A Team Approach: How the LEND Program Can Provide Interdisciplinary Training for Behavior Analysts

Abstract

Supporting people with neurodevelopmental disabilities often requires interdisciplinary collaboration and effective partnerships with clients and their families. Behavior analysts receive intensive training and supervision in a variety of domains; however, expanding interdisciplinary training for behavior analysts is needed. Interdisciplinary training programs, such as the Leadership Education in Neurodevelopmental and Related Disabilities (LEND) programs, offer trainees the opportunity to hone their skills as advocates for people with neurodevelopmental disabilities and collaborators as part of an interdisciplinary team. Historically, many LEND programs have not offered training positions specifically to behavior analysis students or professionals, although some behavior analysts have participated as trainees in other disciplines such as psychology or special education. The benefits, barriers, and possible future directions of interdisciplinary training for behavior analysts within a LEND program are discussed through the experience of the University of Cincinnati LEND Program which added an Applied Behavior Analysis (ABA) training track in 2020.

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Vol.:(0123456789)
Behavior Analysis in Practice
https://doi.org/10.1007/s40617-025-01043-2
TECHNICAL ANDTUTORIALS
A Team Approach: How theLEND Program Can Provide
Interdisciplinary Training forBehavior Analysts
LoriB.Vincent1· MeaganScott2· StephanieWeber3,4· LauraSrivorakiat4· MaryStepanek1· JenniferSmith3,4
Accepted: 14 January 2025
© The Author(s) 2025
Abstract
Supporting people with neurodevelopmental disabilities often requires interdisciplinary collaboration and effective partner-
ships with clients and their families. Behavior analysts receive intensive training and supervision in a variety of domains;
however, expanding interdisciplinary training for behavior analysts is needed. Interdisciplinary training programs, such as
the Leadership Education in Neurodevelopmental and Related Disabilities (LEND) programs, offer trainees the opportunity
to hone their skills as advocates for people with neurodevelopmental disabilities and collaborators as part of an interdiscipli-
nary team. Historically, many LEND programs have not offered training positions specifically to behavior analysis students
or professionals, although some behavior analysts have participated as trainees in other disciplines such as psychology or
special education. The benefits, barriers, and possible future directions of interdisciplinary training for behavior analysts
within a LEND program are discussed through the experience of the University of Cincinnati LEND Program which added
an Applied Behavior Analysis (ABA) training track in 2020.
Keywords LEND program· Applied behavior analysis· Neurodevelopmental disabilities· Autism· Interdisciplinary
work· Training
Interdisciplinary treatment involves professionals from dif-
ferent disciplines who each maintain their respective dis-
ciplinary role, work together to coordinate tasks and care
for a client, have frequent communication and collaboration
about the treatment plan and progress, and have shared goals
and responsibilities (Bowman etal., 2021). Interdisciplinary
treatment is often considered valuable for individuals with
complex needs, including people with neurodevelopmental
disabilities (NDD), although more research in this area is
needed (Bowman etal., 2021; LaFrance etal., 2019).
Key characteristics of interdisciplinary teams include a
shared philosophy, interdependence of team members, pro-
fessional identity based on relevant knowledge rather than
title, leadership skills within the team, dynamic and evolv-
ing collaboration, and a partnership, based on respect and
trust, that uses strong communication skills to combine the
knowledge of others (Kunze & Machalicek, 2022). Although
professionals in the field of applied behavior analysis (ABA)
provide valuable services to people with NDD, they may
at times face cross-disciplinary challenges (e.g., use of dif-
ferent terminology, misconceptions and misunderstandings
between disciplines) that may affect their collaboration with
other providers compared to other professionals in related
fields (Brown & Hendy, 2001; Slim & Reuter-Yuill, 2021).
This may be due to the isolation of behavior analysts in their
training compared to other disciplines (Brown & Hendy,
2001; Kelly & Tincani, 2013) and the training some behavior
analysts receive related to practices considered not evidence-
based used in other disciplines such as occupational therapy
(Leaf etal., 2023). Therefore, effective pre-service training
and increased opportunities for interdisciplinary work is
essential to enhance the skillsets of ABA providers (Kirby
etal., 2022) and improve the overall interdisciplinary care of
* Lori B. Vincent
lori.vincent@uc.edu
1 School ofHuman Services, School Psychology Programs,
University ofCincinnati, 450B Teacher-Dyer Complex,
Cincinnati, OH45221, USA
2 Department ofEducational, School, andCounseling
Psychology, University ofKentucky, Lexington, KY, USA
3 Department ofPediatrics, College ofMedicine, University
ofCincinnati, Cincinnati, OH, USA
4 Cincinnati Children’s Hospital Medical Center, Cincinnati,
OH, USA

Behavior Analysis in Practice
individuals with NDD and their families (Hall, 2005). When
implemented effectively, interdisciplinary care can improve
the family-centered coordinated care that children receive
(Rohrer etal., 2021; Suen etal., 2021); however, there are
still a multitude of challenges and barriers that hinder the
effectiveness of interdisciplinary care including cost of ser-
vices and billing (Bowman etal., 2021), which are beyond
the scope of this paper.
