Why We All Need to Shape the Profession of Behavior Analysis through Advocacy and How to Get Started

Abstract

Many behavior analysts, like professionals in other health-related fields, are not trained to promote themselves, affect public policy, or disseminate information to individuals outside of their field, including to lawmakers. One of the reasons professionals can be experts in their own professions is because they devote their time to advancing their knowledge in their field; thus, they have limited time to spend becoming proficient in public relations, advocacy, and public policy. However, it is precisely these skills that behavior analysts need to hone and utilize effectively if the profession is to be sustainable. This article gives a brief history of the professionalization of behavior analysis, discusses the pitfalls of sometimes only being recognized as a single-disability industry (i.e. autism), explores the behavior of other professions that serve as models for advocacy, and provides recommendations for advocacy at different levels. The intent is to guide the profession and professionals of applied behavior analysis to a sustainable future based on the experiences of leaders of three U.S. state organizations.

The growth in the behavior analysis profession in the past decade has been remarkable. From 2013 to 2023, the number of Board Certified Behavior Analysts® (BCBAs) and Board Certified Assistant Behavior Analysts® (BCaBAs) expanded from about 10,000 to over 56,000, an increase of more than 430% (BACB, 2023). As demand for the services provided by behavior analysts continues to grow, the professionalization of the field follows. Although many know that behavior analysts provide services based in the application of the science of behavior analysis, commonly known as applied behavior analysis (ABA), for persons diagnosed with autism or other neurodevelopmental disorders, those outside the field do not always realize that there are many more applications of the science including but not limited to sports and wellness, organizational management, education, substance abuse, animal training, and sustainability (Heward et al., 2002). The success of ABA in the autism field often overshadows these other applications. Some pitfalls with this are that many interested parties outside of behavior analysts themselves (e.g., insurance companies, company administrators, private equity companies, parent advocacy groups, school systems) are making decisions about the profession and the science, which could lead to a narrowing of the field in the future.

Some behavior analytic professionals have recognized the need for advocacy and public policy work beyond simply practicing ABA or contributing to the science. Those professionals have learned a lot by working with behavior-analytic adjacent organizations (such as those specific to autism) and the field needs to take these lessons and apply them to areas outside of education and autism treatment. The solution is for all behavior analysts to advocate for the profession—regarding services for those with disabilities as well as other applications. In this article we offer suggestions to build advocacy and foster growth of behavior analysis in multiple environments. Recommendations are offered for behavior analysts in leadership positions but also for everyday practitioners.

History

To give a complete or even robust account of the history of behavior analysis and its professionalization is beyond the scope of this article. However, a brief timeline of some important events towards the professionalization of behavior analysis seems necessary. This timeline will set the stage for subsequent discussion of the need for advocacy for the diverse application of behavior analysis and to express to the reader the importance of behavior analysts being involved in disseminating behavior analysis.

Behaviorism first appeared in the United States in the early 1900s. Psychology had only been an experimental discipline for around 50 years when in 1913, Watson published an article entitled “Psychology as the Behaviorist Views It” in the Psychological Review. In this article, Watson presents psychology from a behaviorist’s perspective to be “a purely objective experimental brand of natural science” (Watson, 1913). He eschewed the mainstream psychology focus on consciousness and introspection. This article has been described as his behaviorist manifesto (Morris, 2013). His behaviorist manifesto was a call to action for psychologists to focus on behavior as the subject matter of the broader field.

Twenty-five years later, Skinner published The Behavior of Organisms: An Experimental Analysis in which he describes a science based upon the selection of consequences (Skinner, 1938). It is in this book that Skinner introduces the operant as a unit of measurement and the law of reinforcement, laying the foundation for behavior analysis. It would be another 20 years until the Journal of the Experimental Analysis of Behavior was launched in 1958 and 30 years until the Journal of Applied Behavior Analysis was launched in 1968 (Journal of Experimental Analysis of Behavior, n.d.; Journal of Applied Behavior Analysis, n.d.). In 1964, in between the formations of those journals, the American Psychological Association started Division 25 (Behavior Analysis) to promote “basic research, both animal and human, in the experimental analysis of behavior and the application of the results of such research to human affairs” (Division 25 Behavior Analysis, n.d.). To put the timeline into perspective, it has been only 59 years since the commencement of Division 25, which happened in the same year the Civil Rights Act was introduced. Further, Division 25 was established only 51 years after Watson’s behaviorist manifesto was published; the point being that behavior analysis is a young profession.

In 1974, the Midwestern Association for Behavior Analysis was formed as a member organization for experimental and applied psychologists focusing on behavior analysis. This regional organization grew into what we know today as the Association for Behavior Analysis International (ABAI) with 96 affiliated chapters across the globe, six publications, and events beyond its annual convention (ABAI, 2023). At that time, behavior analysis was growing at a steady rate and behavior analysts were applying what they learned in experimental and applied research to diverse areas including teaching individuals with developmental disabilities and mental health diagnoses, working with children in urban communities, improving the educational systems through advancements in teaching techniques, working with NASA, and using organizational behavior management and safety techniques in companies (History of Behavior Analysis, n.d.).

In 1987 and 1993, studies were published demonstrating great improvements in the lives of children diagnosed with autism spectrum disorder (ASD) using behavior analytic techniques (Lovaas, 1987; McEachin et al., 1993). Although it was not the first of such studies, the 1987 study was groundbreaking as it demonstrated a wide range of skill acquisition and included a larger number of participants compared to previous studies. This led to a sharp increase in demand for behavior analysts who worked with children diagnosed with ASD. With the demand for ABA increasing, the need for credentialing distinct from psychology licensure arose.

The state of Florida was the first to issue a certification for behavior analysts. Individuals who passed the first professionally developed exam in 1983 were called certified behavior analysts (CBA). From that, the Behavior Analyst Certification Board (BACB) was established in 1998, and it created the BCBA and BCaBA credentials contingent upon passing a comprehensive examination and completing supervised training hours. The doctoral level distinction was developed in 2008: the Board Certified Behavior Analyst-Doctoral® (BCBA-D). With the need to increase competence in a field with a significantly growing workforce of direct line staff being supervised by BCBAs and BCaBAs, the BACB developed the Registered Behavior Technician® (RBT) credential in 2013. For a complete history, we refer readers to Johnston et al. (2017), A History of the Professional Credentialing of Applied Behavior Analysts. The development of the BACB, its robust job studies, and subsequent ethics codes were important steps in the professionalization of the field of behavior analysis, further distinguishing it from other professions, including psychology. To focus more specifically on the needs of practitioners and to further the professionalization of behavior analysis, the Association for Professional Behavior Analysts (APBA) was formed in 2007 to represent practitioners in the field. The first state licensure bills for behavior analysts were signed into law in 2009 in Nevada and Oklahoma with a total of 36 states as of this writing recognizing licensure behavior analysts (BACB, n.d.). Other states are in various stages of pursuing licensure as of the writing of this article.

As behavior analysis has its roots in psychology, it is a good exercise to examine the timeline for the establishment of the psychology profession in comparison with behavior analysis. Prior to the 20th century, psychiatrists were responsible for the assessment, diagnosis, and treatment of mental illness—generally in asylums or hospitals (starting in the late 1700s). In 1892, the American Psychological Association (APA) was founded (American Psychological Association, n.d.). In 1909, Freud visited the United States and “talk therapy” was popularized, although it took another 50 years or so for “couch psychology” to become the prototype (Benjamin, 2005).

