Oct. 14, 2025
Around the Spectrum: Consistency Over Chaos: Rethinking Systems in ABA (with Michael Conteh)
We explore how to build autism services that work at scale without burning out the people who make them possible. Michael Conte shares why consistency beats intensity, how leadership must be taught, and how parent partnerships drive real progress at home.
• systems thinking for clinics as they grow
• telescope vs microscope approach to problems
• balancing child needs, provider capacity, and family reality
• consistency over intensity for hours and schedules
• early buy-in with insurers and realistic utilization
• burnout feedback loops and how to break them
• leadership curriculum for BCBAs and managers
• 90-day onboarding for families and staff
• parent data on sleep, hunger, and routine changes
• retention through intrinsic motivation and clear programming
• documenting vision to expose gaps and scale
If this topic sparks something for you and you'd like to explore that connection between leadership and marketing and creating teams that stay, I'm co-hosting a short workshop called Hire to Stay Leadership and Marketing Strategies on Wednesday, November 5th from 12:30 to 1.05 p.m. It's a focused 35 minute session designed to help leaders and business owners take what they already know about people and make it part of how they attract and keep talent. You can find the link to register in the show notes. I'd love to see you there.
Looking to connect your leadership approach with how you attract and retain great talent?
Join Wendy Manganaro for a free 35-minute workshop, Hire to Stay: Leadership & Marketing Strategies, on Wednesday, November 5, from 12:30–1:05 PM ET.
It’s designed for leaders and business owners seeking practical, people-centered strategies to build lasting teams.
Register here → https://us02web.zoom.us/meeting/register/XBSzIhfQTm-NEycZ-OVyyQ
00:00 - Framing The Systems Conversation
00:28 - Meet Michael Conte & His Background
02:04 - Scaling Pains: Clinics Grow, Systems Break
03:46 - Telescope vs Microscope: Systems And People
06:21 - The Hours Dilemma And Real Family Life
10:39 - Consistency As The Central Venn Overlap
13:14 - Insurance, Expectations, And Early Buy-In
16:39 - Burnout Feedback Loops In Clinics
19:23 - Fix First: Teach Leadership, Not Titles
22:08 - Parent Partnerships: Biology And Context
25:01 - 90-Day Onboarding For Families And Staff
28:21 - Retention Systems And Intrinsic Motivation
WEBVTT
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Hi everyone, welcome to Around the Spectrum, where parents, pros, and those in between pull up a chair for honest conversations, grounded guidance, and real stories about raising and supporting autistic kids.
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I'm your host, Wendy Banganero.
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As a parent, marketing leader, and longtime autism ally, I know how overwhelming and isolating this journey can feel.
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That's why we're here, because when we sit at the same table, we understand more and judge less.
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Let's get into today's episode.
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This episode zooms out a bit.
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We're talking about systems, school services, support structures, and how leadership in those areas impacts real families.
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If you've ever wondered why does this feel so hard or is anyone listening, this conversation is for you.
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Today's guest is Michael Conte.
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He is a seasoned leader in both business and clinical practice.
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For 13 years, he served as a CEO of a multi-million dollar company, guiding daily operations, training leaders, and supervising teams.
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Over the course of his career, Michael has worked with more than 1,000 families and trained over 1,000 staff to serve children with autism and other special needs.
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More than 30 of those professionals have gone on to become BCBAs.
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Michael brings a rare blend of expertise.
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He's been a board-certified behavior analyst since 2009, a lean Six Sigma black belt, and a PCC certified executive coach for high performers and leaders.
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His work centers on improving systems, boosting retention, and helping organizations thrive through organized behavior management and process precision.
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He's also the co-author of Off the Waitlist, a parent's guide to young children with disabilities.
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Welcome, Michael.
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Thanks for being on the show with me.
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Thanks for having me, and thanks for all you do to help both parents and providers.
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Yeah, I think this is going to be great.
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And this is such a needed conversation in the ABA space.
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So you're both a BCBA and a systems architect.
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Can you share how your journey evolved from direct clinical work to focusing on systems and leadership?
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Yes, I ran into systems thinking out of necessity.
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My clinic started around 2005, when it was really around 2008 when all the insurance mandates started to go state by state.
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I was fortunate to have a clinic.
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When those mandates went through, all the clinics grew exponentially.
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I found myself from 10 staff to 25 staff to 50 staff within an 18-month period.
