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Permission Employer

This document requests employer permission for an employee, Wael Mahmoud Khalaf Mohamed, to receive supervision towards certification as a Qualified Behavior Analyst (QBA) or Qualified Autism Service Practitioner – Supervisor (QASP-S). These certifications require 1000-1500 hours of supervised practice providing applied behavior analysis services such as assessments, treatment plans, and staff training. The employer confirms that the employee's typical work activities qualify toward supervision and the supervisor will conduct confidential observations to provide feedback to enhance the employee's performance.

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58 views2 pages

Permission Employer

This document requests employer permission for an employee, Wael Mahmoud Khalaf Mohamed, to receive supervision towards certification as a Qualified Behavior Analyst (QBA) or Qualified Autism Service Practitioner – Supervisor (QASP-S). These certifications require 1000-1500 hours of supervised practice providing applied behavior analysis services such as assessments, treatment plans, and staff training. The employer confirms that the employee's typical work activities qualify toward supervision and the supervisor will conduct confidential observations to provide feedback to enhance the employee's performance.

Uploaded by

علم ينتفع به
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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EMPLOYER PERMISSION FOR BEHAVIOR ANALYSIS SUPERVISION

Name—wael Mahmoud khalaf mohamed-------- is pursuing a certification as a Qualified


Behavior Analyst (QBA) / Qualified Autism Service Practitioner –Supervisor QASP-S.
Both QBA and QASP-S are trained to provide Applied Behavior Analysis (ABA)
services, which include assessment and treatment of problem behaviors, design of
learning and working environments, and staff and parent training.

This training requires 1000-1500 hours of supervised practice, which is expected to take
approximately 7-12/months. It has already been determined that the typical activities of
the supervisee meet many of the required activities of supervision. In addition, the
supervisee may seek opportunities to perform assessments or develop protocols beyond
her/his work responsibilities.

Activities that qualify toward QASP-S/ QBA supervision include:

- Conducting assessments related to the need for behavioral intervention (e.g., stimulus
preference assessment, functional assessment, staff performance assessment) or for
evaluating behavioral interventions.
- Designing, implementing, and systematically monitoring skill acquisition and
behavior reduction programs.
- Writing behavior/treatment plans, progress summaries, clinical notes, transition
summaries, and professional correspondence.
- Overseeing the implementation of behavior-analytic programs by others.
- Training others, designing behavioral systems, and performance management.
- Communicating and collaborating effectively with caregivers and other professionals.
- Other activities normally performed by a behavior analyst that are directly related to
behavior analysis, such as attending planning meetings regarding the behavior
analysis program, researching the literature related to the program, talking to
individuals about the program; plus, any additional activities related to behavioral
analysis as outlined by their task list. The supervisor will determine if the activities
qualify.

Finally, supervision requires regular observations from the BCBA/QBA supervisor.


Observations will be conducted at a frequency determined by workload and supervisor
/supervisee agreement. The objective of these observations is to provide critical feedback
to the supervisee and enhance performance. Before the beginning of observations, we
want to inform you that supervision will be conducted in a manner that is least intrusive
to the normal operations of the center and is Extremely Confidential

Supervisor Name:
Phone number:
E-mail:

The purpose of this document is to serve as written permission to assure that the
supervisee’s employer agrees to allow the employee’s participation in supervision.

By signing below, you are assuring the supervisee and supervisor that you agree to your
employee’s participation in supervision.

Signature: _________________________________ Date:________2/3/2023________

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