Registered Behavior Technician FAQs

MetroEHS behavioral technician doing a Q&A interview

Q: What is the RBT certification?

A: RBT certification is a paraprofessional certificate that is in the behavioral analyst field, and you work under the BCBA or BCABA treating and providing services to our kids.

Q: What are the requirements?

A: What it takes to become an RBT here at MetroEHS is you must be 18 years old, a high school diploma, you need the 40 hours of training, and then take a competency test with the supervisor, and then you apply at the BACB website, and take a test, and become an RBT.

Q: What does the training consist of?

A: The RBT training consists of like an interactive and comprehensive 40-hour training that you work in a small group or one on one with other technicians or your BCBA. You’re out in the clinic, hanging out with the kids, learning and watching how they run programs. That could be at the table time or out in natural environment and once you understand the new words in the ABA field, you take your competency test and take the test at the website.

Q: What is the competency test?

A: The competency test is when the supervisor comes out the clinic with you and they watch how you run programs, they interview you, ask questions about the terminology and it’s pretty much just one on one time or you and the supervisor and your client to make sure you understand the terminology and what you’re actually doing and it’s highly encouraged to actually take your RBT test within 90 days of your 40 hour training. It is free of charge. You take the test at the BACB website.

Apply now!

Q: How do I maintain my credentials?

A: To maintain my credentials as an RBT here at MetroEHS, I track all my supervision hours, and I retake my competency test at the year mark or year anniversary of my RBT testing date.

Q: What are the benefits if earning an RBT certification?

A: MetroEHS offers two benefits for becoming an RBT. One is a raise and two, once you become an RBT, you have more opportunities to move up the ladder and become admin or fun stuff.

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July 14, 2023

Navigating Grand Parenting Challenges: A Pathway to Expertise and Support

In the fast-paced world of grand parenting, it’s crucial to stay informed and equipped with the best solutions for raising grandchildren. With approximately 3 million grandparents across the United States taking on the responsibility of raising their grandkids, there is a growing need for expert guidance and support. That’s where the podcast “It’s a Grand Life” comes in, connecting listeners with subject matter experts who understand the unique challenges faced by grand families.

A Valuable Resource:

In a recent episode, host Craig Nash warmly welcomed new listeners from Texas, Nevada, Colorado, Florida, and Alabama. He emphasized the importance of being informed about the best solutions for raising grandkids, setting the objective of “It’s a Grand Life” to present subject matter experts who can provide valuable insights and information.

Expertise in Pediatric Therapies:

The guest of the episode was Kris Krajewski, a speech and language pathologist with MetroEHS Pediatric Therapy, a group dedicated to pediatric therapy in Michigan. Kris shared her background and expertise in speech and language pathology, highlighting her passion for working with children and her personal experience as a parent of a child with Down syndrome.

Comprehensive Approach to Care:

MetroEHS offers a wide range of therapies, including speech, physical, and occupational therapy, as well as applied behavior analysis (ABA) and mental health services. Their focus is on a holistic and coordinated approach, providing support not only to the children but also to their families and caregivers. By incorporating various services, MetroEHS aims to address the unique needs of each child and help them reach their full potential.

Addressing Feeding and Swallowing Issues:

Kris shed light on pediatric feeding disorders, a relatively new diagnosis, and emphasized the importance of understanding the sensory challenges that some children face when it comes to food. MetroEHS provides interventions to help children develop tolerance for different textures and improve their chewing and swallowing abilities.

Navigating the Path to Treatment:

To begin the journey of seeking therapy services, Kris advised starting with a discussion with the child’s pediatrician, who can refer them to appropriate specialists for evaluations and treatments. MetroEHS collaborates with pediatricians, school districts, and insurance providers to ensure comprehensive and accessible care for children.

Supporting Grand Families:

The podcast episode acknowledged that the journey of raising grandchildren can be overwhelming, but it highlighted the importance of seeking help and support. MetroEHS welcomes inquiries and assists families in finding the right resources for their specific needs. Additionally, the Autism Alliance of Michigan was recommended as an excellent resource for families dealing with autism-related concerns.

Raising grandchildren comes with unique challenges, but resources like “It’s a Grand Life” and organizations like MetroEHS provide valuable expertise and support for grand families. By accessing specialized therapies and collaborating with professionals, grandparents can help their grandchildren thrive. Remember, you are not alone in this journey, and there are pathways to assistance and resources available to support you and your grand family along the way.