Just as with early behavior analysis, “No [psychologist] certification or licensure laws existed to define the training or practices of these individuals, and there were few laws to protect the public from fraudulent practices” until the psychology professionals banded together to advocate for themselves (Benjamin, 2005). According to Benjamin,

Clinical psychologists battled psychiatrists for much of the last half of the twentieth century to win their place in professional practice on such issues as licensure, insurance reimbursement, hospital privileges, and the independent practice of psychotherapy. They won some of those battles because clinical trials research indicated that doctoral-level psychologists could do the work as well as their medical counterparts in psychiatry.

This sounds surprisingly similar to the behavior analysis profession’s relationship to psychology and other more established professions. In 1917, the psychiatric community called for an end to clinical psychology saying psychologists could use their assessment skills in advertising and sales, but not in clinical work. But in 1945, Connecticut became the first state to license psychologists, and by 1977 all states had licensed psychologists. It took psychologists 32 years to establish their profession through licensure. Based on the trajectory for behavior analysis, it may be as few as 18 years for all 50 states to have some form of licensure (BACB, n.d.).

Benjamin (2005) further described how psychotherapy had been the prominent focus of psychology and that the field needed to start expanding beyond psychotherapy. This is similar to Humphreys’s (1996) argument that although “clinical psychology’s choice to make psychotherapy a central focus helped some portion of society and brought significant resources to the field, a different central focus might have offered more effective ways of applying psychological knowledge to human problems.” Behavior analysts can learn from the lesson of remaining too narrow with respect to its association with autism services. Although it is important and appropriate to continue to maintain and expand our ability to serve the autistic and neurodevelopmentally delayed population, we also need to push our field outside of our comfort zone to remain relevant. Focusing on breadth will be of benefit to many as our general knowledge about the behavior of organisms grows.

The point of this historical comparison is to help behavior analysts frame the growth of our own profession, particularly in the applied arena. We can also take lessons from the history of psychology to remind us it is important to continually advocate for the profession so that others are not left to shape it. Although it would be comforting to think that the job of advocacy is complete once all states have licenses, other professions’ histories have shown that this is not the case.

The Importance of Advocacy

Advocacy is essential to promote the profession of behavior analysis, maintain the integrity of the field, and ensure that behavior analysts can continue to provide services in a manner that is consistent with the science. Behavior analysts are the experts in behavior analysis, and as such should be present and influential when decisions are being made about how behavior analytic services are regulated and can be provided. There are many parties interested and invested in the field of behavior analysis including parents and individuals who receive the services, organizations that support the use of the science, funders, investors, businesses, and administrators who may or may not fully understand the science and its applications. Whenever there is a clinically necessary and marketable service that has the potential to generate revenue, it is natural for many parties to want to participate in decisions that affect the delivery.

The effect of investor money on a profession is not unique to behavior analysis; other healthcare professions have also been influenced (MedicalNewsToday, 2021). As more people outside the profession recognize the effectiveness of the science of behavior analysis, it will be critical for practitioners and professionals to not allow others’ needs to drive the laws and regulations that affect the science and its practice. If behavior analysts simply practice, as many are wont to do, and do not get involved in advocacy, other parties, such as insurance companies or private equity investors, will dictate how services are provided including key components such as caseload, evaluation of services, reimbursement rates, funding sources, oversight, or employment opportunities. The authors of this article are involved with the leadership of three different state organizations, and each of these organizations has experienced times when policy makers or regulators attempted to make decisions regarding the profession without consulting with the professionals. This is extremely problematic if we, as clinicians, are not educating others, and we are not involved in all discussions that will affect how behavior analytic services can be provided.

A challenge for the behavior analysis profession is that we seem to be inextricably linked to autism. The prowess of Autism Speaks, the Council of Autism Service Providers (CASP), and other disability-specific organizations, as well as the sheer passion of the grassroots movements of family members affected by autism, is responsible for many of the policy successes we have today. However, there is a downside. One concern with the field not developing our own leadership and skills in advocacy is that the overfocus on ABA being tied to autism specifically as a treatment can and has led to flawed laws and regulations. One example of this is the formation of licensure in the State of New York.

New York State enacted licensure for behavior analysts in 2014, but the licensing law restricted the practice of behavior analysis to only working with individuals diagnosed with ASD. This was done essentially to fix what lawmakers saw as a flaw in the autism insurance law that called for coverage for behavior-analytic services. Unfortunately, lawmakers failed to recognize that there was not a license for behavior analysts in New York, thus making this portion of the insurance law unusable, according to the New York State Education Department’s Office of Professions, which governs all professional practices in New York. The New York State Association for Behavior Analysis (NYSABA) tried many tactics to keep the state from limiting the practice of behavior analysts. One attempted avenue of compromise that NYSABA successfully advocated for was the inclusion of the words “related disorders” in the original licensure bill. Unfortunately, the intent of this language (i.e., to broadly include many diagnoses in addition to ASD) was negated when the regulations were written. The regulations were written to specifically state that the “related disorders” was simply the result of the changing criteria in the Diagnostic and Statistical Manual (DSM) from edition IV-R to V (APA, 2013).

After over six years of developing skills in advocacy; identifying a skilled, savvy, passionate lobbyist; developing relationships with legislators; and creating grassroots networks independent of autism organizations, NYSABA was finally able to change the scope of practice in the state. The law is still not perfect because the State of New York sees the field through the lens of a medical treatment due to the way the license came into effect (i.e., insurance laws passed first), but a new law implemented in June 2023 does allow behavior analysts to work with individuals with any diagnosis in the DSM with the prescription of a qualified professional. The association argued successfully that the dearth of behavior analysts in New York (Zhang & Cummings, 2020), as compared to other states in New England, was directly tied to the restriction of the scope to autism. By collaborating with professionals who were not behavior analysts (e.g., American Academy of Pediatrics New York Chapters, University Centers of Excellence) and other advocacy organizations (e.g., Brain Injury Association of New York, Prader-Willi Syndrome Association USA) NYSABA was able to demonstrate that this was not a “self-serving” endeavor, but instead critical for the health and well-being of many individuals in New York.

Although the New York license is an extreme example of what can go wrong when a field is tied to a single disability, other states may also have some limiting factor or other for behavior analysts within their current laws, codes, and regulations. Lack of recognition of behavior analysis beyond autism limits the inclusion of behavior analysts in bills, codes, and regulations that have implications for behavior analytic services. Sometimes behavior analysts aren't included in bills, codes, and regulations that affect business practices for behavioral health care providers or laws that encompass broader disability services coverage. Because behavior analysis is poorly understood and smaller than other professions, our profession can be governed by a nonbehavior-analysis–specific licensing board leading to potential conflict, as it is in the Commonwealth of Virginia, where behavior analysts are licensed by the Board of Medicine; or Ohio and Montana, where they are licensed by the Board of Psychology, etc. (BACB, 2023). In addition, with the success of autism advocates gaining insurance coverage in all 50 states, insurers are often slow or avoidant to recognize the provision of services of behavior analysts beyond autism although there may be no specific restriction to such in the licensure laws. In advocating for the profession in meetings and workgroups, the authors frequently have had to remind or educate colleagues within and outside the profession of ABA, legislators, policy makers, and others, that ABA can be effective beyond autism treatment and that the science behind ABA is not dependent on disability.

It cannot be denied that much of the recent growth in the United States in the number of behavior analytic professionals can be directly attributed to the autism community. According to Trump and Ayres (2019), there are three reasons for this growth: the demonstration of significant changes in behavioral presentations from Lovaas’s 1987 landmark study, advocacy spurred by Maurice’s book (1993) Let Me Hear Your Voice: A Family’s Triumph Over Autism, and legislation mostly spearheaded by families that recognized the need for insurance coverage for ABA for their loved ones. This confluence of events highlighted a significant gap in the skill set and involvement of most behavior analysts in the areas of advocacy and regulatory and legislative change. In states like Virginia and New York, licensure was sought because it was necessary to receive reimbursement via insurance. Behavior analysts in those states and others, often without a clear understanding and guidance for the field, were thrust into becoming advocates for the profession.