Challenges andBarriers toInterdisciplinary
Work andTraining
Research has identified many challenges and barriers that
may impact success in meaningful and productive interdis-
ciplinary collaboration. First, practitioners from different
disciplines may vary in their core values and definitions of
evidence-based practices (EBP), which can lead to contrast-
ing opinions and recommendations (Bowman etal., 2021;
Gasiewski etal., 2021). Additionally, misunderstanding oth-
ers’ roles can often lead to less collaboration and more con-
flict (Gasiewski etal., 2021). For example, negative views
or misperceptions of other disciplines can result in a lack
of trust and respect within an interdisciplinary team (Bow-
man et. al, 2021; Gasiewski etal., 2021). Finally, interdis-
ciplinary teams face challenges when providers engage in
disciplinary-centric attitudes or belief that one’s discipline
is superior and better equipped to address client concerns
(Pecukonis, 2020).
Specifically, ABA providers may find it difficult to col-
laborate with other disciplines and eventually limit collab-
orations due to a misalignment between the fundamental
dimensions of ABA and other disciplines’ practices (Baer
etal., 1968; Cooper etal., 2019; Welch & Polatajko, 2016).
For instance, ABA providers may have negative precon-
ceived notions about other providers use of nonbehavioral
or non-evidence-based interventions that are perceived to
lack systematic instruction, data collection, or individuali-
zation (Gasliewski etal., 2021; Lane & Brown, 2023). This
may stem from ABA providers being less likely to read the
literature from other disciplines related to NDD than their
colleagues from different disciplines (Smith, 2012), thus
resulting in ABA providers relying on their own training,
opinions, and biases. Similarly, other disciplines may not
agree with behavioral-based interventions due to them being
perceived as rigid or ineffective, disregarding clients’ needs,
and undervaluing diversity in individual functioning (Lane
& Brown, 2023; Welch & Polatajko, 2016). Additionally,
differences in terminology and jargon across disciplines can
lead to ineffective communication (Bowman etal., 2021).
This may be especially true for behavior analysts as the field
of ABA has created unambiguous terminology that unifies
the work of behavior analysts yet isolates behavior analysts
from other disciplines (Brown & Hendy, 2001). Interdis-
ciplinary team barriers derive from multiple perspectives,
and these barriers can and should be addressed to increase
effective cross-disciplinary collaboration and quality care.
The Behavior Analyst Certification Board’s (BACB,
2020) Ethical Codes 2.10 requires ABA providers to col-
laborate with other providers for the best interest of the cli-
ent as appropriate. Although the need for interpersonal and
technical skills training for ABA providers is imperative
to the field of ABA (Taylor, etal., 2019), ABA providers
often receive a limited amount of training in collaboration
and interdisciplinary work (Kelly & Tincani, 2013). For
instance, research has shown that ABA providers lack train-
ing in “soft skills,” such as perspective taking and compas-
sionate responding (Taylor etal., 2019). Additionally, a per-
sonality survey found that ABA students demonstrated lower
levels of warmth (i.e., warm, outgoing, attentive to others)
than students within other human service disciplines (Cal-
lahan etal., 2019). This is especially important as behavior
analysts who demonstrated high levels of caring interper-
sonal skills were more highly rated by parents of children
receiving ABA services (Callahan etal., 2019).
Without specific education and/or training in collabora-
tive practice, interdisciplinary collaboration may present
challenges to behavioral health providers. Interdisciplinary
collaboration is rarely observed in academia and interactions
among students of differing professions are not necessar-
ily encouraged or facilitated (Kelly & Tincani, 2013). This
lack of interpersonal collaboration training can lead to dis-
tinct and narrow professional worldviews where providers
embrace their professional identity and continue to create
silos of care due to only collaborating with providers within
the same field (Pecuknois, 2020; Weiss etal., 2022). Addi-
tionally, effective collaborate between ABA providers and
other disciplines may assist in avoiding unnecessary unde-
sirable outcomes, including poor social validity of interven-
tions and negative and/or traumatic experiences of clients
when that integrated care is provided ethically (Cox, 2012,
2019; Kupferstein, 2018; Sandoval-Norton & Shkedy, 2019).
Benets ofInterdisciplinary Teams
To address the lack of training in interdisciplinary work and
barriers to interdisciplinary collaboration, ABA providers
would likely benefit from increased opportunities to work
on interdisciplinary teams. Collaborating within an inter-
disciplinary framework can help ABA providers recognize,
understand, value, and appreciate the contributions of pro-
fessionals from other disciplines (LaFrance etal., 2019). For
example, interdisciplinary training allows ABA trainees to
improve their interpersonal skills in working with families,
clients, and other professionals by creating opportunities for

Behavior Analysis in Practice
ABA trainees to observe the interpersonal skills of profes-
sionals from other disciplines and learn from their interac-
tions with families and clients.
Experience working on interdisciplinary teams can also
help practitioners hone their communication skills to better
communicate with providers from other disciplines. Spe-
cifically, ABA providers can learn to use clear communi-
cation to share knowledge, exchange ideas, and effectively
coordinate care for clients (Bowman etal., 2021). When
ABA providers develop effective communication skills, they
may be more likely to resolve conflicts and misunderstand-
ings that occur within interdisciplinary teams with various
clinical perspectives quickly, effectively, and respectfully.
In addition, having direct experiences can help practition-
ers identify their role within a team setting and create clear
professional boundaries between all interdisciplinary team
members (Bowman etal., 2021).
