Interpret Assessment Data to Determine the Need for Services or Referral
You’ve completed a thorough assessment. You have observation data, caregiver interviews, standardized measures, and medical records in front of you. Now comes one of the most important decisions you’ll make as a BCBA: does this client need ABA services, a referral to another professional, both, or neither?
This decision shapes everything that follows. Get it right, and you connect a client to the care they actually need. Get it wrong, and you risk delaying critical supports, overlooking medical issues, or stepping outside your scope of practice.
The good news? Interpreting assessment data systematically—using a clear decision framework—makes this choice concrete and defensible.
This article walks you through how to interpret assessment data to determine whether to proceed with ABA services or refer elsewhere. You’ll learn which data sources matter most, how to recognize red flags, when scope of practice limits require a referral, and how to document your decision so families understand the reasoning and next steps.
What Does “Interpreting Assessment Data” Really Mean?
Interpreting assessment data means reviewing everything you’ve gathered—observation, interviews, standardized tools, medical records, prior treatment history—and asking: Can ABA address this client’s primary needs? Or do they need something else?
The answer isn’t always black and white. You might conclude that ABA is appropriate and sufficient. You might refer to another professional entirely. You might recommend short-term ABA while the family waits for a psychiatric evaluation. Or you might respectfully decline services because the client’s needs fall outside behavioral analysis.
Each decision rests on solid data from multiple angles. Direct observation and ABC data reveal how behavior is triggered and maintained. Caregiver and teacher interviews add context and history. Standardized assessments (VB-MAPP, ABLLS-R, VABS-3, ABAS-3) measure skill levels objectively. Medical records and prior treatment summaries flag past concerns or diagnoses.
Together, these sources paint a picture far richer than any single measure alone.
Why This Matters
Interpreting assessment data correctly has high stakes.
When you get it right, clients reach the professionals and services they need without unnecessary delays. A child with autism and communication deficits gets ABA paired with speech therapy. A teenager whose sudden aggression stems from undiagnosed seizures gets medical evaluation before—or alongside—behavior intervention. A family exhausted by their child’s behavior receives a clear, compassionate explanation of what’s happening and what comes next.
When interpretation goes wrong, consequences can be serious. You might miss a medical condition driving behavior, leaving a client in unnecessary distress. You might start ABA without checking whether a learning disability is the root cause, delaying essential educational supports. You might overextend your scope by attempting to treat something you’re not trained for, or delay a psychiatric referral that could be lifesaving.
Beyond clinical impact, interpretation decisions affect legal liability, professional credibility, and family trust. Documentation of your decision-making protects you, shows respect for the family, and creates a clear trail for insurance and other providers.
The Core Decision: Services, Referral, or Both?
When you finish interpreting assessment data, you’re making one of four decisions:
Proceed with ABA services. The data show clear functional behavior patterns, measurable skill deficits within ABA’s scope, and genuine functional impairment. You have the competence to help. You move forward with individualized treatment planning.
Refer to another professional. The primary issue falls outside ABA scope—a suspected neurological problem, psychiatric disorder, or learning disability requiring specialist assessment. You don’t start ABA; instead, you provide a warm handoff to the appropriate professional and offer to coordinate once their evaluation is complete.
Provide ABA with coordination or concurrent referral. The client benefits from ABA and needs another service in parallel. A child might start communication-focused ABA while being referred for audiology screening. You manage behavior; the speech-language pathologist manages speech; the team stays connected.
Decline services. The client’s needs don’t match ABA’s scope, or you don’t have the competence to serve them safely. You provide a clear, empathetic explanation and suggest alternative resources.
Each decision is legitimate when grounded in data and ethical reasoning.
What Data Do You Need to Interpret?
Good decisions rest on good data. That means gathering information from multiple sources rather than relying on one person’s impression or one test score.
Direct observation is your behavioral window. When you watch a client in natural settings—home, school, community—you see what actually happens, not what someone remembers or assumes. ABC data reveal patterns: self-injurious behavior occurs when the client is denied a preferred activity (escape function), or aggression happens in busy, loud environments (possible sensory trigger). This information is irreplaceable.