Given that most behavior analysts lack training in the public policy area, often the parsimonious thing to do when faced with regulatory and policy issues is to cede the leadership to others with those skills. Of course, the lack of training could lead to persons who are not behavior analysts themselves being seen as experts and having influence over decisions that could define the profession (Havlik et al., 2019). One might argue that without autism advocates, the field would probably have never moved forward with the legislative wins seen across the country. Often the goals of autism advocates and behavior analysts have been aligned in such a way that collaborative work on issues (e.g., licensure, insurance coverage) made perfect sense. Slowly, however, handfuls of behavior analysts within individual states began to cultivate their own skills in order to participate and eventually lead these efforts. Although there was critical support from ABAI and APBA for the work of the states, the behavior analysts within each state, often led by the autism advocates, generally worked independently on these efforts or worked with autism-specific organizations such as Autism Speaks and CASP. Licensure of a profession is handled by state legislatures in the United States, with each state presenting unique steps and challenges to passing bills. This led to various implementations of licensure bills prior to the provision of model language by national behavior analytic organizations including APBA and ABAI, and some bills have had problematic aspects (e.g., New York).

Although it is bolstering that there are so many that are interested in seeing behavior analysis flourish as a field, it is necessary that behavior analysts are the ones driving the laws, regulations, rules, and policies that will govern how ABA services are provided. We cannot expect one population of consumers of ABA (e.g., autism self-advocates and parents) to advocate for a different population of consumers of ABA (e.g., individuals with ADHD, OCD, ODD, Tourette, brain injury). It is important to recognize the differing agendas of each group and know when to collaborate and when to separate.

Learning from Others

As behavior analysis is a newer profession, those who practice have the benefit of looking to other fields that are more established in advancing their advocacy efforts. Some health-care related fields embrace advocacy as an integral part of their educational training and professional activities. A discussion of three of these professions and their work in advocacy is presented below to inform and guide those who plan to advocate for behavior analysis in the future.

Speech-Language Pathologists and Audiologists

The American Speech-Language-Hearing Association (ASHA) communicates current advocacy work for the field through its website and publications (ASHA, n.d-a.). They publish a public policy agenda on their website every year, which clearly outlines the priorities in public policy advocacy for the profession. The current priority issues are listed on the website, and it is easy for someone to click on a link regarding a specific issue, learn about that issue, and send a prefilled email to their specific legislator. In addition, ASHA provides key talking points for each of the items for members to use in talking with legislators. Furthermore, there is a section on the ASHA website where people can share their stories about how these priorities affect their particular work. For example, one priority regards school caseloads, and practitioners are encouraged to share their stories about how large caseloads have affected them and their clients. Finally, tips for advocacy for individual clinicians are also available on the website. One example is tips for advocating for increased salaries. Although advocating for a raise is entirely different from legislative advocacy, teaching practitioners to communicate their wants and needs to those in power may be a crucial step in shaping that skill set.

The state chapters of ASHA also provide information on their websites regarding advocacy specific to those states. In addition, the National Student Speech Language Hearing Association (NSSLHA) provides information about advocacy for students (NSSLHA, n.d.). Although ASHA and NSSLHA provide a great deal of information on public policy, providers themselves have not necessarily received training in advocacy, and many do not engage in advocacy work. Researchers have suggested that some reasons why providers may not engage in advocacy work include lack of time, knowledge, and support (Lugo et al., 2022). Nevertheless, researchers continue to evaluate ways to increase advocacy by speech language-pathologists and audiologists.

Nurses

Members of the field of nursing have been working on increasing education on public policy advocacy and encouraging nurses to engage in public policy work. Because the nursing field is so specialized, there are a multitude of different nursing associations in the United States and across the world. Many of these associations include information on public policy advocacy on their websites and provide information to their members about current public policy issues. For example, the American Nurses Association (ANA) website contains information about advocacy on the federal and state level as well as access to toolkits and action items (ANA, n.d.). In addition, the American Association of Colleges of Nursing (AACN) includes information on its website regarding various actions that people can take, as well as a federal policy agenda (AACN, n.d.). Furthermore, other organizations for various specialties in nursing also offer information about advocacy for those fields. Sometimes the organizations work together to improve the advocacy for the entire profession, even though often they represent specific areas of practice (e.g., surgical nursing, obstetrical nursing, disability), and increased collaboration creates synergistic effects.

Nursing organizations also provide guidance for including public policy in the education of nurses. The ANA’s Code of Ethics, provision 7.3, includes the responsibility of nurses to participate in health policy development (ANA, 2015). In addition, the AACN have included guidance on training students in masters and doctoral degree programs for nursing on policy and advocacy (American Association of Colleges of Nursing, 2011). De Cordova et al. (2019) reported that although health policy is being incorporated into the curricula of nursing programs, few nurses are actually involved in health and public policy decision making. Some possible reasons include students’ lack of time, knowledge, or interest in public policy. In addition, many faculty do not have the public policy experience to teach these classes or model these skills, and faculty do not have the support from university administration to create or lead curricula in public policy (Thomas et al., 2020). Several publications focus on the need for advocacy in nursing, and nurses and nursing students recognize the value, but work still needs to be done.

Nurses play an important role in the healthcare system and its transformation. They have regular, direct contact with patients and are responsible for providing compassionate and effective care in a safe manner. With their scientific knowledge and their knowledge of the healthcare system and processes, they can and should have a significant impact on the improvement of the healthcare system (Institute of Medicine, 2011). Despite this, nurses are historically not the first profession consulted to assist in health-care reform nor are they often considered for leadership roles within medical systems. Khoury et al. (2011) conducted a survey of opinion leaders from academia, insurance companies, health care executives, corporate sector executives, and government policy makers. These opinion leaders rated nurses as the least likely to have a great deal of influence on health reform (14%), with other professionals being rated as having a great deal of influence including government (75%), insurance executives (56%), pharmaceutical executives (46%), health care executives (46%), doctors (37%), and patients (20%). Although the survey respondents do not view nurses as having a great deal of influence on health reform, many reported that nurses do have a great deal of influence on quality of patient care (50%), reducing medical errors, and patient safety (51%). Therefore, nurses, the group of medical professionals who are thought to have the most contact with patients and knowledge of how the health-care system truly works for patients, are thought to have the least amount of influence on health care reform.

There appear to be several parallels between the professions of nursing and behavior analysis. As of 2020, there are almost 4.2 million registered nurses (RN) and 944,813 licensed practical nurses (LPN) and licensed vocational nurses (LVN) in the United States and 91.6% of nurses are female (Smiley et al., 2021). Although there are significantly fewer behavior analysts, the gender difference is similar to nursing with 86.73% of BCBAs and BCBA-Ds identifying as female (BACB, 2023). Similar to nurses, behavior analysts ensure effective, direct-facing services to help individuals. As helping professionals, nurses and behavior analysts pride themselves on providing high quality services and making meaningful change in the lives of their patients/clients, but few demonstrate leadership in public policy or at the systems level. The professionals on the frontline of patient/client care are in the unique position of best knowing what is needed to improve the services and promote safety and effectiveness. Nevertheless, without education and guidance from the practitioners, policymakers will lose out on the insights they can provide. Some may equate nurses to the RBT level, because of their direct contact with patients, but a nurse’s schooling and experience are more extensive than that of an RBT and continuing education is required for nurses, similar to a BCBA or BCaBA (nurse.com, n.d.). Similar to a nurse and nursing assistant relationship, it is the behavior analysts’ responsibility to oversee the services and the RBT to ensure effective services. The RBT does not have the training to ensure effective services.

