BCBA and the Coronavirus

James Macon, M.Ed., BCBA, LBA.

Updated 3/13/2020

As front-line practitioners in our community, behavior analysts are often the first to come in contact with different bugs and viruses.  Our work requires us to travel to different communities and homes, and we’re often working with dozens of clients, often times in clinics with dozens more staff.  The probability of germs and viruses being transmitted is relatively high.  We are used to this, an it’s why we practice good infection control… whether it’s the flu, hand foot mouth disease, pink eye, or a bacterial infection, behavior analysts are more then familiar with the routine.   This year is different though.  With COVID-19 now a global pandemic, and confirmed cases growing everyday, behavior analysts should take specific steps to help minimize the virus from spreading.  Below are a few things you need to know and some specific steps you should take.

What to know:

Information about the Coronavirus is changing daily.  What we’ve learned so far is that the virus varies in severity and seems to have a preference for older individuals and those with compromised immune systems.  Healthy individuals are less likely to fall ill.  To date, children are far less likely to be infected.  Data taken from South Korea shows 0% of people under 30 have died from the virus. As behavior analysts working with children, this is good news.  Those with compromised immune systems are at risk though, and people should err on the side of caution. 

The virus is spread person to person through respiratory droplets in the air, and symptoms usually appear within 2-14 days after exposure.  Symptoms include a fever, cough, and shortness of breath.   There is also a chance that infection can occur though touching contaminated surfaces, although this is not believed to be the primary way the virus spreads.  If someone has come in contact with an infected individual, they should self-quarantine for 14 days. Below is a summary of confirmed and probable cases across the United States taken from the CDC website (current as of 3/12/2020).

• Total cases: 1,215
• Total deaths: 36
• Jurisdictions reporting cases: 43 (42 states and District of Columbia

Travel-related	125
Close contact	102
Under investigation	988
Total cases	1,215

What to do:

To date, there is no cure for the Coronavirus.  What we do know is that proactive behavior modification is very effective and preventing the spread of the virus.  To be clear, I don’t mean old-school 1970’s behavior mod…but rather some simple  behavior changes that we should all be accustomed to. 

• wash your hands often with warm water and soap (for 20 seconds) or use hand sanitizer.
• avoid touching your eyes, nose, or mouth.
• cover your mouth and nose when coughing or sneezing .
• avoid handshakes.
• avoid contact with sick people who are sick .
• stay home when you are sick.

What to do in an ABA Clinic:

Working in an ABA clinic in the midst of a pandemic might sound scary, but we have to be cautious not to over-react.  We are better at practicing good infection control than most, and we are very used to this routine.  Here are some guidelines you can take to day to help mitigate the virus spreading in your clinic.

1. Educate parents and behavior techs about COVID-19 and preventative behavioral practices.
2. Advise staff and clients to stay home when they are sick
3. Report any sick  and unplanned cancellations to your leadership and to public health officials when possible.
4. If clients do get sick while at the clinic, separate them from others. 
5. Reinforce best practices for washing hands and covering coughs and sneezes.
6. Proactively disinfect and clean frequently touched surfaces, including toys, light switches, doors, tables, etc.
7. Limit large group activities and field-trips.
8. If appropriate, change the venue of services to the home
9. Ensure all sick clients remain at home.

I want to stress #9… clients who are sick need to stay at home.  Many times, parents will drop off their kids at the center and admit that while their kid has a low-grade fever, that they’re actually “fine.”  If we intend on being proactive and stopping the spread of Coronavirus, we can’t allow exceptions that might allow us to unintentionally infect others. 

An additional avenue to explore:

There might be some other specific tools behavior analysts can use.  Telehealth, or telesupervision, for example, is a relatively new service in our field.  It involves the BCBA delivering services remotely by means of telecommunications technology.  It’s possible that funding sources may be willing to accommodate telehealth due to the Coronavirus outbreak.  As a way to help stop the virus from spreading, we should proactively ask our payors if they are willing to do reimburse for this service.

Final thoughts

With the Coronavirus dominating the news cycle and impacting different facets of our everyday life, it’s normal to be concerned.  There is a thin line between panic and concern though, and as practitioners working in the healthcare field, we have to advocate for evidence based strategies to help combat the spread of this virus.  That means educating our parents and staff about Coronavirus risks and simple steps we can take to help prevent it from spreading.  Our clients and families will often look to us, the providers, to help address any concerns they may have.  It’s critical that we are advising them on best practices to take and not unintentionally stoking fears.  Continue to monitor the situation at the Centers for Disease Control and Prevention for the most up to date information, and remember that we all play a role in helping to  prevent the spread of the virus.