Behavior Analysis Center for Autism - BACA

BACA provides ABA therapy to help children with autism.

Equity

Structural Racism and its Impact on ABA: Disparities in Diagnosis and Treatment

by

LEARN is committed to fostering a culture that embraces what makes us each unique—be it race, ethnicity, gender/gender identity, sexual orientation, religion, national origin, disabilities/abilities, or socioeconomic background. LEARN aims to acknowledge the lived experiences and diversity of perspectives of our staff and welcomes our teammates to share their stories to help foster conversations about diversity, equity, and inclusion in our communities.

By: Jasmine White, M.S., BCBA, Behavioral Concepts (BCI)

Today, the topics of diversity, equity, inclusion, and equality are at the forefront of many organizations. The long-standing impact of structural racism and its influence on society can no longer be disregarded. People of all creeds are speaking out against injustices and the need to promote inclusion. The dialogues on disparities have led me to reflect on the field of applied behavior analysis (ABA) and the community which it serves. To what extent has structural racism impacted ABA as a practice? Are ABA practitioners able to identify biases within the field? What is the impact on the provision of services? How does it influence diagnosis? The literature on structural racism has shown that even the most well-intended person can possess biases, we are not immune. Therefore, it is our time as a community to gain an understanding of how structural racism has affected the field of ABA.  

Here at LEARN, it is our goal to contribute to a brighter future for all, which means bringing to light sensitive topics that are impacting the communities we serve. While this may be an uncomfortable conversation, it is needed for the development of cultural humility in ABA practice. LEARN’s focus is twofold, call attention to and create a constructive conversation around disparities in diagnosis and treatment related to diversity, equity, and inclusion. As an organization that serves a diverse population, it is our responsibility to bring attention to the disparities experienced by those we serve and to be a part of the solution towards lasting change. 

Ethnicity is known as belonging to a specific racial, national, or cultural group and observance of that group’s customs, beliefs, and or language. Depending on ethnicity, one may have a life exposed to more inequalities. For racial and ethnic minorities in the United States, these inequalities include health disparities, such as higher rates of chronic disease, lower life expectancy, and decreased quality of life compared to the rates among non-ethnic minorities.

Ethnicity also has a direct impact on how early autism is identified, evaluated, and diagnosed. Research shows that not only do Black and Latino children with autism spectrum disorder (ASD) receive their diagnosis and start intervention at an older age than White children with ASD, but they also less frequently receive evidence-based interventions. For Black and Latino families, this directly impacts service opportunities, outcomes, and quality of life. According to the Center for Disease Control, studies have shown that implicit bias, lack of access to healthcare services, and non-English primary language are potential barriers to the identification of children with ASD. The research established that Black and Latino children receiving ABA services were more likely to score lower on caregiver reports of health care quality than their White counterparts, including areas of access to care, referral frequency, number of service hours, and proportion of unmet service needs.  

As a community, we must investigate ways to expand access and resources to those who so desperately need services. Identify areas of structural racism and work to reduce and eliminate them from ABA practice. Train our practitioners to identify and bracket implicit biases. Find communication methods so that all families can have a voice regardless of the primary language spoken. Explore ways to have open and honest networks of communication so that we can continue to have conversations that evoke change. Here at LEARN, we hope to be a part of the solution to these disparities so that we may create an environment where there is equity in access for those we serve.  

Discover more about LEARN Behavioral’s Diversity, Equity, and Inclusion initiatives. Let us find ways to work together to increase awareness and improve access to the communities we serve. Together, we can achieve more.

LEARN pledges to create a community centered around trust, respect, tolerance, and empathy. Read more about LEARN’s DEI journey in our 2021-22 DEI Annual Report and find out how we are investing in our clinicians’ cultural competence and increasing the diversity of our clinical team. Together, we’re better.

Jasmine is a BCBA and has worked with BCI for four years. She recently graduated Magna Cum Laude with a Master of Science in ABA from Bay Path University in Longmeadow, Massachusetts. Jasmine is currently conducting her thesis on Implicit Bias in ABA and is looking forward to expanding multiculturalism research in the field.  

Spotlight on Diversity in ABA: An Interview with Giovanna “G” Bosco

by

Giovanna “G” Bosco (she/they), a training tech at LEARN Behavioral and AST’s Mandeville, Louisiana, location, spends the bulk of their days preparing and onboarding staff to join the LEARN and AST team. When a friend from another AST region mentioned the open position, G’s love of being around children prompted her to apply. Then, after the job offer arrived, they jumped at the chance to work with kids regularly—and spend her days making a difference in the lives of others.

G took time recently to talk about their work with LEARN’s Diversity, Equity, and Inclusion (DEI) Plan, along with her experience working in ABA at AST. Here, we share the conversation.

Q: What does Diversity, Equity, and Inclusion (DEI) mean to you:

A: To me, diversity is an adjective I use to describe the environment in which I like to place myself. When I think about those individuals I call my friends, co-workers, and fellow community members, I think about how no single person is like another. We each look different, have different social histories, and may even differ on how we function neurologically. Although we may be different from one another, I can learn from each of them things that I would never know if I only surrounded myself with people who look and act like me.

Equity is about establishing a level playing field. I am aware of the privilege I have, and it isn’t enough to ask that those who were not born into same privilege be treated equal. I want everyone to have access to the resources that will ensure everyone has the same fighting chance to be successful in life. Inclusion, or to include others, is an action I decide to do each day. It involves creating an environment that welcomes others and makes them feel safe and secure.

Q: In your opinion, what is the most challenging aspect of working in a diverse environment?

A: Where I live, in Louisiana, the population isn’t all that diverse. So, the most challenging aspect I could identify is in communication, and how I work and relate with new hires who come through training. But recognizing the role communication plays in any interaction with another person is probably a challenge we could all benefit from realizing and thinking more about. As I mentioned, we all have our own differences (internal and external), and recognizing and appreciating that can go a long way. But it’s not always the most intuitive thing to do.

Q: What is your approach to understanding the perspectives of colleagues or clients from different backgrounds?

A: I think the most important thing to do is to create a safe space where people can come forward and explain their perspective on the situation. We might all have different ideas on how to complete tasks or how to address certain situations, but if those involved and I are respectful and open of other ideas, a solution can almost always be found.

Q: Why is DEI important in ABA?

A: In our line of work, it is never just about the diagnosis. Our clients are diverse racially, religiously, and in so many other ways. These social identities will always intersect with their diagnosis, and you cannot serve a client without addressing all of the factors that make them them. So, I think DEI in ABA is important for many reasons. Having a diverse staff can help improve the services we give to our clients and their families … and having staff who are self-aware and willing to learn about each client’s culture will only help us provide quality services. DEI can make us all better colleagues, friends, and neighbors, too.

Q: Tell me about a time when you advocated for diversity and inclusion in the workplace or in your personal life.

A: This one is difficult for me because I don’t truly feel like I’ve advocated for this in the workplace or in my personal life. It’s something that’s just felt inherent—this is coming from someone who always received the citizenship award growing up because I was friendly to everyone. So, I may not be so intentional on acting on it. It started with something my mom always told me: “If you see someone sitting alone, sit with them, even if they don’t want to talk.” I think, overall, that’s a pretty great starting point.

Q: What’s something most colleagues don’t know about you?

A: Most of my wonderful co-workers know that I have a beautiful wife and am part of the LGBTQIA+ community. However, something most of my colleagues don’t know about me is that I identify as non-binary.

To find out how and why we tailor ABA treatment to the unique needs and values of every client and family, read “Perspectives: Embracing Individuality in Behavior Analysis.”