Helping children with autism reach their full potential


Quality Services

Providing quality services to a growing number of people requires a dynamic perspective which incorporates ongoing development of systems and personnel.

For perspective, let’s consider a business model with which are all generally familiar—a school. We can make it a private school in a growing small town which has more would-be students than other available schools to accommodate them.

The owner (or principal) of the school is tasked with a two-variable goal—(1) provide quality education to (2) as many students as practicable. Expanding quality services in an ABA practice (or any other service business, for that matter) involves the same two variables—quality services to as many clients as is practicable. Calculating what that equation looks like is part science, and part art.

The science of a pro-forma business plan for an ABA practice begins with recognizing the boundaries reflected in widely recognized best-practices. BCBAs generally cannot supervise more than about five full-time techs. BCBAs generally cannot sustain billing regimens of more than 30 hours/week. BCBAs are generally not good at everything necessary to provide quality services across a spectrum of likely clients, necessitating more than one BCBA to provide the best quality care.

Without quality, quantity (business volume) lacks meaning. What is the point of providing a community with worthless services? What is the point of running a school in which students learn little or nothing?

At the same time, quality cannot develop without quantity because quality depends upon a team. And teams without quantity are unsustainable. People need to eat. Their careers must provide them with financial support—if not immediately, at the beginning when they are unskilled, at least over time as they grow individually. Quantity and quality are the left and right feet of any business, organization, or relationship. They must move together, in tandem, to get anywhere.

The Art

The art of building a practice is much more nuanced than the basic science of the initial business plan. How does one evaluate a given BCBA’s skill set? How are her strengths most effectively deployed? What assignments and responsibilities are best suited to each clinician? How is the clinical team most effectively deployed to reach both existing and prospective clients? What strategies should the clinical director employ to develop the team?

The wise school principal does not grade herself or her school based upon performance realized within a single hour, day, week, or even year. The wise school principal understands that building an excellent school which provides the best education for its reasonable capacity of students will develop over a longer period—years…even decades. Quality and quantity aren’t in conflict; they are complimentary and interdependent measures of achievement every step of the way.

Pursuing a given target for a certain volume of quality services is also not a static process. As the principal builds her teaching staff, she identifies key personnel who show unusual promise. She adjusts assignments and duties, experiments with new ideas in small ways before implementing big changes, continually moderates among her staff while always maintaining momentum toward future goals. As she builds a cohesive team, the school’s capacity for both quality and quantity grow.

Changing conditions and developing insights concerning both challenges and opportunities typically require significant adjustments to goals and strategies over time. But not day-to-day. Judging the progress of a new employee on a day-to-day basis is reasonable—sometimes essential—but judging the progress of the overall business upon day-to-day events immediately destabilizes the whole organization.

Personnel hoping to build a career with your practice need to know that the captain at the helm can see past the horizon and has a steady hand. They need to know that you have a well-crafted plan which occupies your ongoing attention. They can attend to the day-to-day precisely because they know that you are attending to the year-to-year. Their long-term commitment and orientation toward growing with you cannot soundly exceed the well-developed plan established upon your own resolve and long-term commitment.

How do we know how much we can do well tomorrow? Next month? Next year? We don’t. Just as we don’t even know that we will wake up tomorrow morning. But we can estimate. And estimating risk/reward is a constant fundamental element of the planning function.

Planning is immensely dependent upon the mathematics of future probabilities. No plan is certain because the future is never certain. But some plans are better than others because some probabilities are higher than others. The stronger your probabilities for success, however you measure performance against your well-defined goals, the more confidence you will have to pursue it.

The Visionary

The CEO is the visionary, the architect, and the captain of the ship. Planning is her primary function. And the further out into the future she can effectively focus, the more powerful is her organization’s potential. The chess match typically goes to the player who thinks the most moves ahead…while simultaneously watching out for the pitfalls and traps which could sabotage the game along the way.

Let’s take one more look at our school principal. What will best catalyze her prospects for success? Answer: at least one other someone alongside her to help. Someone she can pour herself into. Someone who can share, complement, and radiate the CEO’s vision in an harmonious way.

Your management team might begin with you alone, but the faster you have your executive assistant, your vice-principal, your first lieutenant, the quicker you move toward both greater quality and faster growth.

The wise CEO has a plan. She knows where she is going. She is ever monitoring progress and developing more definition over how to get there. And most of the “how” comes back to building and maintaining a cohesive management team which, in turn, is able to disseminate guidance, training, and supervision toward a growing next generation of leadership rising up behind them.

Be sure to read our previous blog on Growing Pains.

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