Interdisciplinary Training Components
Interprofessional training for ABA providers could include
opportunities to practice sharing basic information about
each discipline, observe other disciplinary providers, pro-
vide cotreatment sessions, participate in interdisciplinary
case conferences, and read research published by different
disciplines (Gasiewski etal., 2021). Additionally, during the
interdisciplinary training, ABA providers must learn how to
effectively query and consult with other providers, especially
when there are discussions about the implementation of
other disciplines’ evidence-based interventions (Gasiewski
etal., 2021). It is essential for ABA providers to learn to
value the contributions and input from other disciplines, as
this may.
ultimately encourage them to acknowledge and address
professional mistakes and/or areas for growth (Wright,
2019). This might help ABA providers improve their rela-
tionships with clients, families, and other professionals. If
ABA providers grow their humility in their professional
practice, it may also allow them to be more compassionate
and understanding of other providers on the team when mis-
takes are made. This compassion and understanding fosters
trust and mutual respect (Gasiewski etal., 2021). For the
overall wellbeing of the client, it is important that interdis-
ciplinary teams learn to focus on the shared goals and com-
monalities, rather than on individual differences between
disciplines.
There are several promising models of collaborative train-
ing for ABA providers. One strong example is the Melmark’s
Collaboration Learning Series. In this training, ABA pro-
viders are exposed to literature from all disciplines, receive
mentorship on case studies from providers in other disci-
plines, receive feedback on their interactions with providers
from other disciplines, and conduct presentations on allied
disciplines (Boivin etal., 2021). Including these activities
in preservice training provides trainees with a firm under-
standing of the strengths and benefits of other disciplines,
and the value of professional respect and interdisciplinary
collaboration (Boivin etal., 2021).
Additionally, Kunze and Machalicek (2022) have pro-
posed Professional Development Toward Interdisciplinary
Teaming. This model includes three stages: (1) Initial Uni-
Disciplinary Training, (2) Evolving Professional, and (3)
Interdisciplinary Team Member. Uni-disciplinary training is
the earliest stage of training which often includes university
preparation to develop practical knowledge in a single dis-
cipline, allowing the trainee to develop an individual profes-
sional identity. The Evolving Professional stage occurs dur-
ing early practice with supervision where the professional
implements their new skills, identifies where they need addi-
tional training, and seeks further training and supervision
as needed. In the Interdisciplinary Team Member stage, the
professional embraces their area of expertise and recognizes
the constraints of their training and practice in comparison
with other disciplines. At this stage, the professional seeks
interdisciplinary partners to enhance client outcomes and to
further their own training from other disciplines (Kunze &
Machalicek, 2022).
Bowman and colleagues (2021) have also proposed
standards for collaborative practice to promote apprecia-
tion of each discipline’s expertise and to facilitate effective
problem solving. They proposed eight specific standards:
(1) collaborative communication; (2) distinguished roles in
collaboration; (3) role of organization; (4) client care; (5)
conflict resolution; (6) joint partnerships; (7) evidence-based
practice; and (8) collaborative culture. While these frame-
works provide strong guidance in interdisciplinary training
for ABA providers, they do require significant effort to build
and sustain these infrastructures within traditional training
programs that may not have access to providers from other
disciplines. Embedding training opportunities within pro-
grams that already provide quality interdisciplinary train-
ing can decrease the demand on single training programs.
One such training opportunity is through the Leadership
Education in Neurodevelopmental and Related Disabilities
(LEND) programs.
Maternal andChild Health (MCH) LEND
Program Background
LEND programs, funded by the Maternal and Child Health
Bureau (MCHB), include interdisciplinary training for indi-
viduals from a variety of disciplines. Trainees are often grad-
uate students, early career professionals, family members,
or self-advocates who participate in year-long immersive

Behavior Analysis in Practice
training to develop leadership skills in supporting people
with NDD and their families. There are currently 60 LEND
programs across the United States (Association of University
Centers on Disabilities, 2022). Typical disciplines include
audiology, genetic counseling, health administration, medi-
cine, nursing, nutrition, occupational and physical therapy,
pediatric dentistry, psychology, public health, social work,
special education, and speech-language pathology (Keisling
etal., 2017). Additionally, programs include family trainees
(i.e., a family member of individual with an NDD), and self-
advocate trainees (i.e., an individual with an NDD) with
lived experience. The inclusion of people with lived experi-
ence like family members and self-advocates has been found
to help clinical trainees from various professional disciplines
increase their perceived knowledge, skills, and leadership
development in family-centered care (Keisling etal., 2017).
Previous research has found that future professionals who
participated in a LEND program were more likely to find
employment where they can support people with NDD and
demonstrated stronger interdisciplinary practices (Rosen-
burg etal., 2015).
Although LEND programs have been providing interdis-
ciplinary training since the late 1960s, only a few programs
include ABA as a specific training discipline which has been
a missed opportunity both for the field of ABA and LEND
programs. On the basis of our review of the LEND website
(Health Resources & Services Administration, 2024), of the
29 programs in which we could find a list of training disci-
plines on their funded project page or in the linked website,
five listed Applied Behavior Analysis as a discipline. On
the basis of our personal experience and knowledge of fac-
ulty and trainees past and present in other LEND programs,
behavior analysis as a field has been represented in LEND
programs, though often under another discipline such as
psychology, special education, speech and language pathol-
ogy, or occupational therapy. Following changes in insur-
ance coverage of ABA services, state licensure/certification
of behavior analysts, and increase higher education degree
programs specifically in ABA, there have been a signifi-
cant increase in jobs for behavior analysts (BACB, 2024;
Yingling etal., 2022). Although behavior analysts may par-
ticipate in many LEND programs, not having a specific dis-
cipline designation may limit the participation of behavior
analysts who do not have training in an additional discipline
or in the number of trainees from behavior analysis who can
participate as trainees.
