Timothy Zercher 0:00

Well, Emily, thank you so much for joining us. We really appreciate you taking time.

Emily Stampone 0:04

Yeah, absolutely. Thank you for having me.

Timothy Zercher 0:06

Absolutely. Would you mind telling us first kind of what drew you into ABA? What's kept you committed to the field for so long?

Emily Stampone 0:12

Yeah, I love that question. And it's one I like to talk about a little bit. So I like to say that ABA found me. And that might be probably a lot of BCBA stories to some degree, but it wasn't really part of my undergrad program. It wasn't something that they spoke about a whole lot. So I didn't know much about it. I didn't even know what ABA stood for back then. So when I entered my first year post-undergrad, I actually spent a year with City Year, which is an AmeriCorps program. And in that program, my role was supporting teachers at an under-resourced middle school. And I was helping my whole purpose there was helping students stay on track to graduate. So lots of different types of client profiles, not really a clue what I was doing, but I knew I was helping to some degree. And as that year was winding down, I knew I wasn't done doing something that was related to helping kiddos progress. So I started digging around, trying to figure out what I wanted to do. And I landed on an ABA center that had a really simple message that I really resonated with, which was that every child can make progress. And that kind of got me in the door. I was really excited about what that meant. And once I got in there, it was really the work that kept me there. And what I was seeing was just incredible. And my time as a technician, I like to say it was life-changing. I mean, I was watching children of all different ages from two or one and a half, two years old all the way up to 21 who were making incredible progress. And I was seeing their families' lives change right in front of me. And as a technician, my whole purpose there was to carry out those plans at the BCBA for writing. But I quickly realized that I wanted to be the one that was building them and creating these life-changing moments for these kiddos. So that sort of pushed me in the direction of going to grad school and becoming a BCBA. And my first couple of years as a BCBA, I started recognizing that I was not only loving celebrating each of my clients' successes, but I was also loving celebrating other BCBA's successes. I was in some really cool opportunities where I got to train other BCBAs and digging into the data to really ask a simple question of, is this actually working? And that question really pulled me into leadership and helped me to recognize, okay, I want to do more with this, right? Like I have the basics, I have the foundation, but I wanted to get better at answering a simple question of, is this actually working? So pushed me in the round of getting my doctorate, pushed me into leadership positions. And I get to ask that question now for hundreds of kids rather than my seven or eight kiddos that I had on my caseload. So even though the scale's a little bit different, that same reason still continues to resonate with me and exists, right? Are clients still making real progress? And so I get to continue to do that just in a little bit of a different capacity.

Timothy Zercher 2:56

I love that. I love that. That makes a lot of sense. And it seems like a very natural progression from passion to passion, which I love. You mentioned you focus heavily on, I think the term you use is moving organizations beyond compliance. What does meaningful clinical quality actually look like in practice for you?

Emily Stampone 3:13

I mean, the short answer is it's in the data, right? You can slice data in a hundred different ways. But for me and for us, it's always coming back to one thing specifically. Are we meaningfully ameliorating the symptoms of autism that the client has? So everything else kind of falls in line with that. That's in the service of what we're doing. So, in terms of outcomes and clinical quality, we're tracking that through really two types of assessments. We're looking at criterion reference measures, which are really telling us more so what a client is hitting in terms of specific goals on their plan versus norm reference measures, which like the vineland, for example, that's going to tell us something a bit broader. That's telling us where a client stands relative to their peers. And both of them are giving us both sort of that close-up, but also that wide shot, big picture, what's happening here, and are removing that needle with our kiddos. And so that's the part that actually matters is this data and what we're going to do with it. It's not just there that put a number down on a piece of paper. It's there to tell the BCBA when to adapt protocols, when to shift goals, when to maybe take a different approach. So ideally, this data and these clinical outcomes are helping us address our clients' needs before a plateau maybe turns into months of lost progress. And I look at that in that fine line between compliance and quality. Compliance is asking those questions around like, did you follow this plan? Whereas quality is asking, is this still the right plan for the client right now? And how can we ensure that that's it doing that? So kind of again, bringing that back to the data and that's telling the story for us and giving us the tools we need to continue making a meaningful difference.

Timothy Zercher 4:46

Absolutely. And I know you you talk a lot about data, and that's probably a lot of your job, right? Is managing the data. As ABA organizations grow, though, how do you believe leaders can use that data, use that outcome data without losing sight of the individual behind the numbers? Because I know that's also a challenge. I think that's what a lot of organizations really struggle with, especially like they feel like they've lost touch with it, even if they haven't.

Emily Stampone 5:11

Yeah, that's a really good question. And truthfully, it's something that I think about constantly because as I mentioned, my own career started from a caseload of having seven or eight kiddos that I oversaw programming with to moving now to overseeing hundreds of clients and maybe not as their direct BCBA, but I'm looking at the numbers and I'm looking at the data. And one thing that is really important to me is that clients aren't getting lost behind that data. Averages do a nice job of giving us data of like, okay, overall, how are we doing here? But that average can also hide those kiddos that maybe aren't progressing behind the numbers. So what I really like about how we navigate this and how we manage the data from our perspective is sure, it's giving us averages. It's giving us a good sense of how overall we're doing, but it also allows us to get further down into the data and being able to give us really tangible and pinpointed information that we can act on in order to ensure that a child continues to make progress. And not that we're taking that data and just kind of looking at it and be like, okay, you know, that that number looks pretty on paper. Let's just write that one down. It's allowing us to be responsive, it's allowing us to be individualized. And I think that same data that we're looking at is actually what's protecting each of our clients. It's empowering our clinical leaders, like our BCBAs, to have a real pulse on the clinical health of every single client that they're overseeing. And not just a general sense of that, right? Not a general sense of, oh, I think things are going okay or I think things are fine. From where I said, it's doing something else. It's telling me trends, right, across the organization. But as I dig down further into the data, it's also telling me how each BCBA, how each center, how each region is operating and how our what our clinical health really looks like, so that we can tailor our approach to training our BCBAs and our RBTs and better equipping them for what exactly what their clients need. So from my perspective, scale could change how you monitor the quality. Of course it can, but it shouldn't change how we're monitoring and what we're doing with that data. So it's all coming back to the same story as well, why did we start looking at this to begin with? We want to know that we're making a meaningful difference. And so we can start large scale, but as soon as you start to realize, okay, there's some trends we got to act on, it gives us that opportunity to really dig down deeper into that data and make a meaningful difference.

