The Full Story
This wasn’t Dr. Silbaugh’s first effort to address the gaps in quality within the ABA autism services industry. In 2019, behavior analysts Bryant Silbaugh and Robbie El Fattal asked a fundamental question about ABA service delivery: How can we objectively and verifiably determine if an ABA autism service provider is delivering high-quality services? The inability to answer this question by drawing from their decades of collective experience in ABA research and practice suggested a significant gap between research and practice on the topic of ABA service quality—one that had been ignored for too long. To explore quality concepts in ABA service and research, they conducted a study that was later published in 2022 in the journal Behavior Analysis in Practice.
Their findings highlighted three major problems in the ABA service industry:
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ABA service delivery quality (ASDQ) is undefined: Both ABA research and the industry lacked an operational definition of what constitutes quality in ABA service delivery, making it challenging to evaluate or improve services in a systematic, evidence-based way.
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Professional organizations overseeing licensure and certification cannot control ASDQ: Although organizational accreditation and practitioner certification and licensure are critical for high-quality services, these mechanisms do not directly impact the contingencies that affect service quality within individual organizations. Organizations need to take an empirical approach to arranging contingencies within their own walls that reinforce clinical and operational cultural practices that result in high-quality services.
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Without objective indicators, ABA organizations cannot distinguish their quality from competitors: The absence of a consensus definition of quality and standardized quality metrics makes it difficult for organizations to differentiate their services in a meaningful way, potentially leading to a marketplace in which organizations are not adequately incentivized to compete on quality.
In their study, Drs. Silbaugh and El Fattal argued that the field needs more critical discussion of ABA service delivery quality (ASDQ) and that a cohesive theoretical framework is necessary to bring ASDQ within the scope of ABA as a science. As a starting point, they defined ASDQ as, “…the extent to which an organization’s ABA products, services, and outcomes meet standards determined by professionals and consumers, over time, in response to changes in a receiving system, while maximizing the financial health of the organization”, and offered a 6-step call to action for top-down implementation of change initiatives that promote high ASDQ.
Inspired by that study and convinced that systemic change is needed to address issues of quality in the ABA services industry, Dr. Silbaugh founded a NASQN LinkedIn group with the mission to, “Empower practicing behavior analysts everywhere with the resources and connections they need to deliver the highest possible quality ABA services”.
Its vision was to, “serve as a grassroots group of interconnected ABA service delivery professionals who exchange information and resources in support of each other's efforts to amplify the positive impact of ABA around the world by supporting advances in scientific management and robust quality assurance systems in ABA service organizations”.
Dr. Silbaugh believed that a movement was needed to shift the field toward a greater focus on quality assurance and he believed that NASQN could lead that movement.
As NASQN’s LinkedIn group membership steadily grew, Dr. Silbaugh published the groundbreaking book, Quality Control for Behavior Analysts: How to Manage Behavioral Intervention Quality in Autism Service Settings. This book was the first of its kind in the ABA autism services industry. It offers a practical approach for Board Certified Behavior Analysts (BCBAs) to control the quality of their behavioral interventions. By introducing key concepts such as quality planning, control, and improvement, the book provides step-by-step guidance on how behavior analysts can maximize care value through superior clinical outcomes.
The publication empowers practitioners to routinely assess procedural fidelity and interobserver agreement in ways that can dramatically enhance service delivery and quality of life for individuals with autism.
In just seven months, NASQN’s impact on LinkedIn was evident. With over 280 members across the country, the network had grown into an inspired community of professionals committed to quality. Volunteer-led quality workgroups emerged, collaborating to develop practical resources that behavior analysts could apply directly in their workplaces.
These resources will empower analysts to increase the quality of their services and offer ABA business leaders and resources to support top-down quality assurance strategies within their organizations.
What stood out about NASQN’s LinkedIn presence was its inclusivity and diversity. The network’s low barriers to entry attracted members from all corners of the ABA industry—from clinical behavior analysts and researchers to CEOs and vice presidents of quality. NASQN’s membership included influential American leaders in ABA quality and spanned a wide variety of positions, including clinical directors, doctoral students, tech company founders, organizational behavior management experts, AI/UX researchers, and even a former student of B.F. Skinner. This diverse membership reflected NASQN’s mission: to unite and empower professionals at all levels of the ABA autism service industry to collectively elevate service quality.
