In New York, applied behavior analysis (ABA) means the design, implementation, and evaluation of environmental modifications, using behavioral stimuli and consequences, to produce socially significant improvement in human behavior. This includes the use of direct observation, measurement, and functional analysis of the relationship between environment and behavior.
Education Law §8803 restricts the practice of ABA to individuals who are licensed, certified, or exempt. Exemptions are defined in §8807 and include New York licensees in other professions who are trained and qualified to provide ABA services: physicians, nurse practitioners, psychologists, social workers, and mental health practitioners. Only those licensed as Licensed Behavior Analysts (LBAs) or Certified Behavior Analyst Assistants (CBAAs), however, may use those restricted titles.
ABA services are delivered pursuant to a diagnosis and prescription/order of a qualifying professional1. LBAs, CBAAs, and unlicensed personnel are not authorized to diagnose or prescribe.
- ABA services are provided by an individual with an appropriate license or exemption under Education Law. Practitioners must have competence in ABA interventions and comply with provisions to report patient progress to the prescribing/ordering health professional.
- LBAs provide services and activities for the design, implementation, and evaluation of environmental modifications, using behavioral stimuli and consequences, to produce socially significant improvement in human behavior. CBAAs perform tasks assigned by the supervising LBA to implement the ABA plan, in accordance with the law and regulations; CBAAs cannot develop or modify the ABA plan.
- In this guidance, “unlicensed personnel” means individuals who are not licensed in New York State as an LBA, CBAA, or in one of the noted exempt professions. Services that are not restricted by law and regulation may be provided by unlicensed personnel who function as part of the service delivery team in a support capacity.
Foundation for Determining Services Limited to Licensed Providers
When delivering ABA services, providers must consider the licensure law and the level of education and training required to carry out a given activity.
- LBAs are prepared at the master’s level in specified areas of study, consistent with State law and regulation. They complete substantial related experience under supervision; pass a State-accepted professional examination in the field; and are licensed by New York State.
The State does not set standards for unlicensed personnel, but the licensee who delegates support activities remains responsible for services provided and appropriate supervision of the unlicensed personnel. Licensees who delegate professional responsibilities to unlicensed personnel, or who do not provide substantive supervision, are subject to charges of professional misconduct.
Consistent with the scope of practice defined under Article 167 of Education Law, LBAs provide services such as the following:
- determine specific needs via patient intake, based on a valid prescription or order;
- create/design ABA plans, including elements to capture and analyze data;
- modify and terminate ABA plans;
- oversee those plans in collaboration and coordination with other providers and the patient’s family members/caregivers;
- design ABA sessions, including the materials to be used and associated data collection systems;
- supervise and train the individuals who will be conducting the individual sessions, including unlicensed personnel;
- reassess the patient periodically and analyze data to determine progress and revise the plan as needed; and
- report patient progress to the prescribing/ordering health professional.
These services, and others consistent with the LBA’s scope of practice, are distinguished by the advanced level of preparation on which the LBA license is predicated.
In contrast, unlicensed personnel carry out the specific, scripted activities created/designed by the LBA to address the patient’s needs. The ABA plan directs the unlicensed person’s interaction with the patient and engages them as the objective recorder of that interaction. Unlicensed personnel typically perform the following functions:
- meet with the LBA to check their understanding of the ABA plan for the patient, including the scripted activities designed to address the patient’s needs;
- work directly with the patient to carry out the plan designed by the LBA;
- prepare the setting for the plan’s sessions/activities by, among other things, arranging the environment and ensuring that the required session materials are present;
- follow the session instructions as scripted by the LBA;
- record/enter data, without interpretation, using the data collection system designed or directed by the LBA; and
- provide factual session notes for review by the LBA.
These examples are not an exhaustive list of activities, but rather should be read as guiding principles that demonstrate how (1) LBAs create, modify, and terminate the ABA plan, and (2) unlicensed personnel execute supportive tasks as directed that do not require professional judgment or analysis.
- §8802 of Education Law (Article 167) defines the practice of applied behavior analysis.
- §8807 of Education Law (Article 167) enumerates the exemptions in the licensure law.
1Qualifying professionals: physicians; physician assistants; psychologists; nurse practitioners; and licensed clinical social workers. Effective June 24, 2024, the list of qualifying professionals also includes mental health counselors, marriage and family therapists, and psychoanalysts who hold a diagnostic privilege.
September 26, 2023