Program Description
The Cincinnati LEND Program was one of the first LEND
programs to be developed, launching in the late 1960s at
Cincinnati Children’s Hospital. Prior to the 2020–2021
cohort, the Cincinnati LEND Program included the follow-
ing disciplines: Audiology, Biomedical Engineering, Child
Life, Community Engagement, Developmental-Behavioral
Pediatrics, Disability Studies, Diversity, Family, Genetic
Counseling, Nursing, Occupational Therapy, Organizational
Leadership, Physical Therapy, Psychology, Self-Advocacy,
Sibling, Social Work, and Speech-Language Pathology.
Leadership training and interdisciplinary teamwork are both
interwoven throughout all elements of Cincinnati LEND’s
cohort model of professional development. All trainees
participate in eight hours of synchronous, in-person class-
room experiences weekly from August through April of the
academic year. A minimum of 29 trainees are recruited to
participate per year, representing at least 12 distinct disci-
plines. Cincinnati’s LEND curriculum consists of five train-
ing components: (1) Interdisciplinary Leadership Seminar
(LEAD), (2) Interdisciplinary Training Team (ITT), (3) Core
Course, (4) Seminar in Evidence-Based Methods (SEBM),
and (5) Disciplinary Clinical Experiences. Each course and
all projects are based upon one or more of the MCH Leader-
ship Competencies, the 12 domains which define the nec-
essary knowledge and skills for effective leadership in the
NDD field (see Table1; Maternal & Child Health Bureau,
2023). All team-based projects are established to have train-
ees paired or grouped with other disciplines. Additionally,
at the beginning of the year, trainees within each discipline
prepare and deliver an oral presentation to the larger group
on their specific discipline, which includes the scope of prac-
tice in the field of developmental disabilities and training/
licensure requirements.
In the sections below, the LEND core competencies,
development of the LEND ABA track, specific LEND train-
ing activities, alignment of LEND training experience with
the BACB competencies, and recommendations to expand
Table 1 Select LEND training activities
Table from Weber etal., 2021
LEND Course Topic Teaching method Time
Interdisciplinary training team ITT cases Case-based learning, disciplinary presentations 20–25 h per team
Interdisciplinary training team Observations across disciplines Clinical observations, written reflections 8–12 h
Interdisciplinary training team Supervision and management Didactic, group discussion 2 h

Behavior Analysis in Practice
representation of behavior analysts in LEND programs will
be discussed.
LEND Core Competencies
The LEND program focuses on development and demonstra-
tion of core competencies, including (1) interdisciplinary
work; (2); advocacy; (3) intersectional approach; (4) systems
perspective; (5) life course perspective; (6) leadership; (7)
engagement with maternal and child health populations; and
(8) research experience (Bishop etal., 2023). As this paper
focuses on interdisciplinary teamwork, in this section, the
Interprofessional Collaborative Practice Core Competencies
will be discussed. There are four core competency domains
for interprofessional collaborative practice which emphasize
knowledge, skills, attitudes, and values within collaborative
practice (IPEC Expert Panel, 2011, p. 12; IPEC, 2016). The
four Interprofessional Collaborative Practice Competencies
of (1) values and ethics; (2) roles and responsibilities; (3)
interpersonal communication; and (4) team and teamwork
are described in Table2. These competencies require profes-
sionals from different disciplines to respectfully engage in
evidence-based practice and collaboration that incorporates
shared values, goals, and decision-making (Bruder etal.,
2019; LaFrance etal., 2019; Lane & Brown, 2023).
Development ofLEND ABA Training Track
On the basis of the feedback from previous Cincinnati
LEND trainees, there was a desire for additional educa-
tional opportunities to learn about ABA. To address this
need, a Board Certified Behavior Analyst – Doctoral Level
(BCBA-D) psychologist was appointed as LEND faculty to
provide additional ABA-related curriculum, hence leading
to the creation of the ABA training track. The ABA-specific
training track was piloted in the LEND program in 2020
when a trainee applied for a different discipline track but was
also currently in training to become a behavior analyst. Each
year, the training experience has been refined, including the
addition of clinical training, supervision, and identifying the
role of the ABA trainee in LEND specific activities which
are each described below.
Interdisciplinary Training Team (ITT)
This two-semester, team-based experience (60h) uses the
structure of a traditional interdisciplinary team approach to
comprehensive assessment. The course begins with didac-
tics on the comprehensive evaluation process for autism and
other NDD and the basics of standardized testing includ-
ing psychometric properties and common modifications
that may be necessary in testing. Trainees discuss assigned
readings regarding clinical assessment of young children and
interdisciplinary team evaluations and the application of Life
Course Perspective and Social Determinants of Health to
the evaluation process. Next, trainees complete supervised
disciplinary evaluations of children who present with pos-
sible autism or other NDD and/or observe evaluations by
other disciplines which occur during morning LEND hours.
Table3 provides a list of training disciplines and the role
of each discipline during the ITT assessment process. In
afternoon ITT team meetings that occurred every other
week, trainees discuss findings with all LEND disciplines
represented and work together to develop a family-centered
approach to the remaining evaluation visits, information
sharing session, and follow-up with the family. This course
results in frequent robust discussions among trainees and
faculty regarding diagnoses, treatment options, and family
priorities.