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I realized very quickly that I'm finite as a human.
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And if I really want to grow this company and still keep quality there and still have my influence, I'm going to have to think more about systems at scale.
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I think that was that revelation because I was just, I couldn't outwork the growth that was taking place.
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A lot of times we focus on what happens when things go wrong and there's no client.
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I would argue there's just as much stress when things go right.
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Because systems break.
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And I think for a lot of folks in the ABA world, they're like, yay, things are going great.
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And then they don't realize this other shoe of, oh crap, all the things that I did for five folks does not work at 25 plus.
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So I think that's how I ran face first into the systems thinking journey.
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And you're absolutely correct on that, whether it comes from recruiting, marketing side, leadership side, when there's five kids and you're like, oh, it doesn't matter if we handwrite this paper or take these notes this way, and then suddenly there's 50, it makes a really big difference in how you do that.
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How does the combination of behavior analysis, executive coaching, and process improvement provide a different approach to solving problems that ultimately affects the family?
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Near the end of the business journey, I got curious about systems, and that's what led me into Six Sigma.
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And so Lean Six Sigma is the people that make sure that when you have airplanes, that the brakes always work on the airplane.
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So really what it is is the process of reducing efficiency.
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And so what it did for me is now I can zoom out with a telescope and really think this complex problem.
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Is this a system issue?
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Meaning there's really no fundamental on how this should operate?
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Is this just a process issue?
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We don't have protocols.
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We haven't explained why these things are important.
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Or is this a people issue?
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I think that really helped because sometimes we look at problems, but that's a systems problem.
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You have a different solution.
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That really allowed me to use the telescope to look at these complex issues.
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But then as a behavior analyst, I can also look at the microscope, especially on the people side.
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How are people being motivated?
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Is there clarity of the vision?
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I think once I looked at the telescope and the microscope, it allowed me to peel each part of the onion of the problem, and that's what helped to move things along.
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So I'm a big family using both, and that really helps me to get better insight.
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One of the things that I know for sure is that there's always a balancing act, right?
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And in that balancing act, you're trying to balance families, you're trying to balance hours, you're trying to balance the actual care the child needs.
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Like there's all of these balancing things that need to happen.
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And without systems, I know that it can go certainly awry.
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So what would you say in there would be the best way to find balance?
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Because everything, and one of the things that I really do want to ask you as a BCBA, because I am always curious about this as a parent, I fully 100% support BCBAs and when they do an assessment and say this kid needs this many hours.
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That doesn't always work with the family.
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So how does that balance?
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That's a big balance act of what does the business need, what does the child need, and what can the family functionally do?
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How do we not make the family feel bad, but try to balance that?
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That is complex to find the Venn diagram between the provider company, the amount a child can actually do, and what the environment the family can provide.
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It's very complex.
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In our journey, that's something that we had to have lots of conversations about because all three need to go in the same direction and fit into the Venn diagram.
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So if I had to say what's the central piece that needs to be in the Venn diagram, I would choose the word consistency.
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A family has to feel comfortable that they consistently bring this child to the place, or if it's in-home, have the place available and have enough power that are consistent that they can do some of the things in the environment that keeps the child growing.
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On the provider side, can they bring the quality of staff that really helps that child to get consistency in positive repetitions, creating an environment where motivation is rich and not just training a new person on the job?
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It's more about their age and what they're able to do.
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And I think we have to recognize that behavior analysis is important, but nothing beats biology.
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When a kid is two, there's no reason for them to be sitting at a table for long periods of time.
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A young brain is not fit to work in that environment.
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Keeping consistency is the overarching theme.
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When BCBAs are trying to understand, a child may benefit from having a full 40 hours a week, but if the staffing is not behind it, if the parents need time to onboard, and the child is two years old, starting at 20 to 25, if that fits all three diagram, is the current optimum.
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And then maybe over time you can expand.
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I know insurances get very cranky when you try to add more hours, but I think we're doing it injustice.
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There's so much inconsistency that we're really demotivating the parents because they're not really seeing the progress.
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We're demoing the staff because of so much kind of turnover.
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And I think you just lose more in that process versus just being consistent with what all three parties can perform.
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And actually, to that point, that makes me curious about this because I'm sure you've seen this is that when you aren't able to be consistent, let's say it's 25 hours or 30 hours, right?