The nursing profession has acknowledged this issue and has been taking steps to address it. In response to the 2011 publication titled The Future of Nursing: Leading Change, Advancing Health by the Institute of Medicine, the Nurses on Boards Coalition was started in 2014 with the goal of increasing the number of nurses in decision-making roles serving on boards. This coalition includes a large number of nursing organizations collaborating on the goal of increasing placements of nurses on boards for hospitals, health-care systems, private companies, and government appointments, as well as placements on local boards in local school systems, neighborhood associations, places of worship, youth sports leagues, etc. They believe that all boards would benefit from the perspectives and skills that a nurse can contribute. One of the key metrics of this coalition is the increase in the number of nurses on boards, from 3,111 to 4,499 to 5,034 in 2017, 2018, and 2019, respectively (Harper & Benson, 2019). The nursing profession is recognizing that having nurses on health-care boards will allow them to influence the health-care system. In addition, serving on other boards that are not necessarily health care-related, allows them to demonstrate that their knowledge, skills, and perspective can be applied to many areas.

Pediatricians

A third group of professionals who have been successful in promoting the importance of advocacy of the profession are pediatricians. The American Academy of Pediatrics includes many sections on its website dedicated to advocacy (AAP, n.d.-a). In addition, they provide an advocacy report summarizing the issues for the profession for their members.

Similar to nurses, pediatricians typically have coursework in their education programs that focuses on advocacy. The Accreditation Council for Graduate Medical Education (ACGME) includes advocacy in the common program requirements for residency programs in pediatrics (ACGME, n.d.). Although many education programs include coursework in advocacy, the advocacy curricula vary greatly by program and not all programs have required courses in advocacy (Dodson et al., 2021).

Professional standards for pediatricians also call for them to engage in advocacy work. There have been many scholarly articles supporting and evaluating advocacy curricula in graduate medical education, and it appears that there is a strong emphasis on advocacy work in the literature, as well (Howell et al., 2019). In addition, there has been literature and discussion surrounding incorporating advocacy into the scholarly activities that are recognized for promotion in academia. Scholarly roles for promotion traditionally consisted of clinical care, research scholarship, and education/teaching. Over the last couple of years, there has been a push to include advocacy as a form of scholarship towards promotion, thus equating advocacy to research and teaching in that respect (Nerlinger et al., 2023; Nerlinger & Shah, 2022); Nerlinger et al., 2018). The Community Pediatrics Training Initiative of the American Academy of Pediatrics has developed an advocacy portfolio to facilitate documentation of advocacy work for educators (AAP, n.d.-b). In a recent publication, Bode et al. (2022), representing seven academic medical centers, discussed the incorporation of advocacy into the traditional academic promotion process. They also described how their institutions have been creating pathways for academic promotion based on advocacy work of educators. In fact, Duke University School of Medicine includes information on their website on how they incorporate advocacy into the promotion process (Best et al., n.d.). By including advocacy as scholarly activity, medical schools allow faculty the time and putatively reinforce the effort to engage in public policy work and mentor others in public policy work.

There are several scholarly articles related to using behavior analysis to shape public policy (e.g., Fawcett, 1991; Glenn, 2004; Reed et al., 2021; Tagliabue, 2023). In addition, other articles provide recommendations for behavior analysts to become more involved in public policy (Fawcett et al., 1988; Sánchez et al., 2020). Although these articles provide useful information and action steps, still few behavior analysts are engaged in public policy work and/or reading these types of articles. In addition, there is a scarcity of articles or information focused on providing skills for everyday behavior analysts to advocate for the profession of behavior analysis. The field of behavior analysis can learn from the professions included above as well as other more established professions about how to effectively include advocacy into curriculum, ethical standards, and even workload, and how to provide advocacy tools to its members. It is extremely important that behavior analysts are involved in the decisions and policies that are made for the profession, although this does not seem to be the focus for most behavior analysts as 0.6% list their primary area of professional emphasis as “Public Policy and Advocacy” (BACB, 2023). As a field, we should be engaging in actions to increase advocacy efforts of behavior analysts. If behavior analysts are not engaged in advocacy, we are allowing others to define our field.

Behavior analysis is still a young field compared to fields such as psychology or nursing. Despite our newness, the growth in the number of practitioners is rapid. Factors including effectiveness of services, need for services, financial reimbursement, and lucrative financial opportunities for agencies providing ABA services have led to an increase in the demand for ABA services, but there are not enough behavior analysts to provide the services, let alone advocate for the field. Thus, as a field we need to develop strong systems for increasing advocacy efforts of behavior analysts and students to ensure the integrity of our field, while reinforcing those efforts and calling attention to their importance.

Steps to Advocacy

We hope we have made a strong case for the need for advocacy and now offer suggestions for three different groups of behavior analysts: leaders of national organizations, leaders of state or local organizations, and all practicing behavior analysts. The missions of many behavior analytic organizations relate to advancing the science and application of behavior analysis, including disseminating knowledge from the science and providing resources to the behavior analytic community and the public. In addition to adding a focus on advocacy to their missions and strategic goals, the ability of organizations to incorporate the following suggestions will depend upon a large number of behavior analysts volunteering their time and contributing financially to organizations. Organizations may not have the resources to immediately act upon all these recommendations. These recommendations are made with the intent that various organizations and behavior analysts will work together to prioritize and incorporate new practices over the next couple of years as they have the capacity to do so. We believe it is the personal responsibility of every behavior analyst to support state and national organizations so they can perform these important actions on behalf of the profession.

Recommendations for National Organizations

There are three main organizations in behavior analysis who can help increase advocacy efforts of behavior analysts: The BACB is a 501-c3 nonprofit corporation whose mission is to “protect consumers of behavior-analytic services by systematically establishing, promoting, and disseminating professional standards of practice” (BACB, 2023). Due to its 501c3 status, the BACB is limited in the amount of lobbying and advocacy it can do (Takagi, 2019). ABAI, a 501c6 organization, has been “the primary membership organization for those interested in the philosophy, science, application, and teaching of behavior analysis since 1974.” APBA is a 501-c6 nonprofit organization founded in 2007. Its mission “is to promote and advance the science-based practice of applied behavior analysis” (APBA, n.d.). As a 501c6, APBA is better positioned to lobby on behalf of practitioners than the BACB and has historically taken a lead in working with state associations to obtain licensure, although ABAI also has a committee focused on licensure that provides resources to its affiliate member organizations.

The authors would like to acknowledge the hard work put forth by these national organizations, as well as that of Autism Speaks and Council of Autism Service Providers (CASP) in their advocacy efforts for the field. These national organizations have been especially helpful in supporting state associations when asked. Based on the authors’ personal and professional conversations with other state leaders, however, not every state association has accessed this help, or is even aware of the offer of help. The following suggestions are in no way meant as a criticism of the involvement or lack thereof of the aforementioned organizations in state advocacy efforts. Most, if not all, state organizations are represented primarily by volunteers, who have limited time and resources to address all of the issues affecting their members. The authors have appreciated the efforts of ABAI and APBA in offering trainings, support in many forms (e.g., expert counsel, advocacy letters), and periodic strategic discussions. For this reason it is critical for state level associations to support the work and leadership of our national organizations either fiscally or otherwise.

It is important to mention that there are other national organizations who represent behavior analysis beyond those mentioned above. These include but are not limited to Asians & Pacific Islanders Association for Behavior Analysis (APIABA), Behavior Analysis Leadership Council (BALC), Black Applied Behavior Analysts (BABA), Latino Association for Behavior Analysis (LABA), Women in Behavior Analysis (WIBA), and the World Behavior Analysis Day Alliance (WBADA). These organizations and others can also play a role in helping to shape the profession that works within the limits of their IRS designation. Modeling the efforts of the nursing profession, there may be a benefit in multiple organizations working together on certain initiatives. These groups could partner with others as they feel their priorities align.