During the team meetings, all trainees can query and con-
ceptualize the various disciplinary evaluation methodology
and results. These meetings often result in conversations
about clarifying the client’s concerns through the lens of all
the participating clinical trainees and how to apply a family-
centered approach during future follow-up with the client
and their family. The ABA trainee participates in the ITT
Table 2 Interprofessional collaborative practice core competencies
Core competency Description
Value and ethics Working with professionals from other disciplines to maintain a climate of mutual respect and shared values
and to construct a culture that embodies a shared understanding of interprofessional education and collabora-
tive principles. This also includes demonstrating cultural sensitivity and responsiveness, cultural humility, and
cultural reciprocity
Roles and responsibilities Acknowledgement of team members’ roles and abilities and development of a clear scope of practice and
competence with respect to discipline specific competencies. Clear communication of roles is needed, along
with self-reflection, ongoing clarity of roles and responsibilities of each team member, and development of an
interdependent relationship
Interpersonal communication Clear, understandable, and respectful communication across disciplines. Communication should express empathy
and compassion and focus on resolution of conflicts
Teams and teamwork Applying relationship and team-building values and principles while seeing each disciplines’ contribution as
equally significant and meaningful (Bricker etal., 2022)

Behavior Analysis in Practice
experience with two distinct clients and families during the
LEND training year. Trainees rotate roles in the ITT process
and their leadership skills in this process are evaluated by
the LEND supervisors and staff.
Initially, the ABA trainee served in a nonclinical role
where they participated in interdisciplinary observation and
ITT team discussion but did not conduct an actual assess-
ment. When the track started, ABA was not a discipline that
participated in evaluations at the medical center which was
the rationale for the initial clinical observer role. The ulti-
mate goal of interweaving ABA into the ITT experience was
to add the ABA trainee as a clinical, patient-facing disci-
pline. On the basis of ABA trainee feedback over the initial
training years, an ABA evaluation has been added solely for
the purpose of the ITT. Depending on the client’s history
and concern, the ABA trainee can conduct an indirect func-
tional behavior assessment interview and/or survey with a
caregiver, direct observation of the child’s behavior, and a
preference assessment with the child. The ABA trainee pre-
pares and delivers a presentation to their ITT which includes
a discussion on the assessment tools used, the results of the
assessment(s) (e.g., a functional hypothesis of challenging
behavior, a preference hierarchy), and recommendations for
the family and/or child. The ABA trainee also answers any
questions regarding the functional and preference assess-
ment processes and the rationale behind the provided rec-
ommendations and to set the stage for treatment planning if
behavioral interventions are warranted. At the conclusion
of all discipline evaluations and presentations, the trainee
participates in a case conference with the team in which final
diagnoses and recommendations are determined. The trainee
may also assist in providing integrated results to the family
following the full team evaluation offering an opportunity
to share ABA strategies to be used in home, educational, or
other therapeutic settings.
Core Course
The Core Course training includes didactic and experimen-
tal content materials to increase knowledge in topics such
as NDDs, life course and public health perspectives, fam-
ily partnerships and family-centered practice, and selected
populations and systems. The Core Course includes a total
of 60h of didactic training across the academic year. At
the end of each semester, trainees write reflection essays on
three Core Course sessions of their choice, sharing how they
would apply the key messages from each session in their
current or future practice, research, or advocacy experiences.
The ABA trainee participates in all Core Course expe-
riences, which are opportunities to learn about other dis-
ciplines supporting people with NDD and various topics
relative to leadership. As an additional leadership experi-
ence, the ABA trainee co-facilitates a Core Course session
with their ABA Supplemental Faculty Member related to the
history and foundations of ABA. A LEND graduate from
the Advocacy discipline who identifies as Autistic has also
collaborated on this presentation with the ABA trainee and
Faculty Member. This has created an opportunity to discuss
the field not only from the perspectives of ABA providers
but also with a member of the autistic community. The pres-
entation often leads to an open discussion among trainees
and presenters regarding the positive and negative experi-
ences of ABA, collaboration with other disciplines and self-
advocates, and areas for growth within the field.
Interdisciplinary Leadership Seminar (LEAD)
In the Leadership Series (60 h total), LEND faculty provide
didactic and experiential content related to self-reflection
of one’s own leadership journey and application to inter-
disciplinary teamwork and advanced leadership skills.
Table 3 Interdisciplinary training team
Discipline Role and responsibilities
Applied Behavior Analysis Functional Behavior Assessment (FBA) Caregiver Interview; preference assessment
Audiology Hearing; speech discrimination; auditory responsiveness
Developmental-Behavioral Pediatrics Medical history; family history; presenting developmental concerns; physical exam
Family Family history; family strengths/challenges; family goals
Genetic Counseling Family history risk assessment of genetic conditions; genogram
Occupational Therapy Fine motor skills; sensory processing; activities of daily living
Physical Therapy Gross motor skills; gait; coordination; balance
Psychology Cognitive functioning; adaptive functioning; behavioral functioning; executive
functioning; social-emotional functioning; autism specific measures and observa-
tions
Social Work Psychosocial history; stressors; resources
Special Education Academic functioning; review of Individualized Education Plan (IEP)
Speech Language Pathology Expressive and receptive language; social-pragmatic skills; articulation

Behavior Analysis in Practice
Trainees complete the StrengthsFinder self-assessment tool
early in the training year to model the expectation to build
on the strengths of all team members, including those with
lived experience of NDD. Faculty-led sessions discuss the
importance of self-regulation and emotional intelligence in
interactions with teams and patients/clients in healthcare
settings. This course also provides content and experiences
related to navigating crucial conversations, negotiation, con-
flict resolution, and administrative issues, and explores The
Five Dysfunctions of a Team (Lencioni, 2002). Similarly,
focused discussions on burnout and compassion fatigue are
offered to support the long-term professional development
and leadership capacity for these emerging professionals.
