Quality Is a Choice: What Treatment Intensity Says About Who We Are in ABA
Let’s Start with This Simple Truth: It’s Always About the Kids
When we recommend how many ABA hours a child should receive, we’re not just filling out a form. We’re making a decision that impacts that child’s life, their family, and their future.
But let me ask you—be honest: when was the last time you or someone on your team made an intensity recommendation based more on what insurance would approve, or what your schedule could handle, than what the child actually needed ?
It happens....
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A lot. And it’s not because behavior analysts don’t care. It’s because the system we’re working in pulls us toward billable hours, utilization targets, and operational stress. This isn’t about finger-pointing—it’s about reflection.
A Wake-Up Call from Hustyi & Yingling (2025)
A recent article in OUTCOMES Magazine by Bryant Silbaugh and Aarti Thakore really hit home. They summarized findings from a study by Hustyi & Yingling published in Behavior Analysis in Practice earlier this year.
Read the study here: Hustyi & Yingling (2025) – Behavior Analysis in Practice
Read the summary article here: OUTCOMES Magazine – Issue 01, 2025
The findings were sobering: no consistency, no standards, and too much guessing when it comes to treatment intensity.
If We’re Guessing, We’ve Already Lost the Vision
Here’s the hard truth: if we’re using utilization data to determine treatment intensity, we’ve either lost our vision , or we never had one to begin with .
At 3 Pie Squared, we ask leadership teams:
- Do you know what you stand for?
- Do your values guide your decisions?
- If funder pressure disappeared tomorrow, would you still run your company the same way?
Culture and Values Start With Honest Conversations
Sit down with your team and ask:
- “Do you feel like you’re able to follow our company values?”
- “Have you been in any situations recently where you couldn’t follow your ethics or our values?”
These two questions can change your business. They reconnect your staff to the why. That’s where quality starts—not in a policy manual, but in the real world.
Quality Is a Way of Operating
The OUTCOMES article outlines a quality assurance approach we fully support:
- Quality is ethics. Every treatment hour must be justified by need—not convenience.
- Quality is sustainability. Burnout doesn’t build lasting care.
- Quality is morality. If you wouldn’t do it for your own kid, don’t recommend it for someone else’s.
- Quality is a choice. Every intake, every session, every decision is an opportunity to choose quality.
This Is Why We Built 3 Pie Squared
April and I lived the grind. That’s why we help behavior analysts:
- Build onboarding and staffing systems grounded in values
- Know when and how to scale
- Determine what to pay staff with confidence
- Free up mental space to actually lead with intention
You don’t have to do this alone. We’ve helped companies across the U.S. reclaim their vision and make quality their operating system.
The Storm Is Real, But the Opportunity Is Greater
We’re at a turning point. If we don’t start choosing quality now, others will choose for us—through regulations, cuts, and audits. But it’s not too late.
“If you’re struggling with a decision, look at it through the lens of the child. Then your decision is easy.” — Dr. Patricia Krantz
That’s the heart of this work.
What You Can Do Today
Take 10 minutes and reflect:
- Are your decisions aligned with your values?
- Are you making treatment decisions you’d stand by if funding disappeared?
- Do your staff feel safe telling you when they can’t uphold their ethics?
You’re not alone. We’re here. And we believe in your ability to build the company you dreamed of.
Let’s Choose Quality—Together
Need help creating sustainable, ethical systems in your ABA practice? Book a free consult - we would love to talk! Let’s build the future of ABA—one value-aligned decision at a time.
