The recent shift to define ABA as medically necessary (APBA, April 10, 2020) further highlights the need for the professional practice community-at-large to establish a shared understanding for the defining features of socially meaningful case conceptualization (SMCC). This is of particular concern for newer practitioners (certified in the last 5 years) who are expected to make appropriate ABA service recommendations with potentially limited guidance from more experienced clinicians. Previous authors have addressed these and related concerns by focusing on topics such as social validity (e.g., Wolf, 1978), but a far greater concern is whether practitioners are addressing the most socially meaningful goal(s) in the first place. Failure to do so often means adhering to a symptom-reduction approach alone (i.e., primarily based on standardized developmental and psychoeducational “excesses/deficits” with no individualization).
This presentation addresses several crucial considerations for providing medically necessary ABA services, including related guidance for adjusting previously established approaches to clinical practice.