In the leadership series, the ABA trainee engages in indi-
vidual and team-based experiential learning to build knowl-
edge in all 12 MCH Leadership Competencies. Some exam-
ples of the activities in this series include Individualized
Leadership Plan (ILP), Family Mentoring Project (FMP),
Community Leadership Project (CLP), and Disciplinary
Presentation. The ILP includes goals and action plans cre-
ated by the ABA trainee which guide them in incorporating
new knowledge and skills, based on the MCH Leadership
Competencies, into daily practice (e.g., reading articles
about culturally affirming ABA practices or taking the
lead on coaching caregivers in clinical appointments). The
trainee and their supervisor monitor the students’ progress
together throughout the LEND training year using this liv-
ing document.
To better understand the greater local community (i.e.,
families of a child with NDD and community-based organi-
zations), the ABA trainee participates in the FMP and the
CLP. From both experiences, the ABA trainee’s role is that
of a learner, instead of the expert. The FMP allows the
trainee to learn about a families’ experiences navigating
the educational and healthcare systems through individual
meetings and support group settings. The CLP involves
volunteering with a community organization that provides
direct services or supports to children with disabilities and
their families. The trainee can also choose to observe Early
Intervention providers as they implement evidence-based
services in the home setting. These family-centered and
community-based activities provide invaluable experiences
and knowledge and encourage the ABA trainee to reflect on
how to better serve the NDD community through family-
centered care and appropriate resources.
Lastly, the Disciplinary Presentation provides an oppor-
tunity for the ABA trainee to educate LEND trainees from
other disciplines on the training and role of a behavior
analyst, while simultaneously providing clarity on any
previous misconceptions of the profession. Ultimately, the
experiences within the leadership series are designed to
improve the ABA trainee’s leadership development through
self-assessment, reflection, community-partnership, and
mentorship, which in return, serves to improve the train-
ee’s current and future skills when working with the NDD
community.
Seminar inEvidence‑Based Methods (SEBM)
The Seminar in Evidence-Based Methods (SEBM) allows
the trainees to engage in various levels of research during
their LEND training through interdisciplinary project teams.
The ABA trainee collaborates with trainees and faculty from
other disciplines on a research project. The ABA trainee’s
role can vary depending on the SEBM project and the expe-
riences of the trainee but may include writing an Institu-
tional Research Board (IRB) research proposal, implement-
ing different research methodology (e.g., interviews, focus
groups, questionnaires), and analyzing and interpreting data.
All trainee teams participate in the dissemination of their
findings at the Ohio LEND Poster Symposium in partner-
ship with the LEND program at The Ohio State University/
Nisonger Center.
The following is an example of an SEBM research project
and a description of a previous ABA trainee’s role within
the project. The example SEBM research project utilized a
family-centered perspective to better understand the lived
experiences of people with a disability and their families in
community settings. As part of their leadership goals, the
ABA trainee led a focus group that included members from
a hospital-based family advisory council to get community
members’ feedback on what inclusion looks like in the com-
munity. Once the trainees had the community’s feedback,
they used the information to guide the development of a
survey related to inclusion in different settings. The ABA
trainee, along with the other trainees, documented progress
of the project and future directions via a poster presentation.
Disciplinary Clinical Experiences
During the ABA trainee pilot year, the role did not include
a clinical experience for two reasons. First, the COVID-19
pandemic resulted in substantially limited services during
that time. Second, there was not enough time in the planning
process to partner with a clinician who provided ABA-based
services at the medical center. During the second year of the
ABA training discipline, a supervised clinical experience
was added for the ABA trainee. The trainee provided direct
and/or consultative services in a Brief Intensive Behavior
Therapy (BIBT) clinic with supervision from the ABA
LEND Supplemental Faculty Member (BCBA-D) and a
licensed psychologist who ran the clinic. This clinical expe-
rience enhanced the training program by enabling the ABA
LEND trainee to directly apply the theoretical knowledge
and leadership skills from the LEND curriculum. Addition-
ally, it provided opportunities for the trainee to participate in

Behavior Analysis in Practice
meaningful discussion with trainees from various disciplines
about their clinical training experiences.
The BIBT clinic provides direct services to children
who demonstrate significantly challenging behaviors (e.g.,
children with aggressive and disruptive behaviors that are
unsafe) and their families. Families attend clinic twice a
week for 8weeks, which aligns with the ABA trainee’s clinic
schedule. The ABA LEND trainee engages in the clinical
experience twice per week for a total of 8h (4h of direct
and 4h of indirect client work) and can follow multiple
families throughout their time in clinic. To assist in devel-
oping clear and objective clinical goals while in the BIBT
program, the ABA LEND trainee, Supplemental Faculty,
and clinical supervisor use the trainee’s ILP, based on the
MCH leadership competencies (e.g., cultural competency,
teaching/coaching/mentoring, negotiation/conflict resolu-
tion) to guide the clinical training experience.
The ABA LEND training experience is comprehensive,
where the ABA trainee has multiple opportunities to partake
in various leadership roles throughout their training experi-
ence in the BIBT program that enhance their clinician skills.