With its steadily expanding network, the publication of Dr. Silbaugh’s book, NASQN’s newsletter “ABA Quality Report”, a growing reference list of professional development opportunities and resources for quality, and a commitment to driving innovation in quality assurance, NASQN was an emerging force for change in ABA practice.
The next chapter in NASQN’s story begins with servant leader, quality engineer, and seasoned behavior analyst Dr. Jeremy Wilson. With Dr. Wilson’s support, NASQN took the leap to become a nonprofit organization in Texas to take the quality movement to the next level: formation of a Board of Directors to lead multiple major initiatives with the potential to deliver a brighter future in service delivery quality for American ABA.
Our Present: Expanding the NASQN Vision and Capacity to Drive Change
Today, NASQN is more than just a LinkedIn professional networking group—it is a movement. Through strategic partnerships, recruitment of top talent, and moonshot industry-changing initiatives, NASQN will work to help behavior analysts improve their practices and deliver better outcomes.
With the creation of high-performance workgroups to spearhead these efforts, NASQN emphasizes quality assurance, scientific management, and large-scale changes in industry safeguards and organizational practices that lead to high-quality ABA services.
Trends in the field suggest that the growth of ABA services has outpaced the industry’s understanding of quality assurance in service delivery and the effectiveness of existing safeguards.
Issues such as malpractice in ABA autism services, high levels of burnout and turnover, historically inadequate certification exam pass rates, and insufficient fieldwork supervision all point to a need for better quality assurance in practitioner preparation and practice.
Additionally, the workforce's inability to meet the rising demand for high-quality services, combined with a lack of research on ABA service quality, has left service providers without clear, empirically driven guidelines for promoting quality assurance in service delivery and professional development pathways in quality.
These trends indicate that the ABA autism service industry has reached a critical turning point.
In response to a turning point in the ABA service industry (Silbaugh, submitted), NASQN is championing a national research agenda focused on understanding the variables that influence ABA service quality with an emphasis on quality planning, control, and improvement.
Through its research initiatives, NASQN urges behavior analysts to collaborate on addressing gaps in quality assurance practices.
We seek to support industry-wide contingencies that promote the publication of quality assurance studies essential for building a strong ABA service quality research base.
This research will enable ABA leaders to design total performance systems that compensate for inadequate external quality controls by prioritizing contingency control over high-quality service delivery practices within their organizations.
By joining NASQN, ABA professionals can connect with other stakeholders to participate in this quality research agenda.
By encouraging practitioners to adopt this approach, NASQN empowers quality managers to develop reliable and effective systems that can maintain high standards of service, even in the face of external challenges.
NASQN creates a space for collaboration between professionals, researchers, and policymakers, and other stakeholders to come together to share their successes, troubleshoot challenges, and exchange innovative ideas that move quality assurance forward.
Three freely available NASQN resources make it easier for ABA service professionals to pursue professional development in quality assurance.
Our quarterly newsletter, the ABA Quality Report, is the industry’s only newsletter in the ABA services industry dedicated solely to ABA quality news, research, and opportunity. It provides members with updates on peer-reviewed quality research, links to current quality conference talks, updates from resource-generating workgroups, featured books on quality, calls for papers, and more.
Our ABA quality quick start reference list provides members with information and links to professional organizations for quality, quality books and articles, links to continuing education on quality, and links to industry guidelines and standards. ABA service professionals can use the quick start reference list to accelerate their professional development in quality assurance.
NASQN high-performance work teams are groups of ABA service professionals who volunteer their time to work together on the development of resources stakeholders can use to improve quality. Participation in high-performance work teams can have many benefits for our members such as knowledge sharing and learning, networking opportunities, skill development, professional recognition, and leadership skill development.
Today NASQN is a nonprofit organization headquartered in Texas, which has filed for 501(c)(6) status with the IRS, dedicated to empowering practicing behavior analysts with the resources and connections they need to deliver the highest possible quality of ABA services. NASQN operates as a membership-based organization, focusing on advancing scientific management and quality assurance in ABA service settings through collaboration, resource sharing, and innovative initiatives that promote attainment of high standards of practice within the ABA community.