Caregiver and teacher interviews add context and historical depth. You learn about sleep patterns, medical history, medication changes, family stressors, and how behavior has changed over time. Parents notice patterns formal observation might miss. Teachers know whether a behavior is new or longstanding. These insights often reveal whether behavior is stable or escalating—a critical distinction when deciding urgency.
Standardized measures bring objectivity and comparability. Tools like the VB-MAPP, ABLLS-R, VABS-3, and ABAS-3 measure skill levels against established norms. A child might score in the 8th percentile on adaptive behavior—clear evidence of functional impairment. Standardized data also satisfy insurance requirements and educational criteria.
Medical records and prior assessments flag important background. A diagnosis of autism spectrum disorder, documented seizures, or recent surgery all shape how you interpret current behavior. Previous treatment summaries show what’s been tried and why it did or didn’t work. You avoid repeating failed interventions and build on what was successful.
When you synthesize all four sources, you get a clearer picture than any single source offers. Multi-source data also reduce bias. If a parent says behavior is constant but observation shows it happens only in specific situations, that discrepancy is meaningful—it might point to a particular trigger or a need for more skill-building in that context.
Key Distinctions That Guide Your Decision
As you interpret data, several core distinctions help you land on the right decision.
Functional impairment versus normative variation. All children have tantrums. Some three-year-olds have limited language. Not every variation is a disorder or requires treatment.
Functional impairment means the behavior or skill deficit is getting in the way of daily life—school, home safety, social relationships, self-care. A child whose occasional frustration leads to brief crying shows normative variation. A child whose aggression prevents school attendance or injures others shows functional impairment.
Your assessment data should quantify severity. Standardized measures show whether a skill is below the norm. Caregiver reports show whether it’s affecting function.
Behavioral function versus medical or neurological cause. A behavior might look like it serves an escape function, but a medical condition could be driving it. A child who covers her ears during transitions might have sensory sensitivities linked to autism—or she might be experiencing pain from an ear infection.
Behavior is seldom purely behavioral. Your role is to recognize when medical or neurological factors likely play a role and refer accordingly. If assessment data include fever, recent illness, medication changes, or symptoms matching a known medical condition, coordinate with medical providers before or alongside ABA.
Scope of practice versus individual competence. You have a professional scope—what BCBAs are trained and licensed to do. You also have personal competence—your individual training and expertise.
A BCBA’s scope includes assessment, functional analysis, intervention design, and supervision. It does not include diagnosing medical or psychiatric disorders, prescribing medication, or conducting medical imaging.
Even within ABA scope, individual competence matters. A BCBA trained in adolescent ABA may not have competence with toddlers. If you lack competence, refer or pursue training. If the need falls outside BCBA scope entirely, refer.
Immediate safety risk versus non-urgent concerns. Some red flags demand action today. Self-harm, suspected abuse, active suicidality, or medical emergency require immediate response. Other concerns—gradual skill decline or emerging anxiety—are real but allow time for orderly assessment and referral.
Your interpretation should flag urgency explicitly so families and other providers understand what needs to happen first.
Red Flags That Signal Referral
Certain findings in your assessment data are red flags. They don’t automatically disqualify ABA, but they require action—usually referral or coordination with another professional.
Unexplained medical symptoms warrant medical evaluation. Persistent fever, unexplained rashes, complaints of pain, or sudden changes in eating or sleep should prompt a pediatric referral. Rapid regression—a child who was speaking and now is not, or who suddenly became aggressive—often points to medical or neurological change, not a behavioral problem you can train away.
Signs of abuse or neglect trigger mandatory reporting obligations. Unexplained bruising, burns, or other injuries; a child’s report of being hit or locked away; severe malnutrition; or extreme fear of a caregiver are red flags. Your job is to report to child protective services as your jurisdiction requires, not to investigate or “give the family a chance.” Safety comes first.
Suspected psychiatric or neurodevelopmental disorders beyond your competence require specialist input. If data suggest significant mood symptoms, psychosis, eating disorder behaviors, or severe anxiety, a psychiatric referral is appropriate. If there’s concern about intellectual disability, learning disorder, or other neurodevelopmental condition, educational or medical psychology evaluation should precede or accompany ABA.