For example, throughout the 8weeks when working with
a client and their family, the trainee assesses the client’s
behavior by developing, implementing, and coaching pref-
erence and functional behavior assessment protocols. Addi-
tionally, to enhance consultation skills, the ABA trainee
learns to develop a family-centered approach by collabo-
rating with caregivers to develop behavior treatment plans
and increase generalization of behaviors outside of the clinic
setting. There are also times where the ABA trainee can take
a more indirect role and focus on improving their data col-
lection and analysis skills before and during treatment, such
as recording and graphing the frequency and duration of the
client’s behavior. Another opportunity for the ABA trainee
involves presenting at national conferences using the experi-
ences and cases from their clinical experience.
Training Experience Alignment withBCBA
Competencies
The training experience of LEND ABA trainees aligns
with training in each competency domain of the BCBA 6th
Edition Test Content Outline List (BACB, 2023). Clinical
supervision provides trainees opportunities to demonstrate
skills across all domains. The specific domains in which
the trainee receives training across the year depend on
cases and clinical opportunities; however, to ensure proper
supervision across domains, specific cases and activities
may be selected to enhance the trainee’s supervised clinical
experience. Interdisciplinary collaboration throughout the
LEND program provides trainees with strong experiences in
identifying information in records at the outset of the case,
working with other disciplines to gather a broader range of
relevant information (F.1.) and collaborating with others to
enhance services (H.8.).
In addition to domains covered during the individual
clinical training and supervision, the LEND program over-
all offers ABA trainees unique, interdisciplinary training
to address specific task areas. For instance, as part of the
LEND program the ABA trainee provides education on
behaviorism and Applied Behavior Analysis through for-
mal presentations to all trainees across disciplines and as a
participant in interdisciplinary research, advocacy, and clini-
cal activities. These activities include explaining the philo-
sophical assumptions underlying behavior analysis (task list
item A.2.), defining behavior from the perspective of radical
behaviorism (A.3.), distinguishing experimental and applied
behavior analysis and the professional practice of behavior
analysis (A.4.), and explaining the dimensions of applied
behavior analysis (A.5.). During the LEND presentations,
the trainee also answers questions from colleagues from
other disciplines about ABA and listens to their perspectives
and experiences with ABA-based services and providers.
This practice of active listening and responding to people
with different perspectives with compassion and respect
aligns with task list items E.1. (Identify and apply core
principles underlying the ethics codes) and E.8. (Identify
and apply interpersonal and other skills). Through the entire
year of training, the ABA trainee can develop respectful and
compassionate relationships with trainees and faculty from
other disciplines, even when there initially may be conflict
due to negative perspectives of ABA or unpleasant experi-
ences with an ABA service or provider. A strong focus of the
LEND program is understanding personal biases and how
those biases impact professional work (E.11.). Additionally,
trainees receive extensive training and feedback on cultural
competency and humility throughout the LEND curriculum
and activities (E.9.).
Recommendations forExpansion ofBehavior
Analysis withinLEND Training Programs
As many LEND programs may include behavior analysis
trainees and faculty either within a behavior analysis specific
track or within another discipline (e.g., psychology, special
education), research on the current role of training about
applied behavior analysis and inclusion of behavior analysts
within LEND programs (e.g., how many of the didactics and
activities include behavior analysts or have an ABA compo-
nent) should be assessed. Additionally, for LEND programs
that do not include behavior analysts consistently in their
training programs, it will be important to understand the
barriers for inclusion of behavior analysts and possible solu-
tions to address these barriers which could include budget-
ary restrictions, lack of connection with behavior analysts in
the area, or trainees from other disciplines, including parents

Behavior Analysis in Practice
and self-advocates who may have objections or concerns
related to inclusion of professionals from ABA. LEND pro-
grams that currently include behavior analysts who partici-
pate under another training discipline such as psychology,
speech and language pathology, occupational therapy, or
special education, should assess if the creation of a behavior
analysis specific training track would increase awareness of
behavior analysis as its own discipline and allow for expan-
sion of faculty and trainee to behavior analysts who do not
have training in an additional discipline. Table4 provides a
list of possible guiding questions for inclusion of a behavior
analysis specific track for LEND programs that do not cur-
rently have one.
Our program faced several of these barriers. Each year,
we have had to evaluate and adjust the budget as needed to
ensure a behavior analysis trainee and supplemental fac-
ulty in behavior analysis can be included in the program.
To increase connections with local behavior analysts and
trainees, we reached out to the ABA program at a local
university and are continuing to develop that partner-
ship. Our future work to increase connections with local
behavior analysis will include reaching out to local ABA
service providers to develop more potential partnerships
within the community. Each year, we provide a LEND
didactic training session on ABA in which all LEND
trainees across disciplines are encouraged to share their
knowledge and honest opinions and experiences with the
field during the discussions. To date, we have collected de-
identified informal survey feedback from LEND trainees
about this didactic training session which has been over-
whelmingly positive regarding increasing the knowledge
of participants about ABA and addressing some previous
misconceptions and understandings. Evaluating changes in
perspectives of LEND Trainees from other disciplines with
inclusion of an ABA specific track is an area for future
research.
For behavior analysts seeking additional interdiscipli-
nary training, determine if a LEND program is available
in your region (https:// mchb. hrsa. gov/ progr ams- impact/
focus- areas/ mch- w orkf orce- devel opment/ funded- proje ct?
train= 285& inst= All& state= All& region= All& search =)
and contact specific LEND programs to inquire about
possibilities for training and/or collaboration. This could
include partnering on research, advocacy, or community
outreach as a first step in developing an increased relation-
ship between behavior analysts within the community and
local LEND programs.
