VIDEO SESSION – Establishing Regulations of Behaviour Analysts in Ontario | CPO x ONTABA

Applied Behavior Analysis (ABA) is the application of the science of learning to understand and improve behavior that is meaningful to the person and those around them. ABA considers how the environment impacts learning. The term behaviour refers to anything a person says or does, including skills and actions needed to talk, play, and live. Behavior can also be private (e.g., thoughts and feelings).

ABA can help increase helpful or functional skills (e.g., communication) and/or decrease behaviours that are harmful or interfere with learning (e.g., self-injury).

ABA intervention uses evidence-based procedures such as positive reinforcement to address a client’s concerns and needs and to reduce interfering behaviour and increase desirable behaviour.  Behaviour Analysts practice in a variety of settings with many different client populations.   

Resources:

1. The Ontario Association for Behaviour Analysis (ONTABA) has developed this graphic to describe ABA, what it is and what it is not.  The graphic and more information can be found on their website.
2. The Behavior Analysis Certification Board (BACB) has additional information on its website about the profession of ABA and the client populations it serves.

In 2017, the Minister of Health and Long-Term Care asked the Health Professions Regulatory Advisory Council (HPRAC) to provide advice on:

• What activities or aspects associated with ABA therapy pose a significant and inherent risk of harm (if any), and whether the risk of harm of this therapy varies by client population (e.g., children and adults); and
• If there is a risk of harm, what is the range of options for an approach to oversight that could be considered?

In HPRAC’s January 2018 report to the Minister of Health and Long-Term Care, Applied Behaviour Analysis: Risk of Harm and Oversight, it concluded:

“Based on the evidence reviewed, HPRAC affirms that there is a risk of harm associated with most ABA interventions for clients, therefore oversight is recommended. Several oversight options to regulating providers were examined with a particular focus on clinical supervisors.”

With respect to oversight, HPRAC recommended the following:

“Because ABA therapy is deemed to pose a significant and inherent risk of harm across many client populations, HPRAC recommends that ABA providers performing a clinical supervisory role be regulated under an established health regulatory college, governed by the Regulated Health Professions Act, 1991 (RHPA). Other ABA providers would be accountable to the regulated clinical supervisors.”

To protect the public from risk of harm, once regulated Behaviour Analysts who supervise and/or deliver ABA interventions will have to meet clearly defined standards.  These standards will include having the necessary knowledge, skills, and judgement to meet practice requirements and to be allowed to use the regulated title “Behaviour Analyst”.

Anyone who wants to practise a regulated health profession in Ontario, i.e., psychologists, psychological associates, physicians, nurses, dentists, occupational therapists etc., and now, Behaviour Analysts, must be registered with, and be accountable to, a health regulatory College.   A College is not a university, community college, or school. Instead, its mandate is to protect the interests of the public by ensuring that clients receive competent and ethical professional services from qualified providers.

Ontario Health Regulators includes the 26 health regulatory Colleges in Ontario, including the College of Psychologists of Ontario. To learn more about how and why health professions are regulated in Ontario, visit their website.

On June 3, 2021, the enabling legislation to authorize the College of Psychologists of Ontario to regulate the profession of Applied Behaviour Analysis (ABA),  Bill 283, Advancing Oversight and Planning in Ontario’s Health System Act, 2021 received Royal Assent. Included in Schedule 4 of this Bill is the legislative authority for the College to regulate the profession of Applied Behaviour Analysis. On July 1, 2024 this legislation will be proclaimed by the government and will repeal the Psychology Act, 1991 to replace it with the Psychology and Applied Behaviour Analysis Act, 2021.

The new Act establishes the regulation of two separate and distinct professions, Psychology and Applied Behaviour Analysis within one College. The current College of Psychologists of Ontario will be the regulator for both professions and will be renamed the College of Psychologists and Behaviour Analysts of Ontario to reflect its expanded role. The legislation maintains the regulatory framework for current members, Psychologists and Psychological Associates, but additionally:

• Defines the scope of practice for ABA: “The practice of applied behaviour analysis is the assessment of covert and overt behaviour and its functions through direct observation and measurement, and the design, implementation, delivery and evaluation of interventions derived from the principles of behaviour in order to produce meaningful improvements”;
• Restricts the use of the title “Behaviour Analyst” to members of the new College registered as Behaviour Analysts;
• Expands the “Representations of Qualifications” restriction to include holding oneself out as qualified to practice as a Behaviour Analyst or in a specialty of behaviour analysis; and
• Updates the size and composition of the current College’s Council to enable fair representation for both professions.

In 2017, the Health Professions Regulatory Advisory Council (HPRAC), at the request of the then Minister of Health and Long-Term Care, undertook to review Applied Behavioural Analysis; its potential for harm and need for regulation. In response to a request for information, the College submitted a letter which stated, in part, that, “Should ABA regulation proceed in Ontario, the Council of the College of Psychologists is prepared to undertake this process within its governance structure”.

On September 19, 2019, the College received a letter from Minister Todd Smith of the Ministry of Children, Community and Social Services and Minister Christine Elliott of the Ministry of Health inviting the College to confirm its interest in undertaking the regulation of ABA as part of its governance structure. In their letter, the Ministers state that, “Strengthening the oversight of behavioural clinicians will protect vulnerable Ontarians from risk of harm and set standard expectations for professional standards and educational requirements for ABA providers across the province. It will also support families in finding qualified providers, and making complaints about providers, if necessary. Our ministries would like to begin with regulating those who are in a supervisory role, and we envision that this will be broadened to include front-line clinicians over time.”

On September 27, 2019, the Council of the College of Psychologists passed a motion confirming the offer to undertake the regulation of ABA within its governance structure.

Any person wishing to use the title “Behaviour Analyst”, a variation or abbreviation or an equivalent in another language, must register with the College.  This would apply to clinical supervisors who provide clinical direction and supervision of ABA activities, which include behaviour assessment, designing an intervention plan, implementing intervention plans, and monitoring and evaluating the plans.  Beginning on July 1, 2024, and going forward, only those who have registered with the College will have access to the restricted title “Behaviour Analyst”.

Service providers who deliver ABA interventions directly to a client or caregiver and are accountable to a Behaviour Analyst clinical supervisor will not be regulated.

For more information, visit the Applied Behaviour Analysis (ABA) Portal on the College of Psychologists of Ontario’s website, watch the College’s recently released video information session on the regulation of ABA, review the FAQs page for answers to frequently asked questions, or contact the College at aba@cpo.on.ca.

Many professionals registered with other regulatory colleges, including nurses, social workers, occupational therapists, speech language pathologists, educators, and others, may use behavioural techniques in their practice.  As noted above, these will remain in the public domain and are not restricted activities.  If, however, a practitioner wishes to  use the title “Behaviour Analyst” or indicate any certification or designation or communicate in any way that could be considered as holding themself out as a person who is qualified to practice as a Behaviour Analyst, they will be required to also register with the College of Psychologists and Behaviour Analysts of Ontario.

Dual registration occurs often in many sectors as professionals may hold certificates of registration with more than one regulator to practice multiple professions.  It is permissible, and may be necessary, for a Behaviour Analyst to be registered with more than one regulatory College. In this same vein, Psychologists and Psychological Associates, that want to be able to use the restricted title “Behaviour Analyst”, must meet the registration requirements to obtain a second certificate of registration authorizing practice as a Behaviour Analyst.