The Behavioral View Episode 6.2: Outcomes-Based Care in ABA with Yagnesh Vadgama

In this episode of The Behavioral View, Nissa Van Etten, Olivia Teal, Elizabeth Barajas, and Yagnesh Vadgama discuss the evolution of outcomes-based care within applied behavior analysis (ABA). Drawing from extensive experience in both clinical practice and payer systems, Vadgama outlines the differences between traditional fee-for-service models and outcomes-based care frameworks. The panel explores how standardized assessments, aggregate data analysis, and empirically supported dosing recommendations can create greater alignment between providers and payers while maintaining individualized clinical decision-making.

The discussion addresses administrative burden, prior authorization processes, value-based payment arrangements, caregiver involvement, social determinants of health, and interdisciplinary collaboration. Emphasis is placed on transparency, data-driven decision making, and protecting the integrity of behavior analytic practice while demonstrating measurable outcomes at both the individual and population levels. This course provides practical insight into how outcomes-based care models may shape the future of ABA service delivery.

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Show Notes:

 

References 

Frazier, T. W., Youngstrom, E. A., Speer, L., Embacher, R., Law, P., Constantino, J., Findling, R. L., Hardan, A. Y., & Eng, C. (2014). Validation of proposed DSM-5 criteria for autism spectrum disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 53(1), 28–40. https://doi.org/10.1016/j.jaac.2013.10.012 

Frazier, T. W., Klingemier, E. W., Beukemann, M., Speer, L., Markowitz, L., Parikh, S., & Strauss, M. S. (2021). Development and validation of the Autism Impact Measure (AIM). Journal of Autism and Developmental Disorders, 51, 3407–3421. https://doi.org/10.1007/s10803-020-04795-1 

Smith, P. C., Sagan, A., Siciliani, L., & Figueras, J. (2023). Building on value-based health care: Towards a health system perspective. Health Policy, 138, 104918. https://doi.org/10.1016/j.healthpol.2023.104918 
 

AI.Measures Scientific Support  

Ferguson, E. F., Frazier, T. W., Hardan, A. Y., & Uljarević, M. (2025). Challenging behavior domains in individuals with neurodevelopmental genetic syndromes: The role of psychological features. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, 0(1), 1-12  

  

Frazier, T. W., Huba, K., Frazier, A. R., Womack, R. A., Youngstrom, E. A., Chetcuti, L., Hardan, A. Y., & Uljarevic, M. (2025). Maximizing accurate detection of divergence from normative expectation in behavioral intervention outcome assessment. Research in Autism, 126, 202646.  

  

Frazier, T. W., Youngstrom, E. A., Frazier, A. R., & Uljarevic, M. (2025). A critical appraisal of the measurement of adaptive social communication behaviors in the behavioral intervention context. Behavioral Sciences, 15(6), 722  

  

Frazier, T.W., Helton, M., Akouri, C., Chetcuti, L., Uljarevic, M. (2025) Identifying Reliable Change In Outcome Assessments for Behavioral Intervention. Behavioral Interventions.  

  

Frazier, T. W., Dimitropoulos, A., Abbeduto, L., Armstrong-Brine, M., Kralovic, S., Shih, A., Hardan, A. Y., Youngstrom, E. A., Uljarevic, M., Verbal Beginnings, T. (2024). Psychometric evaluation of the Autism Symptom Dimensions Questionnaire. Developmental Medicine and Child Neurology.  