Table 4 Guiding questions for addition of ABA discipline in LEND programs
Phase Considerations
Initial planning • Is there support from LEND leadership regarding the addition of a BA track in LEND?
• Do we have a person(s) to be a clinical supervisor and/or LEND faculty?
○ Is there guidance to follow from MCHB regarding the criteria for who can serve as a supervisor or
supplementary faculty?
○ Would there be any time or space conflicts?
• What are the budgetary/funding needs for supervisor, supplementary faculty, and/or BA trainee?
• Is there a need for current trainees to learn more about ABA and ABA providers? (solicitating feed-
back from current trainees)
• Are there behavior analysists and/or behavior analysis students interested in being LEND trainees in
an ABA specific training track (checking with local behavior analysts and behavior analysis higher
education programs)
• Is there a need in the community for the addition of a BA track?
• How can we fully integrate the BA LEND track into LEND’s core components (e.g., BA trainee con-
tributes FBA/preference assessment to the Interdisciplinary Training Team experience)
• What might be objections or concerns with the LEND program or local community to adding a behav-
ior analysis training discipline?
• How would we know if adding a behavior analysis discipline benefitted our LEND training program?
• How would we know if LEND training was beneficial to behavior analysis trainees?
Implementation • How do we provide support to the BA LEND trainee and their supervisors?
• How do we measure progress in the implementation of the new BA LEND track?
• What type of data could be collected both quantitative and qualitative?
• From whom are we collecting the data: the BA LEND trainee, trainees in other disciplines, supervi-
sors/faculty, clients and/or other partners?
• How often should we collect data? Formative vs. summative?
Evaluation • Did we meet our goal in successfully creating and developing a BA LEND trainee track?
• How do we know when the goal is met?
• During the process of adding a BA LEND trainee track, what went well? What could be improved on?
• How can our efforts be sustained in the following years?

Behavior Analysis in Practice
Summary
Recently, concerns regarding ABA services for people
with NDD, especially autism, have been raised by clients,
caregivers, and other professionals, including the ethics
of using certain behavioral strategies (e.g., punishment,
extinction) and the use of behavioral strategies to teach
behaviors to have neurodivergent people appear neurotypi-
cal (e.g., Kupferstein, 2018; Sandoval-Norton & Shkedy,
2019). One important way we can better understand the
experiences of people with NDD in ABA-based services
is to develop relationships with programs that offer the
opportunity for collaboration and critical reflections.
By using a more person-centered, trauma-informed, and
interdisciplinary approach, ABA providers can improve
not only the public perception of ABA-based services,
but, most importantly, the positive outcomes and experi-
ences of clients they aim to serve (Rajaraman etal., 2021).
Additionally, participation in interdisciplinary work and
programs, such as LEND, increases the transparency of
the work of ABA providers and can clarify misconceptions
or misunderstandings that typically create barriers toward
cross-disciplinary collaboration.
LEND programs have provided training to professionals
in supporting people with NDD for over 60 years; how-
ever, many of these programs have not included profes-
sionals and trainees in the field of ABA (Health Resources
& Services Administration, 2024). This has been a missed
training opportunity for both LEND programs and ABA
providers. At the beginning of each training year, there are
often many trainees from other disciplines who know very
little about ABA. Other trainees who have more knowledge
or experiences with ABA-based services can share their
experiences and perspectives on the field. Having an ABA
trainee present during these discussions can be invalua-
ble for clarifying misconceptions and for the trainee to
practice active listening and empathy as others share their
experiences.
LEND training includes many interdisciplinary training
activities, including core course content across disciplines
and interdisciplinary training clinical opportunities such as
the ITT. Participation in a LEND program has been found
to increase trainees’ skills and attitudes toward interdis-
ciplinary work, as well as their leadership competencies
(Smith etal., 2022; Weber etal., 2021). Partnering with
existing interdisciplinary programs, such as LEND, can
create opportunities for ABA trainees and professionals
to increase their training and skills in interdisciplinary
work and expand their knowledge about the field and role
of behavior analysts in interdisciplinary care of people
with NDD. To increase the presence of ABA within LEND
programs, there first needs to be partnerships developed
between ABA providers and LEND faculty. This can be
accomplished through presentations to LEND trainees,
collaborative research activities, or opportunities for
LEND trainees and faculty to observe ABA-based ser-
vices. Through these relationships, perhaps additional
LEND ABA training opportunities can be developed.
Funding Maternal and Child Health Bureau grant number
T73MC00032.
Data Availability The current manuscript does not include any associ-
ated data.
Declarations
Conflict of Interest The authors have no financial or non-financial con-
flicts of interest to disclose.
Author Note The Leadership Education in Neurodevelopmental
and related Disabilities Program (LEND) is funded through the
Maternal and Child Health Bureau/Health Resources and Services
Administration (HRSA) Grant No: T73MC00032.
Open Access This article is licensed under a Creative Commons Attri-
bution 4.0 International License, which permits use, sharing, adapta-
tion, distribution and reproduction in any medium or format, as long
as you give appropriate credit to the original author(s) and the source,
provide a link to the Creative Commons licence, and indicate if changes
were made. The images or other third party material in this article are
included in the article’s Creative Commons licence, unless indicated
otherwise in a credit line to the material. If material is not included in
the article’s Creative Commons licence and your intended use is not
permitted by statutory regulation or exceeds the permitted use, you will
need to obtain permission directly from the copyright holder. To view a
copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
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