Timothy Zercher 7:25

I love that. So said differently, right? The data doesn't remove you from the story, it tells a clearer picture of the story, right? Of the individual.

Emily Stampone 7:32

Exactly.

Timothy Zercher 7:33

Yeah, I love that. What have you found is the hardest part of growing an organization or a team? Because I know you've been involved in a lot of growth.

Emily Stampone 7:41

Yeah. Oh, that's a really good question. So, I mean, there's a lot of challenges. I could probably talk with you the whole time we're together on different types of challenges and how we're managing them. But in my seat specifically, and where I feel like I'm spending a good amount of my time as we continue to grow, is also ensuring that we're staying on top of how often payer requirements are evolving. I mean, if you're keeping tabs on the field at ABI, there's a lot of change happening. And one of the biggest things is keeping up with anything payer related. So ensuring that documentation-wise, compliance-wise, all those things continue to be at the forefront to kind of help us move things forward because ultimately all of those things are going to result back to access to care for the clients. If we don't have those things in order, that's going to impact our clients' ability to access services. So we need to make sure we get that right. So as we grow, we can't just build our systems one time and then let them carry everything forward. We have to continue to build upon them and have them be more adaptable to the systems that have to change with them. So, in essence, I actually think that might have made us stronger, where I say we're continuously monitoring things, we're making sure that our people are trained well on expectations. And the most important thing to me, and I feel like I could speak from probably the majority, if not everybody, in the organization, is that we want to continue to do things the best we can so that we can continue to provide services to our kiddos. And as we grow and we grow responsibly, that means that we're continuing to stay on top of all these things that are changing around us. So that access to care continues to be again at the forefront of everything that we're doing.

Timothy Zercher 9:16

I love that. Yeah, that makes complete sense. Talent is also so central to maintaining quality service, both in just being able to staff basic positions, but also in finding talented, skilled BCBAs and RBTs. What worked best for you and your team right now for finding and attracting that talent?

Emily Stampone 9:34

Oh man, that's a really good question. The first thing that comes to my mind is where our focus is. So our focus is on doing the things that we do well, which is maintaining high quality services at ABA. And I sort of let that speak for us. I mean, if you talk to staff that are working in the organization right now, whether that's staff that are on the front line or other departments like finance or recruiting, compliance, marketing, whoever you want to talk to, all of our conversations are all sort of rooted back to the same thing, which is quality. Quality is at the core of everything that we're doing. And I think that helps us be competitive in this very crowded market that we're in, because finding a quality service or service provider, I should say, is quite a challenge nowadays. There are so many people there. I mean, ABA companies are next door to each other nowadays. So when there are RBTs and BCPAs going out there and looking for a company that they want to invest their time in and be invested in, they're looking for things like are they providing quality services? Are they known for that? Do their families feel that way? And do their staff feel that way? And the other piece of that is how will they invest in me? A lot of companies will tell you we're very focused on the quality of services we provide for our clients. And that is true. That should be at the very forefront of everything. But they also, I mean, the market is, like I said, very saturated. You have to make yourself a differentiator in this market. So also helping our staff recognize how we're going to invest in them. I mean, that's a game changer for people. And I think it should be. You should ask those questions of I'm going to put my blood, sweat, and tears into the services I provide to the kiddos I work with. But what are you doing for me? How can you help me continue to do that really well? And I think that's a really valid question. So internally, we're always looking at different ways that we can help people get time back in their days, help make things more efficient and streamlined. And there's so much out there that can help support that, especially with AI being more readily available. If you do that responsibly and appropriately, that itself can be a game changer for the market. So lots of different moving pieces with that. But I think the the biggest thing for us is continuing to do things that we do really well, which is quality services and let that speak for us and bring the right people to us.

Timothy Zercher 11:43

Yeah, I think you're completely correct. I think people want to know that the work that they're doing is valuable and is actually helping. I don't think most BCBAs get into ABA just because they think it'll be really profitable or it's the best possible career for making a ton of money. They do it because they want to make an impact.

Emily Stampone 12:00

Yeah, I agree with you. I think everybody's stories somehow align in some shape or form because we're all looking for the same thing. We're all looking to make a difference in the kiddos' lives. And I would bet that every single person that you get to talk to, or even beyond this, you know, RBTs and up, they're all going to have some type of success story that brought them in and reeled them in initially. And I think that's what's so cool and unique about the field of ABA is the people are here for a good reason. And that's for the the kids we get to work with, or individuals if you're working with older ones. But yeah, it's a really neat field for so many different reasons.

Timothy Zercher 12:34

Well said, and that's a great place to end. So thank you so much for joining us. Thank you for sharing, sharing your experience and thank you for the work that you're doing for you and your team and uh the individuals that they serve.

Emily Stampone 12:44

Of course. Thanks so much for having me.

Timothy Zercher 12:46

Absolutely.