  

Frazier, T. W., Busch, R. M., Klaas, P., Lachlan, K., Jeste, S., Kolevzon, A., Loth, E., Harris, J., Speer, L., Pepper, T., Anthony, K., Graglia, J. M., Delagrammatikas, C., Bedrosian-Sermone, S., Beekhuyzen, J., Smith-Hicks, C., Sahin, M., Eng, C., Hardan, A. Y., & Uljarevic, M. (2023). Development of informant-report neurobehavioral survey scales for PTEN hamartoma tumor syndrome and related neurodevelopmental genetic syndromes. Am J Med Genet A, 191(7), 1741-1757. https://doi.org/10.1002/ajmg.a.63195  

  

Frazier, T. W., Crowley, E., Shih, A., Vasudevan, V., Karpur, A., Uljarevic, M., & Cai, R. Y. (2022). Associations between executive functioning, challenging behavior, and quality of life in children and adolescents with and without neurodevelopmental conditions. Frontiers in Psychology. https://doi.org/10.3389/fpsyg.2022.1022700  

  

Frazier, T. W., Dimitropoulos, A., Abbeduto, L., Armstrong-Brine, M., Kralovic, S., Shih, A., Hardan, A. Y., Youngstrom, E. A., Uljarevic, M., & Quadrant Biosciences - As You Are Team. (2023). The Autism Symptom Dimensions Questionnaire: Development and psychometric evaluation of a new, open-source measure of autism symptomatology. Developmental Medicine and Child Neurology. https://doi.org/10.1111/dmcn.15497  

  

Frazier, T. W., Dimitropoulos, A., Abbeduto, L., Armstrong-Brine, M., Kralovic, S., Shih, A., Hardan, A. Y., Youngstrom, E. A., Uljarevic, M., Womack, R., Wolf, D., Chappell, N., & Verbal Beginnings Team. (2024). Psychometric Evaluation of the Autism Symptom Dimensions Questionnaire (ASDQ). Developmental Medicine and Child Neurology.  

  

Frazier, T. W., Hyland, A. C., Markowitz, L. A., Speer, L. L., & Diekroger, E. A. (2020). Psychometric evaluation of the revised child and family quality of life questionnaire (CFQL-2). Research in Autism Spectrum Disorders, 70. https://doi.org/https://doi.org/10.1016/j.rasd.2019.101474  

  

Frazier, T. W., Khaliq, I., Scullin, K., Uljarevic, M., Shih, A., & Karpur, A. (2022). Development and psychometric evaluation of the open-source challenging behavior scale. Journal of Autism and Developmental Disabilities. https://doi.org/https://doi.org/10.1007/s10803-022-05750-5  

  

Frazier, T. W., Krishna, J., Klingemier, E., Beukemann, M., Nawabit, R., & Ibrahim, S. (2017). A Randomized, Crossover Trial of a Novel Sound-to-Sleep Mattress Technology in Children with Autism and Sleep Difficulties. J Clin Sleep Med, 13(1), 95-104. https://doi.org/10.5664/jcsm.6398  

  

Frazier, T. W., Busch, R. M., Klass, P., Crowley, E., Lachlan, K., Jeste, S., Kolevzon, A., Loth, E., Harris, J., Pepper, T., Anthony, K., Graglia, J. M., Helde, K., Delagrammatikas, C., Bedrosian-Sermone, S., Smith-Hicks, C., Sahin, M., Eng, C., Hardan, A. Y., . . . Uljarevic, M. (2024). Quantifying Neurobehavioral Profiles across Neurodevelopmental Genetic Syndromes and Idiopathic Neurodevelopmental Disorders. Developmental Medicine and Child Neurology. https://doi.org/https://doi.org/10.1111/dmcn.16112  

  

Uljarevic, M., Cai, R. Y., Hardan, A. Y., & Frazier, T. W. (2022). Development and validation of the Executive Functioning Scale. Front Psychiatry, 13, 1078211. https://doi.org/10.3389/fpsyt.2022.1078211  

  

Uljarevic, M., Spackman, E. K., Cai, R. Y., Paszek, K. J., Hardan, A. Y., & Frazier, T. W. (2022). Daily living skills scale: Development and preliminary validation.  

Frazier, T. W., Helton, M., Akouri, C., Chetcuti, L., & Uljarevic, M. (2025). Identifying reliable change in outcome assessments for behavioral interventions. Behavioral Interventions, 40, e70007. https://doi.org/https://doi.org/10.1002/bin.70007 
 

Resources 
CentralReach. (n.d.). AI Measures (AIM). https://centralreach.com