Our core values are opportunity, momentum, moonshots, accountability, and quality. NASQN members constantly seek opportunities to improve policies, systems, processes, procedures and practices across the industry that impact ABA service quality. When opportunities arise, we gain momentum through progressive and incremental goal attainment and celebrating our wins. With that momentum we shoot for the moon to achieve improvements in ABA service delivery quality believed to be impossible. And along the way we hold ourselves and our colleagues accountable for delivering on our promises, prioritizing quality from start to finish.
Our Future: NASQN’S Action Plan for American ABA
In July of 2024, with the help of Dr. Jeremy Wilson, NASQN the LinkedIn group launched an initiative to form a Board of Directors who would govern a future nonprofit NASQN professional trade association. The search was highly successful, resulting in numerous applications a limited number of seats. And in October of 2024, highly qualified and experienced ABA service professionals from across the country joined to form NASQN’s Board of Directors.
Together, the Board will lead high-performance work teams to secure a brighter future for the industry and all its stakeholders. They do this by leading the start of a radical transformation of the ABA autism services industry with a focus on establishing new forms of quality control and promoting contingencies that govern practitioner preparation and the cultural practices that produce high ASDQ.
Our Mission. With its new status as a nonprofit organization, NASQN's will continue its mission as a grassroots group of interconnected ABA service delivery professionals who exchange information and resources that empower behavior analysts to deliver high-quality services with scientific management and robust quality assurance.
But its vision will expand.
Our Vision. NASQN will be America’s leading safeguard for quality in the ABA service delivery industry by promoting alignment of contingencies selective for high-quality services with ABA practices that produce optimal outcomes for service recipients, nationwide.
To achieve this new vision, NASQN will pursue a comprehensive five-point action plan, consisting of 14 initiatives aimed at empowering ABA professionals to put quality at the forefront of everything they do.
NASQN's Action Plan for American ABA
1. Transforming Practitioner Preparation for Future Generations
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Transition to a Value-Based Supervision Model: NASQN will advocate for a shift to a value- and competency-based supervision model for student analysts. We’ll do this by establishing contingencies for fieldwork supervision to ensure practitioner certification, licensure, and credential renewal depend on competencies in practice, not good test taking or fly-through CEUs, so future practitioners are equipped to deliver high-quality services.
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Quality Management Curriculum in ABA: NASQN will push for quality management and assurance to become foundational knowledge in ABA graduate and undergraduate curricula, preparing future practitioners to support and evaluate quality within their organizations.
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Put the Analysis Back into ABA: NASQN will advocate for a new tiered certification model that requires behavior analysts to demonstrate fluency in single-subject design methodology and functional control over behavior in practice, ensuring that services meet the analytic dimension of ABA.
2. Strengthening Workforce Sustainability
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Positive Trends in Attrition, Burnout, and Turnover: NASQN is committed to researching and addressing factors that impact workforce sustainability, advocating for industry changes to reduce burnout, attrition, and turnover, and ensure practitioners can build long-term careers in ABA.
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Developing Quality Leadership: NASQN will support the growing prevalence of "quality" roles in ABA organizations, advocating for champions of quality in every service provider organization.
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Fighting for Fair Caseloads and Compensation: NASQN will push for increased reimbursement rates and support efforts to lower caseloads and increase salaries, ensuring practitioners are compensated fairly and able to provide the highest quality services.
3. Empower Small ABA Businesses
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Replace Fee-For-Service with Alternative Reimbursement Models: NASQN will advocate for a shift from the current fee-for-service insurance reimbursement model to an alternative payment structure and models, which will incentivize providers to focus on service quality rather than quantity.
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Eliminate Private Equity Dominance: NASQN will work to reverse the growing dominance of private equity ownership in ABA service organizations, that prioritizes rapid growth and profit over long-term clinical quality and sustainability.
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Reducing Clinical and Operational Waste: NASQN will work to simplify CPT codes, expand billable activities permitted by payors, and reduce administrative burdens, ensuring that behavior analysts can focus on delivering high-quality, evidence-based practices rather than drowning in billing complexities.
