.

The final subdomain is at the individual level of vantage analysis and includes three questions. At the individual level of vantage analysis, it is important to evaluate individual values reflected through outcomes and responsibilities (Chase & Smith, 1994). For example, question 16 asks if the employee can alter their job task while completing essential job functions. The question asks if accommodations could be implemented for specific job duties.

These examples of tools may serve as starting points for the field of applied behavior analysis to start developing best practices, guidelines, and assessments for organizations. They can be used by organizations and individuals to evaluate and develop practices supporting employees with disabilities.

Both the DASP and the DAVA would ideally serve as ongoing assessments of an organization. The example tools would serve as guides to develop disability-affirming policies and practices within organizations and clinical practices. The tools are designed for practitioners, clinicians, and supervisors who work in behavior analytic services.

Discussion

The purpose of this article was to review the literature and guidelines established by other fields, such as psychology, for working with supervisees with disabilities and to propose a conceptually systematic framework of guidelines for behavior-analytic supervision of supervisees with disabilities. This article should serve as a starting point for the field of ABA to extend cultural awareness practices and research into the supervision of individuals with disabilities. The BACB Fifth Edition Task List (BACB, 2020a, b) does not specifically refer to the supervision of individuals with disabilities, yet master’s programs in ABA base their curriculum on the Task List. Furthermore, the Ethics Code for Behavior Analysts includes the requirement for individualized supervision and training but does not specify the need to incorporate accessible supervision materials (BACB, 2020b). In section 4.06, the Board specifies that behavior analysts must provide evidence-based and individualized supervision and training (BACB, 2020b). The Code does not, however, specifically mention the accessibility of supervision materials (BACB, 2020b). Section 4.07 specifies that behavior analysts must address diversity during training with the supervisee; however, the Code does not mention the diversity of the supervisee and does not mention if the supervisor must already have training on diversity (BACB, 2020b). Incorporating diversity issues during supervision might be difficult in practice, as research has shown that BACB-credentialed individuals reported that their graduate training did not provide them with the multicultural skills they needed in practice (Conners et al., 2019).

Future Directions

Evaluation of best practices on the role of the supervisor as supervisor-advocate is a critical first step in determining the most effective interventions. It could help the field of ABA make strides in creating a disability-affirming environment. Applying a model of supervisor-advocate would be aligned with the research and recommendations published on cultural humility.

Behavioral instruction offers a promising avenue for inclusion in training. Behavioral instruction represents behavior-analytic instruction methods sharing common characteristics including contingency management, component-composite analysis, repeated opportunities to practice the components of observable and measurable behavior, and continuous measurement (Bernstein & Chase, 2013). Behavioral instruction can be utilized to teach future behavior analysts, supervisors, and supervisees critical skills and knowledge for working with a supervisee with disabilities. The BACB Supervisor Training Curriculum (2020a) already recommends supervisors use BST to improve supervisee performance, but additional behavioral instruction methods could be used. Modifications to BST can be implemented to ensure the accessibility of the training. Supervisors using BST must ensure the accessibility of the training to supervisees with disabilities. For example, if using video models, models should be accessible to individuals with vision and hearing impairments by providing closed captioning and adequate quality sound. In addition, a text alternative should be provided with the video model and made available to supervisees who need it. Competency-based training (Parsons & Reid, 1995; Parsons et al., 2012), a type of behavioral instruction, could be used to teach socially significant skills for working with supervisees with disabilities. Precision teaching (Johnson & Layng, 1996) could also be used to increase fluency in disability-related skills in supervisors.

The examples of tools proposed in Appendix C and D are derived from work in other disciplines but are untested. Future research, through appropriate measures and experimental designs, may evaluate effectiveness in relation to disability-affirming behaviors and: (1) usability; (2) social significance of each question; (3) effectiveness of the tool as an assessment of disability-affirming behaviors; (4) experimental control; (5) external validity across organizations; (6) effect at changing future behavior and policies across individuals and organizations; and (7) consistency in measurement. Rigorous experimental evaluation is necessary to develop and determine the efficacy of disability-affirming assessments to produce measurable and socially significant behavior change at the institutional and individual levels. Developing tools based on OBM research would provide a solid foundation for the further development and integration of best practices and guidelines for practitioners, supervisors, employees, and organizations alike.

In summary, supervision is critical to the delivery of high-quality services to clients (Turner et al., 2016). Examples from the field of psychology such as the disability-affirming training environment (Lund et al., 2020) support the critical role of the supervisor. Behavior analysis is sensitive to individual differences that allow practitioners to develop robust, empirical, and inclusive guidelines for working with supervisees with disabilities, by using antecedent, operant, and system-wide interventions. The proposed assessments show the need to develop assessment tools and continued training both in university coursework and during supervised fieldwork in disability-affirming practices for supervisees. Specific policies could be developed at the institutional level in fieldwork settings regarding the support available for supervisees with disabilities and whom to contact to ask for available accommodations in addition to their supervisor.

Supplementary Information

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Declarations

Conflicts of Interest/Competing Interests

The author has no conflict of interest to declare.