Medication changes or concerns about side effects warrant medical review. If a family reports behavior worsened after starting a new medication, or the client seems sedated, in pain, or unusually irritable, a prescriber should weigh in before ABA adjusts the behavior plan.
Functional Impairment: How You Know It’s Real
ABA is appropriate for behavior that’s causing meaningful difficulty. That’s where functional impairment comes in.
Functional impairment shows up in domains that matter: safety, communication and social skills, self-care, learning, and family functioning. A child whose self-injurious behavior risks serious injury is functionally impaired. A teenager whose social anxiety prevents school attendance is functionally impaired. A young adult whose limited cooking skills means reliance on others is functionally impaired in a way that matters for independence.
Your standardized assessments give you one window into impairment. A score on the VABS-3 showing adaptive behavior one standard deviation or more below the mean is objective evidence. Many insurance companies require this level of documented deficit to authorize services.
Caregiver report and your own observation round out the picture. Ask directly: How is this affecting your family? Can your child participate in school? Is safety at risk? Do they struggle with daily routines? The answers show whether a skill deficit is causing real hardship or whether behavior, while present, isn’t disrupting life in a way that requires intervention.
One caution: be wary of basing impairment judgments on a single source. A parent might underestimate a skill because they haven’t seen the child in another context. A school report might reflect performance in one setting, not overall capacity. Observation over time, in multiple settings, gives you the clearest picture.
Multi-Source Data in Action: A Real Example
Imagine you’re assessing a seven-year-old with reported “behavior problems.” Here’s how multi-source data change the decision.
What the parent says: “He won’t listen. He’s defiant. He won’t do anything I ask.”
What the teacher reports: “He struggles during independent work time. He seems confused about what to do. He asks for help a lot, and when I redirect him to try first, he gives up quickly.”
What you observe: During a 30-minute session, the child shows strong reciprocal play with you—good attention, social engagement. When given a written worksheet and asked to work independently, he sits quietly for 20 seconds, then raises his hand. He appears uncertain, not oppositional.
What the school records show: A three-month-old educational evaluation notes the child scored significantly below grade level on reading and math screening. The IEP recommends small-group instruction, but he hasn’t started yet.
What standardized assessment shows: VB-MAPP suggests moderate language and learning delays. ABAS-3 shows deficits in academic skills.
Your interpretation: This isn’t primarily a behavioral defiance problem. The child is likely struggling with academic demands that exceed his current skill level. His “non-compliance” is often confusion or inability, not willful refusal.
Behavior intervention alone won’t solve this. He needs the academic supports noted in his IEP, and possibly ABA focused narrowly on classroom routines and asking-for-help skills while those academic supports are in place. You recommend coordinating with special education, not ABA alone.
This is why multi-source data matter. One source—parent report—suggested a referral to ABA. The full picture pointed toward education and coordination.
When to Proceed with ABA Services
You move forward with ABA when the data show:
Clear, measurable target behaviors with identifiable function. ABC data or functional assessment reveals patterns. Behavior happens in response to specific triggers and is maintained by specific consequences. You can design interventions that replace or reduce the behavior because you understand what’s maintaining it.
Functional impairment documented across sources. Standardized measures, observation, and caregiver report all point to real difficulty in daily life. The impairment meets your agency’s threshold for services.
Skill deficits that ABA can address. The client needs communication, social, self-care, or learning skills that behavior analysis can teach. You’re not expecting ABA to fix a hearing loss or intellectual disability, but you can teach alternative communication, coping skills, or daily routines.
Safety-first baseline. There’s no active abuse, unaddressed medical emergency, or acute psychiatric crisis demanding immediate referral elsewhere. You’ve flagged medical or psychiatric concerns and either referred or planned coordination.
Client and caregiver engagement. The family understands the plan, consents to it, and is willing to participate. You’ve explained findings and rationale in plain language.
When all these elements align, ABA is appropriate, and you move to treatment planning.