4. Prioritizing ABA Service Quality in Research and Practice
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Incentivizing ABA Quality Research: NASQN will establish a peer-reviewed journal and incentivize research focused on ABA service delivery quality, addressing the current lack of empirical research on variables that influence service quality.
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Shifting Professional Development to Focus on Quality: NASQN will host an annual conference and other professional development opportunities dedicated exclusively to ABA service delivery quality, expanding behavior analysts' scope of competence to include quality assurance.
5. Unlocking Access to High-Quality ABA Services for All Americans
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Universal Access to ABA Services: NASQN will advocate for the elimination of the autism diagnosis requirement for ABA coverage, ensuring that any individual in need of behavior analytic services can access them, regardless of their diagnosis.
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Putting Behavior Analysts in Government: NASQN will work to support behavior analysts in securing local, state, and federal government positions to advocate for increased reimbursement rates, quality assurance, and universal access to services.
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Ending Inappropriate Treatment Limits: NASQN will fight against illegal treatment limits imposed by insurance companies, ensuring that all clients can receive the appropriate level of service without unnecessary delays or restrictions.
Looking ahead, NASQN is preparing to take its mission to new heights. We envision a future where every ABA provider is recognized for their commitment to quality, and where every individual receiving services experiences the positive outcomes they deserve. We are developing groundbreaking initiatives that will reshape the industry:
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Quality Control Over ABA Microcredentials: Historically, behavior analysts could obtain their certification by completing a university course sequence, a minimum number of fieldwork supervision hours, and pass a multiple-choice exam. All without necessarily being required to demonstrate competencies in the fundamentals of ABA practice. To move the needle on quality assurance, we must put non-competency-based certification exam requirements in the past. Microcredentials are the future of practitioner preparation and continuing education in ABA. Unlike conventional activities that result in degrees, or continuing education units, microcredentials acknowledge and reward competent and fluent demonstrations of behavior analytic skills. NASQN will operate as a safeguard for quality by accrediting ABA microcredential providers. With this product, NASQN will help control the quality of ABA microcredentials, and establish the value of microcredentials with professional trade associations, payors, practitioners, business leaders, and more.
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New Certifications and Accreditation: For decades, professionals have pursued professional development in quality and obtained quality certifications in industries other than ABA service delivery, such as manufacturing and pharmaceuticals. As the ABA service delivery industry matures and expands, ABA professionals too will need professional development pathways that lead to expertise and certification in quality. Accordingly, NASQN will lead the development of new certification programs focused on quality control and management in ABA service organizations. Our aim is to establish NASQN as a recognized standard for quality in ABA, develop quality certifications specific to the various roles in ABA service delivery such as behavior technicians, clinical supervisors, operations managers, clinical directors, and more; and establish the value of ABA quality certifications with payors through preferred payor relationships, streamlined credentialing, enhanced reimbursement rates, and more.
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Research Incentives: NASQN will create financial mechanisms such as grants and awards that incentivize and accelerate industry-wide research on ABA service quality, ensuring that scientific advancements in quality assurance continue to inform practice.
Our impact can already be felt, but to truly achieve our vision, we need more resources and support. That’s where you come in.
NASQN’s expanded mission is ambitious, but it is vital for addressing the research-to-practice gap in quality assurance and reshaping the future of ABA autism services. With our five-point action plan, NASQN is poised to become a transformative force in the ABA industry, ensuring that high-quality services are accessible, sustainable, and driven by data and science.
Your donations help NASQN’s ambitious agenda break new ground and gain momentum by supporting the following:
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Startup costs
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Operational infrastructure
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New incentives for quality assurance research
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R&D on microcredential accreditation and quality certification programs
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NASQN’s 2025 ABA Quality Webinar Series
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First Annual Quality Conference
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ABA quality job board
Every donation, no matter the size, could make a difference in the lives of millions of people impacted by ABA research and services, especially families of service recipients.
Together we can help promote quality assurance in the ABA industry and close the gap between actual and expected outcomes in ABA service delivery settings.
Thank you for your kindness, generosity, and support!