May 18, 2026

Questions to Ask Before My Clinical Fellowship Year

Starting your Clinical Fellowship year is exciting—but it can also feel overwhelming. Before you jump in, take a little time to reflect. Asking yourself the right questions now can help you find the best fit and start your career with confidence.

1. Who will my clients be?

Do you see yourself in pediatrics (schools, outpatient, hospital?) or working with adult patients (in the hospital, SNF, outpatient, or specializing?),? What areas draw you in? Articulation, AAC, literacy, language, or feeding? You don’t have to have it all figured out—but having a general direction helps.

2. What work environment fits me best?

Think about where you thrive! Do you prefer a fast-paced clinic , scheduling yourself in a school environment, or in home with your patients? Do you want to work closely with other professionals everyday or have more independence?

3. What kind of support do I need?

Your CF supervisor plays a huge role in your experience. Ask yourself: Do I want hands-on guidance? Frequent feedback? A team I can easily turn to with questions? An experienced mentor?

4. What do I want to learn this year?

Your CF isn’t just about completing hours—it’s about growing your skills. What do you want to feel confident in by the end of the year?

5. What are my non-negotiables?

Consider what matters most to you. Ask about caseload size (both appointments and number of patients/students whose cases you must manage), work-life balance, mentorship, or pay structure (W2 vs 1099). Knowing your priorities will help you make the right decision.

You can also ask about benefits! Some benefits make a big difference today like PTO, paid holidays (are they taken out of your PTO?), medical coverage, and more. Other will shape your future in a big way, like the retirement plan options.

6. How will I take care of myself?

This year can be demanding. Think about how you’ll manage stress, stay organized, and maintain balance so you can show up as your best self.

Your CF year is just the beginning. Taking time to reflect now can set you up for a more meaningful, supported, and successful start in the field. And if you can, find a mentor who will guide you through these sometimes-challenging questions.

April 14, 2026

When Should Physicians Refer a Child for Integrated Pediatric Therapy?

Why Integrated Therapy Models Can Improve Functional Outcomes in Pediatric Patients

Pediatric patients with developmental, neurological, behavioral, and sensory conditions rarely present with isolated deficits. In clinical practice, delays in motor function, communication, regulation, feeding, and adaptive behavior frequently overlap, influencing one another in ways that can complicate both diagnosis and treatment planning. Yet despite this reality, many children still enter care through fragmented referral pathways, receiving services across separate disciplines without a unified plan of care.

For physicians, this can create a familiar challenge: a child may be referred for speech concerns, but underlying sensory processing difficulties, motor impairments, or behavioral barriers may be limiting progress. Another patient may be receiving occupational therapy while untreated communication deficits continue to interfere with participation, safety, and family routines. When care is siloed, treatment goals may be addressed in isolation rather than in the context of the child’s overall functional development.

An integrated therapy model offers a more clinically aligned approach. By coordinating services such as Applied Behavior Analysis (ABA), Occupational Therapy (OT), Speech-Language Pathology (SLP), and Physical Therapy (PT) under one interdisciplinary framework, integrated care supports shared functional outcomes rather than disconnected discipline-specific objectives.

The Clinical Problem With Fragmented Pediatric Therapy

Children with autism spectrum disorder, global developmental delays, neurological diagnoses, genetic syndromes, feeding disorders, and sensory-behavioral challenges often require support in multiple developmental domains at the same time. Traditional referral patterns, however, can delay this process. Families may be referred sequentially, moving from one specialty to another over the course of weeks or months. In the meantime, opportunities for early, coordinated intervention may be missed.

This fragmented model can contribute to delayed progress, duplication of effort, inconsistent treatment strategies, and increased caregiver burden. Parents may be left trying to reconcile different home programs, communication methods, and therapeutic priorities across providers. Physicians, in turn, may receive updates from multiple sources without a single cohesive picture of the child’s functional status or trajectory.

What Is an Integrated Therapy Model?

An integrated therapy model brings multiple pediatric disciplines together within a coordinated plan of care. Rather than treating communication, mobility, sensory regulation, and behavior as separate issues to be addressed in parallel but independent tracks, the interdisciplinary team collaborates around shared goals tied to everyday function.

These goals may include functional communication, feeding independence, improved transitions, school readiness, social participation, gross motor mobility, or greater independence with activities of daily living. The emphasis is not simply on increasing therapy volume, but on aligning interventions so that each discipline reinforces the others.