When to Refer or Coordinate
Referral or coordination is appropriate when:
- The primary issue falls outside ABA scope (medical diagnosis, psychiatric condition, learning disability requiring specialist assessment)
- You lack individual competence in the population or presenting problem
- Assessment data suggest medical or neurological causes that should be evaluated first
- Red flags (abuse, neglect, safety risk, or rapid decline) demand urgent specialist input
- The client didn’t respond to ABA in the past, suggesting a different approach might be needed
- Caregiver priorities or cultural factors indicate another service better aligns with family values
A referral is not a rejection. You’re directing the client toward the help they truly need. Often, referral and ABA happen together—the family pursues medical evaluation while ABA addresses function, or a client receives special education services and ABA concurrently.
The key is transparency. Explain your reasoning clearly. Provide specific referral options, not vague suggestions. Offer to share assessment data (with consent) so the receiving provider has context. Follow up to ensure the family connected with the referral and received care.
Documentation and Communication
Your interpretation decision must be documented. Here’s what that looks like:
Write down what data you reviewed. “Assessment included parent interview, teacher consultation, direct observation of 45 minutes across two settings, VB-MAPP, VABS-3, medical records from pediatrician dated [date], and prior speech-language evaluation.”
Summarize the key findings. “Functional behavior assessment identified escape-maintained self-injurious behavior occurring 3–5 times daily in response to academic demands. Standardized measures show adaptive behavior in the 5th percentile. Medical clearance obtained.”
State your decision and rationale. “ABA services are appropriate. This client meets medical necessity criteria: documented diagnosis of autism spectrum disorder, functional impairment in adaptive behavior, and clear behavioral function that intervention can address. Recommend 15 hours per week focused on communication, academic task tolerance, and replacement behaviors.”
Or: “Referral to psychiatry is recommended. Assessment data suggest significant anxiety and possible depressive symptoms that warrant psychiatric evaluation prior to or concurrent with ABA intervention. Will coordinate with psychiatrist once client is established in care.”
Name next steps. Who will make the referral? When? How will information be shared? What should the family do? Clear next steps prevent confusion and ensure action.
This documentation protects you, shows families you’ve thought carefully, and creates a record for insurance and other providers.
Short-Term ABA While Awaiting Referral
Sometimes a family is ready to start ABA, but a referral is pending—perhaps waiting for a pediatric neurology appointment or psychiatric evaluation. In this situation, short-term ABA can provide support while the referral process unfolds.
This is appropriate if it’s documented and scoped. Tell the family explicitly: “We’ll provide ABA focused on communication and daily routines while you pursue the medical evaluation. These services are temporary, and we’ll adjust or pause if new information emerges.”
Agree on a plan: If the pediatrician finds a seizure disorder, how will behavior intervention change? If a psychiatrist recommends medication, when will ABA resume? You’re providing a bridge, not a permanent full-service plan.
This approach requires careful consent and communication. The family must understand the limits and rationale. Documentation must note that services are interim and contingent on the referral outcome. You’re not hiding the referral or delaying it while hoping ABA alone fixes the problem. You’re moving forward thoughtfully while ensuring the client gets the specialist input they need.
Practical Next Steps: Use a Decision Framework
To make interpretation concrete, use a simple framework:
First, gather your multi-source data and review it.
Second, check for red flags—medical concerns, abuse indicators, safety risk, or urgent psychiatric symptoms. If red flags are present, prioritize referral and safety planning.
Third, evaluate whether the primary issue fits ABA scope and your competence. If yes, continue. If no, refer.
Fourth, confirm that functional impairment is documented and caregiver engagement is strong. If both are present, proceed with ABA and detailed treatment planning.
This sequence ensures you don’t miss safety concerns, you respect scope of practice, and you’re confident in your decision before investing time and resources.
Key Takeaways
Interpreting assessment data to determine need for services or referral is a high-leverage decision.
Use multi-source data—observation, interviews, standardized measures, and records—to avoid tunnel vision. Recognize red flags that signal referral. Respect your scope of practice and individual competence. Document your reasoning clearly and communicate it to families in plain language.
Remember that referral and ABA often happen together. Your role is to ensure the client reaches all the services they need, whether or not ABA is one of them.
When you get this right, clients move forward faster, families feel heard, and your professional credibility grows. The effort to interpret data systematically is time invested in better care.