The authors have the following requests for national organizations that advocate for ABA, while understanding the constraints under which those organizations work:

• Add advocacy to the ethics code or standards as nurses and pediatricians have done. Showing that advocacy needs to be a priority for behavior analysts will bolster those who are involved in advocacy and encourage those who are not (American Nurses Association, 2015; Howell et al., 2019; Dodson et al., 2021)

• Similar to medical schools for pediatricians, behavior analysis training programs should consider incorporating advocacy into the scholarly activities that are recognized for promotion in academia. Thus, providing the time and reinforcement for professors in behavior analysis to engage in advocacy work and mentor others in this extremely important area. In order for this to happen, either a leadership organization such as the BACB ABAI, or APBA will need to develop standards that are to be followed by the university programs (through requirements of accredited schools or verified course sequences, or through the published ethics code), or some of the larger, more influential universities can set an example. Earnest et al. (2010) laid out a plan for medical schools that can be referenced, as well as the work that has been done since then.

• Develop resources similar to those that ASHA provides including but not limited to legislative contacts, talking points, and a policy agenda. The authors want to commend the work that APBA, Autism Speaks, BACB, CASP, and the ABA Billing Coalition have done regarding ABA billing codes (abacodes.com) and negotiating with Tricare and would welcome one or multiple national organizations taking a strong leadership role for public policy and advocacy in the future. It is important to mention that the authors’ present top result in a Google Search for “Advocacy Behavior Analysis” is information on ASHA’s website regarding applied behavior analysis (ABA). ASHA states that ABA services and licensure for ABA have been introduced in many states, but other services, such as services provided by speech language pathologists are being denied. Therefore, it is important that children with ASD are able to access professionals from various disciplines including speech language-pathologists and audiologists (ASHA, n.d.-b). The fact that the first result for advocacy in behavior analysis was an advocacy effort from another field is evidence that behavior analysts need to at least increase efforts in this arena.

• Partner with organizations that represent the clients we serve in addition to autism such as Tourette Syndrome and traumatic brain injury groups, substance abuse treatment groups, Alzheimer’s groups, etc., as that is vital to getting legislation passed where our agenda intersects with theirs. Modeled on the success of autism advocacy and advocacy in other professions, we see a need for a national public policy agenda specific to behavior analysis and a lobbyist on a national level. It is important that behavior analysts take the lead in policy that affects ABA service provision. These collaborations go both ways and behavior analysts should provide support to our partner organizations where we can (e.g., signing on in support of a bill that affects a population we serve but does not directly affect ABA service provision to foster partnerships).

• Hire a public relations specialist on behalf of the profession to help disseminate information to the public. This will assist indirectly with public policy efforts and help solve the problem that results from behavior analysts not tending to be marketing or public relations specialists. We recognize that efforts such as these take considerable costs and manpower and suggest working with state leadership to acquire funds and lead a campaign.

• Take the lead in helping place behavior analysts in key positions on state and national boards. These boards would not need to be limited to health care as behavior analysts have a variety of useful skills and experiences that can be of service on any board. Encouraging behavior analysts to run for office would be beneficial for the profession as well as the localities, states, and nation where they would serve. This would allow for behavior analysts to have a direct voice in the legislative decision making that may affect the profession.

Recommendations for State Organizations

Many but not all states have a state organization devoted to the behavior analysis science and profession. Many of these organizations are state chapters of ABAI and/or affiliates of APBA (ABAI, n.d.; APBA, n.d.). Some organizations represent multiple states (e.g. Four Corners ABA, Southeastern ABA), and some states have more than one organization (e.g., Massachusetts). To better understand the steps the authors believe these state organizations need to take to become good advocates for the profession, it is useful to explore some examples of work that state organizations have done. Incorporated into these examples are recommendations to increase advocacy on the state level.

Lessons from New York

NYSABA became an official chapter of ABAI in 1989 and was incorporated in 2000. In 2007, NYSABA hired a lobbyist to work on providing an exemption for BCBAs from the psychology practice law in New York State. In November 2008, due to the significant pushback from psychologists, NYSABA abandoned attempts to get an exemption and began working on specific licensure for behavior analysts. NYSABA worked on an independent behavior analysis license for several years in collaboration with many people and organizations. In November 2012, the NYS Autism Insurance Reform Law went into effect, but per the New York State Department of Education Office of Professions, only licensed individuals could provide the services. Because there was not a license for behavior analysts in New York State, the only behavior analysts that could provide ABA services were ones that were also licensed in another profession (e.g., psychology, social work), which left fewer than 100 ABA providers eligible to provide insurance-based services in New York State. Therefore, a draft bill was introduced to license behavior analysts so that ABA could be provided through commercial health insurance.

In January 2014, the law was passed to license behavior analysts, but a restriction was placed on the scope of practice as we discussed earlier. Although the enactment of required coverage provided motivation for lawmakers to pass a law to license behavior analysts; unfortunately, because it was tied to insurance reform the result was a license with a restriction to work only with clients with a diagnosis of ASD. NYSABA was successful in advocating for a behavior-analytic–specific licensing board in the law, but the board was advisory only to the department of education, who interpreted the legislation very narrowly to restrict the scope to the DSM diagnosis of autism. NYSABA immediately began working to advocate for the removal of the scope restriction. After many years of advocating for the field of behavior analysis, on December 29, 2021, the bill was passed with a date for enactment into law of June 30, 2023, that removed the restriction on the scope of practice.

The removal of the scope restriction is not due to one specific initiative, but rather many we share as guidance for other state organizations:

1. Partnering with as many groups and individuals as possible, which included ABA organizations and autism organizations, as well as organizations and individuals outside of the autism community that recognized the need for ABA services. It was extremely important for legislators to hear from organizations, professionals, and individuals who recognized that ABA was warranted, but that the services were not available.

2. Collaborating with parents of individuals who received ABA services or needed ABA services to educate legislators on the need for ABA services. Although it was helpful for legislators to hear from behavior analysts and professionals, it is extremely important for them to hear from the people who have benefitted or are in need of the services—especially if they are constituents in that legislator’s district.

3. Finding a lobbyist who understood the necessity to include NYSABA board members in all of the meetings with legislators and set up countless and frequent virtual meetings when in-person meetings were not an option.

4. Changing the messaging about the desired removal of the scope restriction. Once NYSABA was able to articulate that the initial restriction on the scope of practice was created to facilitate access to services that consumers were legally entitled to receive and due to the origin of the license (i.e., the autism law) rather than a true reflection of the field, legislators began to understand how problematic the restriction actually was.

5. Creating a protocol for people to easily send a pre-written letter to their legislators articulating the problem and expressing their support for the bill. Many people wanted to help but did not know how to find their legislators or how to reach out.

Lessons from Texas

The Texas Association for Behavior Analysis (TxABA) was founded in 1986 and is a 501c3, which limits TxABA’s ability to be involved in public policy and lobbying (Takagi, 2019). In 2015, TxABA started the legal process to launch the TxABA Public Policy Group (PPG) as a separate 501c6 entity that focuses on legislative issues and hires a lobbyist to represent behavior analysis to legislators. TxABA is the controlling member of the TxABA PPG, keeping the organizations connected but allowing the TxABA PPG to function independently as a 501c6.

Having two separate organizations has the benefit of keeping the main organization, TxABA, focused on the overall field and the promotion of the science of behavior analysis in its different areas. At the same time, it allows the TxABA PPG officers to focus on legislative issues, a monumental task that necessitates numerous volunteer hours and the ability to act quickly. Although this model works well for Texas, the biggest hurdles in being separate entities is that it limits administrative support, and the model may not be feasible for smaller state organizations that are in their initial years.

