A Proposed Process for Risk Mitigation During the COVID-19 Pandemic

Area of Science:

• Behavioral Science
• Public Health
• Infectious Disease Epidemiology

Background:

• Executive orders during the COVID-19 pandemic prompted some applied behavior analysis (ABA) providers to consider themselves essential personnel.
• This designation led to interpretations that in-person ABA services should continue universally, regardless of public health recommendations or local mandates.

Purpose of the Study:

• To argue against a blanket interpretation of "essential personnel" status for all in-person applied behavior analysis (ABA) services during the COVID-19 pandemic.
• To analyze the risks associated with continuing in-person ABA services versus suspending services or transitioning to remote delivery models.

Main Methods:

• Review of risks associated with in-person applied behavior analysis (ABA) service delivery during a pandemic.
• Analysis of risks linked to the temporary suspension of ABA services.
• Evaluation of risks associated with transitioning ABA services to remote or telehealth modalities.

Main Results:

• Continued in-person ABA services pose significant risks of severe harm to clients, families, caregivers, staff, and the healthcare system.
• Temporary suspension or transition to remote ABA services is often warranted until in-person contact is deemed safe by health experts.
• In rare circumstances, suspending or transitioning ABA services may pose risks, necessitating continued in-person care with rigorous risk mitigation.

Conclusions:

• Applied behavior analysis (ABA) providers must exercise caution and critical judgment regarding in-person service delivery during the COVID-19 pandemic.
• A nuanced approach is required, prioritizing client and public safety by considering remote options or temporary service suspension when necessary.
• Risk assessment and mitigation strategies are crucial, especially in the rare instances where in-person ABA services must continue.