For the referring physician, this model can improve both clinical clarity and continuity of care. Instead of scattered recommendations, the result is a more streamlined treatment course centered on measurable, meaningful progress.

Why Integrated Care Can Produce Faster Functional Gains

One of the primary advantages of integrated pediatric therapy is simultaneous skill development. A child is not required to “complete” one form of therapy before another begins. Instead, deficits across domains can be addressed concurrently, which is often more reflective of how development actually occurs.

For example, a child working on expressive language in speech therapy may also need occupational therapy support for sensory modulation and motor planning, while ABA helps reinforce communication attempts across routines and environments. In a coordinated model, those interventions are not separate—they are mutually reinforcing. This kind of overlap can accelerate the acquisition and generalization of functional skills.

Integrated care also improves goal setting. When therapists across disciplines are aligned around outcomes such as feeding, social participation, transitions, mobility, or independence, treatment tends to be more efficient. This reduces contradictory strategies, minimizes duplication, and makes progress easier for both families and physicians to follow.

Another important factor is treatment intensity without fragmentation. Children with complex needs often benefit from more frequent intervention, but high therapy intensity can become burdensome when services are spread across unrelated systems, schedules, and locations. Integrated models can increase intensity while preserving continuity, making it easier for children to receive comprehensive care without overwhelming families.

Reinforcement Across Disciplines Improves Generalization

Generalization remains one of the most important markers of meaningful pediatric progress. A skill demonstrated in a single therapy session has limited value if it does not transfer into the home, school, or community environment. Integrated care helps close this gap.

When one provider introduces a communication strategy, self-regulation support, mobility goal, or feeding intervention, the rest of the team can reinforce that same skill during their own sessions. A child who practices requesting in speech therapy may use the same communication system during ABA and OT. A sensory regulation strategy introduced in occupational therapy may support participation during speech sessions or improve tolerance for physical therapy tasks.

This consistency can speed carryover and reduce the risk that gains remain context-dependent. For physicians monitoring developmental progress, that translates into more functional outcomes rather than isolated clinical wins.

The Importance of Early Multidisciplinary Access

Early intervention is well established as a major factor in pediatric outcomes, but access delays across disciplines remain common. A child may begin one service while waiting for another referral, evaluation, or authorization, even when needs in multiple domains are already evident.

Integrated models reduce that lag by allowing children to access multiple specialists earlier in the care process. This is especially important for patients whose communication, sensory, behavioral, and motor needs are intertwined. Earlier multidisciplinary involvement can support developmental momentum, reduce avoidable decline in function, and improve long-term participation outcomes.

For physicians, this means that an integrated referral may be appropriate not only when a child is already receiving multiple therapies, but also when the clinical presentation strongly suggests interconnected needs from the outset.

Which Patients May Benefit Most From an Integrated Referral?

Integrated therapy is particularly valuable for pediatric patients whose presentation crosses traditional discipline boundaries. This often includes children with autism spectrum disorder, global developmental delay, speech and language delays with behavioral or sensory components, neurological conditions, genetic disorders, feeding difficulties, and motor impairments that affect participation in daily routines.

It may also be the right model for children whose progress has plateaued in a single-discipline setting, especially when underlying barriers appear to involve multiple systems. In these cases, coordinated treatment can help identify whether communication, regulation, sensory processing, strength, endurance, or adaptive functioning is limiting advancement.

What Referring Physicians Can Expect

From the physician’s perspective, integrated care can simplify the referral and follow-up process. Instead of navigating feedback from multiple unconnected providers, physicians can expect more coordinated communication, a unified plan of care, and reporting that reflects cross-disciplinary collaboration.

Families also benefit from reduced navigation burden. When care is organized around the child rather than around separate service lines, it becomes easier for caregivers to understand treatment priorities and implement strategies consistently. This can improve adherence, engagement, and follow-through outside the clinic.

Most importantly, integrated care better reflects how children function in the real world. Development does not occur in isolated domains, and pediatric therapy is often most effective when treatment recognizes that reality.

A More Functional Model for Pediatric Referral

For pediatric patients with complex developmental, behavioral, sensory, and physical needs, integrated therapy models offer a more coordinated and clinically meaningful path forward. By aligning ABA, OT, SLP, and PT around shared functional outcomes, interdisciplinary care can reduce fragmentation, support faster skill acquisition, and improve generalization into daily life.

When multiple developmental domains are affected, a multidisciplinary referral is not simply convenient—it may be the most appropriate model of care.

To refer a patient, visit https://www.metroehs.com/referrals