Lessons from Virginia

The Virginia Association for Behavior Analysis (VirginiaABA) was founded in 2003 and is a 501c6 organization. The organization has a standing public policy committee and is focused on long-term strategy. The policy committee is curated to include multiple types of practitioners including autism treatment, private schools, adult services, and juvenile justice, among others, according to the executive director. They have employed a lobbyist since 2017 and have a goal to introduce at least one new bill a year to further the profession and remain visible to lawmakers. This strategy will eventually be no longer feasible, but at this time there are several laws, codes, and regulations where licensed behavior analysts are not included with their peers and it is not practical to address them all at once. Sometimes VirginiaABA partners with other organizations such as Autism Speaks, the Autism Society of Central Virginia, the Virginia Autism Foundation, and the Virginia Autism Project when priorities align. VirginiaABA also endeavors to disseminate information beyond the field about what behavior analysis is and what behavior analysts do. They host videos on their website of interviews with professionals who practice ABA outside of autism or education designed to inform the public as well as professionals in Virginia.

In 2010 an autism insurance law was passed in Virginia that included a license provision, which placed behavior analysts in the Board of Medicine. As there were no regulations for a license, a bill was passed in 2012 giving the Board of Medicine the authority to promulgate a working group to develop a license. Despite the license originating with the autism law, behavior analysts in the working group were successful in keeping the scope of practice broad and not specific to any disability group. Over the following years, VirginiaABA partnered with other groups to remove the age cap in the autism law (it was originally one of the most restrictive at ages 2 to 6), include licensed behavior analysts (LBAs) and licensed assistant behavior analysts (LABAs) as school staff in their own rights (as behavior analysts and not teachers or administrators), and include LBAs as licensed mental health professionals so that they can deliver differing types of state services with multiple populations, among other initiatives (Virginiaaba.org, n.d.). The association also ensures that its leadership are active participants in key workgroups in Virginia such as Medicaid services, brain injury, and crisis services. Great successes include working with state representatives to broaden the application of Medicaid services beyond those diagnosed with autism and encouraging state representatives and legislators to proactively reach out to VirginiaABA when there are policy and regulation changes that affect behavior analysts. Although behavior analysts are still not yet able to receive reimbursement in every area that our scope of practice covers, VirginiaABA consistently looks forward to a future where there are a variety of opportunities for practitioners.

The experiences that the authors have had with these state associations have taught us that collaboration with national organizations and other state organizations is valuable in supporting a growing public policy committee who can learn from others’ mistakes and successes. Without collaboration, state organizations may repeat mistakes made by other organizations. In addition, the lack of collaboration and cooperation could lead to issues affecting behavior analysts in one state having either positive or negative consequences that affect practitioners in other states or even other countries. Take the example of restriction of the practice of behavior analysts to autism in New York. That could have been significantly problematic if other states or countries followed suit. In some cases, it was only in open communication between state and/or province (i.e., Canada) organizations that helped thwart that concern. Collaboration is necessary to inform a state’s public policy committee on what has been tried in the past, what has succeeded, what has failed, and where to go next. Collaboration among states can be facilitated through national organizations where membership is shared (such as being a chapter of ABAI or an affiliate of APBA), or simply by contacting a nearby or similar-sized state via their website. One example of collaboration is this article, which came about because representatives of the three states already had a relationship and were sharing information and best practices.

State organizations have many avenues to improve the advocacy of behavior analysis. The authors have these recommendations for state association leaders:

Raise the Necessary Funds

Similar to advocacy, behavior analysts do not tend to have a great amount of experience with fundraising. State organization leadership must realize it is necessary to consider local, state, and federal laws when fundraising. Dependent on the type of organization, there are laws that govern how, when, where, who, and how much an organization can raise. Earlier in this article we brushed on the choice of being a 501c3 organization versus 501c6 with respect to TxABA, however, most of that is beyond the scope of the article and we recommend organizations considering separation consult with professionals to learn the restrictions based on type. Something you must not overlook is that a majority of states have laws that require an organization to register as a fundraiser. This provision can be easily searched online.

Prior to fundraising, it is suggested you develop a committee to oversee the activities and/or look at hiring a fundraising expert to oversee the process. Regardless of the decision, it is important that there be someone who is responsible for fundraising that can ensure the organization is headed in the right direction and adhering to its mission (Temkin, 2001). If you decide that you want to apply for grants, you may need to invest in an experienced grant writer. There are a lot of nuances involved with grants and those who have been in the business a long time are more likely to be aware of the tricks of the trade—regardless of industry.

With a team and policies in place, an organization has a cornucopia of fundraising avenues to pursue. Event fundraising can be a great way to make money and to get people together in support of your mission. Some ideas include a dance or gala, show or talent showcase, golf/cornhole/other sports tournament, casino night, 5K or fun run/walk, conference that includes continuing education (which most state organizations already do), dinner, happy hour, or a carnival. Although there are many avenues of fundraising, they all have the same goal: to make the most money for the organization by expending the least amount of effort (Gmerek, 2019). For many types of events and sales, there are companies who will run them for a fee. State organizations may consider partnering with these companies for a maximum effect and minimal effort if able to absorb the costs.

Hire a Lobbyist

There is no substitute for a great lobbyist. Hire the lobbyists, marketers, or PR specialists needed to make the best impact, leaving time to focus on where your skills are the best fit. Find a lobbyist who understands the difference in priorities for behavior analysts versus specific disability groups. Lobbyists are likely to have strong relationships with lawmakers and understand the necessary components of passing bills and accessing government throughout the state. Although it is not impossible to accomplish what is needed without a lobbyist, if the state organization is serious about affecting the laws related to its profession (and not allowing others to have influence), a lobbyist is crucial.

Beyond initiating association-driven bills related to behavior analysis, lobbyists monitor drafted and introduced bills. This is vital to getting behavior analysts in discussions when another profession may introduce a bill that could hinder behavior analytic services and harm consumers of behavior analytic services. It is important to note that if a state organization also has a paid consultant or employee (such as an administrative coordinator or executive director) and that person participates in lobbying efforts, then they must also register and follow all laws for lobbyists in their state.

Establish Clear Priorities

In setting your policy agenda, it is generally a good idea to survey the behavior analysts in your state. The goal is to identify the main issues that are affecting service delivery and subsequently, those they serve. Some initiatives that may grow out of a survey of members’ needs may be broader such as introducing a bill for licensure and others may include smaller changes to language in current bills or additions to bills. Still others might actually be the “low-hanging fruit” of getting a behavior-analyst representative on a state-wide committee. Offer these and other organization-developed suggestions to your members in a survey and have them rank order their priorities. This can be a good time to invite members to join committees or task forces that focus on subspecialty areas. Once you have your survey results, your public policy group can work with the lobbyist to identify what is likely to be passed during the next legislative session. It is important that you have a few targeted and clearly defined priorities. Too many “asks” in one legislative session may backfire. You need to be targeted in your legislative priorities to get something accomplished.

Hone Your Political Message

When meeting and working with politicians, it’s important to put your personal politics aside and focus on the process. Work primarily with the party that is in power (without alienating other parties). If introducing a bill, choose someone who is in the party of power as it will be more likely to pass.

In addition, it is important to understand the specific workings of your state legislature and every state is different. Local politics can also vary widely even within a particular state. Be sure to do your homework and, although you can learn from what other states have done in the past, especially where they have made mistakes, each state organization needs to become the expert in their area. National organizations such as APBA, CASP, and ABAI will have an easier time advising if the state organization is familiar with the state/local politics.

Identify strong supporters in the legislature. It took 10 years for NYSABA to find someone who was almost as passionate about ABA as they were. For Virginia, it was necessary to find multiple legislators to carry bills as champions either retired or were voted out of office. It is crucial to understand your government audience and their reinforcers. Knowing what is important to your legislators and understanding that situations may change will help you to better partner with them or at least get a favorable vote. Many times, legislators have become advocates for ABA because they have a child or know a child that is receiving ABA services.

There’s a reason people refer to legislative advocacy as sausage making. It is very messy. Know your “wish list” but also know what you will be willing to accept, because you probably won’t walk away with everything you want. Use your skill at shaping and understand that relationship development is the key. As legislators get to know you, they will become more likely to take your call, respond to your social media, and personally answer your emails. Good lobbyists know how to develop great rapport with legislative offices, but it is important that legislators have direct access to behavior analysts as well.

Every time you meet someone when advocating, identify their relationship to your issue. For example, if someone is concerned about aging and you are trying to get a bill passed, connect it to aging issues. If possible, connect your issue to others’ priorities. For example, if there is concern about the mental health of children coming back to school, show how your priorities also align. If there is concern about isolation in prison, and you may be able to help, describe how. This truly is the beauty of the field of behavior analysis. There is relevance to anywhere people behave.

Finally, make sure not to use jargon and to practice your elevator pitch. Remember that legislators and the general public will often have no experience with the profession of behavior analysis and at best will think of ABA as a therapy for individuals with autism. It is up to practitioners to share accurate information and descriptions of ABA.

Leverage the Media

There may be times when it is necessary to call on the media to get your message out. Use the media effectively and control your message. Do not call on them too often or you may teach them to ignore your requests. State organizations also may be contacted if there is a controversial topic in your area that has either caught the attention of the media, or someone (such as a parent or caregiver) has contacted the media and they are now looking for another opinion. In those instances, it may be best to get their information and tell them you will call them back. Be careful that your words cannot come back to harm you later. Are you focusing on one diagnosis at the detriment of another? Get your board together and discuss fully all the aspects ahead of time.

Manage your Partnerships

Partnerships are important, including choosing partners (e.g., advocacy organizations for certain populations or professions, state government partners, legislative partners) and knowing when to take the lead. It is critical that our field learn from all of the significant benefits of prior collaborative work on advocacy initiatives and begin to develop our own way forward—not necessarily independently from advocacy groups such as autism advocates, because collaborative advocacy is extremely effective, but to develop our own advocacy agendas and skills that covers the breadth of the field is important work. For example, although there has been much alignment in the goals of behavior analysts and autism advocates, the goals may not be perfectly matched in all cases. There may be situations where individuals advocating on behalf of persons with autism (because that is their primary goal) may prioritize different advocacy initiatives. For example, when there are multiple legislative “asks” (e.g., Medicaid coverage, licensing for the profession) there may be a difference in the order with which advocates for the field may place one over the other as compared to families of individuals attempting to get services for their loved ones. Although both may be important to both groups, some professionals might argue that licensure (or fixing licensure) is a priority over adding Medicaid coverage for ABA. This is because without appropriate licensure laws it may not be possible to implement Medicaid effectively. On the other hand, the significant need of so many who need the services of behavior analysts may make adding Medicaid services the priority for autism advocates. Neither may be wrong, they may just not be synchronous. Asynchrony can create difficulty in the advocacy work because multiple legislative priorities in the same legislative session can be problematic, and legislators do not understand why they are being asked to advocate for multiple initiatives seemingly for one profession (especially as many legislators do not make the distinction between the autism community and the behavior analysis profession). In these cases, the lack of leadership on the part of behavior analysts in these legislative spaces can lead to the field’s priorities not moving forward because legislators look to autism advocates to be the voice of the field due to their expertise with advocacy work and their ability to mobilize so many voices. One might argue that it is easier to mobilize those to have a passion for their child (who has a particular disability) than it is to mobilize those to be passionate for the science and practice of behavior analysis. Finally, it is necessary to note that lawmakers are more likely to listen to those who provide ways for the state to save money, or better yet, keep them in office.

Help others whenever possible. When you are working with groups as mentioned above, make sure that you are providing support for their work, and they will be more inclined to support your work. If you ask other organizations to write letters of support for your issue, be sure to step up when they need you or your organization. Identify your “friends,” such as advocacy groups and adjacent fields to partner with on various issues. Virginia was surprised by representatives for school psychologists speaking on behalf of a bill they sponsored without originally approaching them. VirginiaABA was grateful for their help and could have worked more closely with them to align messages and priorities.

Observe those persons or groups who seem to have success in moving legislation. Find ways to connect with them to collaborate and/or learn from them. Be honest in your admiration for their efforts and ask for help. They may be willing to teach you what they have learned.

Be careful not to look like you are trying to help yourself. You need the constituents of the legislators to speak up and you especially need families who can tell a story. “In Escape from the Ivory Tower, Baron (2010) argued that speaking and writing for a scientific audience requires a different repertoire than is effective for communicating with journalists and policymakers. She further argued many scientists have not developed the necessary repertoire.” (Detrich, 2018). It may be necessary to work within your public policy committee (and every state should have one) to focus on the message.

Behavior analysts should also work to foster professional relationships with auxiliary professional organizations within your state. Similar to the request for national organizations, state organizations are poised to strategically position behavior analysts on boards of government agencies and workgroups on a state level by nominating those who would serve their areas well, similar to the nurses’ initiative (Harper & Benson, 2019). Some examples of boards would be state licensing boards, boards for local disability groups, local school boards, neighborhood associations, and hospital boards. It should be noted that the Nurses on Boards Coalition provides personal educational sessions to nurses serving on boards (Harper & Benson, 2019). Although it is important that behavior analysts serve on behavior analytic boards, it is also important to provide a behavior analytic perspective for boards that may not understand behavior analysis but can benefit from the additional perspective. For example, a behavior analyst serving on a board of a hospital may provide suggestions to improve patient satisfaction, safety, etc. Serving on these boards allows for collaboration with other professions, organizations, and people and can help others understand the benefits of behavior analysis and disseminate the science. In addition, it allows the behavior analyst to grow both professionally and personally and bring the perspectives of the board to their own practice.

Capitalize on Your Members’ Skills and Enthusiasm

Although the majority of BCBAs work with the autism population (BACB, 2023), there are still many who practice in other areas such as sports psychology, health and fitness, substance use disorders, gerontology, environmental sustainability, public heath, and organizational behavior management. Actively seek behavior analysts who practice in these alternative settings and invite them to participate in the association. Give space for them to recruit other behavior analysts to work in those fields. In order for the profession to continue to grow, it’s necessary for behavior analysts to diversify. Those who already have experience can help others broaden their horizons.

Think of behavior analysis advocacy as a grassroots campaign. Look around at other successful grassroots campaigns in your state and identify the key strategies; maybe even hire an experienced political organizer. Encourage your members to work with you for the benefit of the profession. Establish coalitions of groups (e.g., colleges, parents, organizations). Many hands make light work, as the proverb says. As Lorri Unumb, CEO of CASP, has said in conducting advocacy training, find your “grass tops.” Grass tops are individuals who have influential relationships with policymakers, usually through a personal connection. Ask through your membership if anyone is connected to anyone involved in politics or serving on influential boards in your state. This can be accomplished by identifying the groups important to your targeted policy makers. For example, surveying your membership to see if anyone has a connection to someone or an organization that is a big donor to that policymaker. Another example is seeing if someone serves on a charity board with the family member of a policymaker. Reach out to them to see if they will support and discuss the issue with the policymaker. Grassroots campaigns can be successful, but they need strong leaders with a lot of influence (i.e., grass tops).

Get your members excited about your issue by organizing events and communicating what you are doing to address the issues in your state that are important to the behavior analysis profession. Help others to get involved by making it easier for them to do so. For instance, when passing licensure in Virginia, the state association made index cards with information about each legislator. The cards were left at the bill patron’s office and behavior analysts were encouraged to go to the capitol, take a handful of cards and talk to the people listed on them. Notes were left on the backs of cards, so people were on the same page. This was in 2012, when there was less sharing of documentation online. These days this type of organization is much easier given online resources.

Beware of and manage members who may try to work against the benefit of the profession for their own personal gain. Begin including advocacy sections on your websites specific to your state, as well as highlighting the work that your public policy committee is doing. If you don’t yet have a committee, start one. The website can include a summary of the public policy goals for the year, current issues facing the profession, talking points for these issues, links to find someone’s legislator and pre-written letters or samples, and links to be able to share stories of how these issues may affect their work. Use social media and be up on the trends for your state. For example, X (formerly Twitter) is big in New York for politics. Clubhouse is becoming a place to learn and be seen, but Facebook still can be useful. Unfortunately, as soon as you figure it out, it may change. Many behavior analysts have social media figured out. Find those in your state and ask for their help.

We recognize that these recommendations are easy to present but more difficult to implement. Much of the work that is being done by these ABA organizations is performed by volunteers in individual states. These volunteers are already taking countless hours to meet with legislators, policymakers, stakeholders, consumers, organizations, etc., and putting out fires on legislative or regulatory issues. Many do not have the time to put together public policy agendas, action toolkits, and talking points that are necessary for the field, even though that would be more efficient in the long run. Therefore, it is important to get more people involved so that the workload can be spread around.

Recommendations for Individual Behavior Analysis

We hope we have made a good case for why it is important for behavior analysts to advocate for their profession and have encouraged behavior analysts to want to explore more of what they can do to further their profession. Before providing insight for behavior analysts who are not in leadership positions on a state or national level, it is important to impress that behavior analysts should strive to represent the best of our profession in their daily professional activities so that when they advocate for representation of the profession, it is well-received. It is no secret that there are plenty of misconceptions about the practice of behavior analysis and that practitioners can share some of the blame for those misconceptions.

In 2013, Jose Martinez-Diaz, PhD, presented a keynote at the annual conference for the Virginia Association for Behavior Analysis. He summed up the main goal of an ABA practitioner in clear and simple terms: “to help individuals achieve meaningful outcomes and improve their quality of life” (Martinez-Diaz, 2014).

Representing the best qualities of the behavior analysis profession is just the first step. The linchpin of advocacy is effective communication. Behavior analysts often are accused of not communicating effectively with those outside our field. This must be changed if we are to become better advocates. In 2014, an article was published by Critchfield that outlined the Ten Rules for Discussing Behavior Analysis. This 10-rule conveyance is instructive for everyday behavior analysts to disseminate information about our profession. One suggestion that Critchfield makes is that it is easier to prevent than to rectify the behavior of misrepresenting behavior analysis. This encourages us to actively engage in dissemination behavior. Critchfield also notes that skills become more fluent with practice, and that giving the science away is our best vehicle (Critchfield, 2014).

Not everyone has the skills to disseminate effectively, however behavior analysts make a living teaching new skills to people with those deficits. According to Bailey and Burch (2022) in 25 Essential Skills and Strategies for the Behavior Analyst, there are several communication skills that are necessary for effective communication, including marketing skills, networking skills (in the form of an elevator pitch), persuasion skills, negotiation skills, and shaping skills, just to name a few. Once the key skills needed have been identified, the next step is to do what behavior analysts do and break those skills down to teach them to fluency. It may be difficult for behavior analysts to assess our own skills and develop our own behavior plans with respect to advocacy, but this would be an excellent opportunity for someone to create a training program focused on behavior analysts looking to advocate for their profession.

A major contribution that individual behavior analysts can make is to financially support and be involved with state and/or national level behavior analytic organizations. Our above recommendations to state and national organizations are not possible without increased resources. Lobbyists are expensive but pivotal to public policy success. Most state organizations cannot afford a lobbyist and need members and businesses within their state to contribute financially through renewing their membership every year, registering for events, purchasing CEUs, and being sponsors and exhibitors. Many state and national associations provide high quality CEU opportunities even if members are not able to attend their annual conference. Some of these events may be more expensive than other CEU options but the money is going to support the association in hiring staff to coordinate events and committees and in many states public policy initiatives. There are many costs beyond the lobbyist, including travel to the capitol, printing materials to leave with legislative staff, and maintaining a website.

Behavior analysts who are excited to get more involved with public policy and advocacy should contact their state or national organizations to join in the effort. Some additional tasks you can do, beyond what has been described above include:

• Meet with elected officials and share about what you do for individuals in that community. Every behavior analyst should get to know their state legislators.

• As a concerned citizen, write post cards to help officials who are friendly to behavior analysis get elected.

• Run for office! If this is something that you are able to do, consider serving the public as a local superintendent or even state legislator. Many other professions have champions who are elected officials, and it is time behavior analysts were included.

• Explore your secretary of state’s website (in your state) for openings on advisory boards. Put in an application to serve—especially for behavior analysis advisory boards and similar professions.

• Serve on boards that are not specific to behavior analysis (e.g., local school boards) and bring a behavior analytic perspective that may be missed.

• Be cognizant of other professionals who work in the same space and become good partners. Get to know speech therapists, occupational therapists, teachers, doctors, and other people who work with the same populations that you do and show them how well you can collaborate. Help them to see that ABA is not just an autism treatment and to better understand what ABA is and does.

• Those who are ambitious can lead grassroots efforts to increase dissemination of behavior analysis.

• Assist with creating materials for distribution via social media, emails, or physical materials.

• Develop your dissemination skills. Learn to translate jargon in easy terms for your clients and the general public. This is a skill that needs to be practiced.

• If you have a specific skill set that you are willing to donate to the organization or have connections to influential people in your state, tell the organization when you are getting involved (e.g., I have some graphic design experience, I can make TikTok videos, I have a podcast, my cousin works for a state senator, I’m good at public speaking and can teach others).

• Do presentations for local organizations, such as parenting groups or professional organizations. Participate in a call for papers for non-ABA conferences.

• Participate at career days in your local public schools to inform others about careers in behavior analysis.

Conclusion

The salient point of this article is that every behavior analyst has an obligation to positively affect the profession through advocacy and dissemination. And all behavior analysts have an opportunity to do so with the effect being dependent upon their experiences and positions in the field. This task may seem daunting, although maybe less so if one is presented with some ideas to get started as we have endeavored to do. Through this article, the authors hope that leaders of national and state organizations, as well as individual practicing behavior analysts, will find inspiration and perform at least one of the advocacy activities listed herein.

Individuals can start by joining their national and state organizations. The membership process is generally easy to find and follow. If all behavior analysts were a member of at least one organization, the influx of cash to those groups would help leaders to address the issues that are most important to the field. With the extra funding, national and state organizations could focus on branding and public relations as well as advocacy using professionals who focus on those skills. Those professionals can create job aids or checklists, similar to what the World Health Organization created to help doctors better explain about vaccines (World Health Organization, 2017) for individual behavior analysts to use to advocate in their area, thus creating an army of advocates.

Working together is the only way to achieve better dissemination of our field to others, and a more robust understanding of what it is that behavior analysts actually do and how behavior analysts can be beneficial to society. Expecting others to do this work at best may lead to missing important aspects, and at worst may lead to the diminution of our field. It’s time for you to get involved!

Funding

This article was not supported by any funding.

Data Availability

Data sharing is not applicable to this article as no data were collected for this article.

Declarations

Conflict of Interest

The authors declare that they do not have any conflict of interest.

Ethical approval

No studies involving human participants were conducted to prepare this article.