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And a parent, they're up front and they say, okay, but if you want the service, so now there's 30 hours, right?
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I'm just saying, for instance, the parent can't be consistent for I'm curious too when we say, but this is what they need, and really stick with that line, and then the family can't do it.
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Does it tell the insurance company this child doesn't really need those hours?
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When you go to renew the assessment.
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If you think as the specialist that they need X amount, but the parent only bring them 10, from a rationale standpoint, that's gonna affect your hours for that particular child.
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It brings up a big gap when it comes to ABA companies and parents.
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On the ABA side, we need to really have a conversation with the parent on what does it mean to be a part of this journey?
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Because a lot of the time, just your insurance covers it, you're eligible.
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There's not a lot of talk on, and it's not the hey, you gotta go do all this ABA work.
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It's just rather really understanding how much time do you have to allocate?
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What times are you potentially available?
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And by not having that conversation early, sometimes you can go through an assessment and go through all these things, and they're like, oh wait, I just need it for 10 hours.
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I can't do anymore.
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So I really think we have to build a relationship with the family.
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Sometimes it tends to be mom that you talk to a lot, but if you can really explain what ABA will do, especially in those first 30 to 90 days, and get the buy-in of what they can do to optimize it, that makes it where everyone is bought in.
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And then that creates a good accountability versus everyone hoping and praying.
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When you do that, that's when all the balls fall down and all the fingers start pointing at each other.
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Absolutely.
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As a parent who had therapists in her home, felt like day in and day out for a while.
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It's important to understand and have that conversation without the assumption that this is gonna work at a hundred percent.
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I think that that's really important to have those conversations with the family early about what that looks like for them and what that looks like for the provider and what they can do.
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So there's a lot of child.
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I'm very aware of the amount of BCBA burnout and overwhelmen because there is more child diagnosis.
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My son was diagnosed in 2007, and we've come a long way since 2007.
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And so when they don't have a process in place, right?
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You're a new BCBA, you go to a company and there is no process in place, suddenly they're trying to do 35, 40 hours plus notes.
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How do you see stress and burnout manifest in their daily work life?
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Because it's got to affect them.
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So the way I see stress and management affect the BCBAs, and I had a front row seat as the CEO of a company, and we had up to three locations, and we had our ups and downs.
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When I think about that question, what really comes to mind, you start to see the essence of burnout and stress when the BCBAs start to isolate from the staff.
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Because in some ways, the staff are a primary source of their frustration, having to answer all these questions on the spot to get some of the frustration from the staff come directly to them as a clinician.
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When they start to pull away, they're going less into the room because that ends up to be more work versus reinforcing.
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I think those are the telltale signs.
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So what it does, it creates a bad feedback loop.
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And then it's hard trying to help someone else in the process.
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It is challenging.
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You're constantly having to critique someone.
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But when they start to pull away, they're not in the rooms as much.
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So then there's more mistakes that happen.
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So the staff get more upset.
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As soon as they come in, then the BCBA gets more jaded and starts to detach.
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Once you do that feedback loop for a while, you get the full disconnect.
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The BCBA is frustrated with the staff, and the staff were frustrated with the BCBA.
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That's when the rain cloud of stress envelops the whole clinic.
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And we've had that happen.
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And so we have to think how do we find ways that the communication bridge stays open?
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Once it breaks, that's when most clinics really start to devolve.
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So when stress arises and it's due to poor systems, what's a process change leaders make that would immediately ease the pressure off?
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I'm sure that all BCBAs would like to know what that is because as they're going through the process of being frustrated, that would be great to understand.
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Yes.
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One of my biggest soapboxes, BCBAs and any corporation, we must not assume that just because someone has a title, they are a leader.
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Leadership is a cluster of skills that needs to be taught, needs to be grown.
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And so much we go, okay, you're a BCBA, you're supposed to help this kid with autism, help the family build a great environment, and lead all these other human beings.
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I think we're really set eating people up for lack of success.
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And so if you want to have a well-functioning clinic, you need to have a robust leadership curriculum.
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It can be asynchronous.
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There's plenty of videos on YouTube, you can do training, so you have to do all the heavy lifting.
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But we have to get away from this assumption that you can lead other humans.
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For all of human history, I would argue that's the hardest thing besides raising a human, which I think is the hardest, the second hardest is leading humans.
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And I think if we just took a step back and realized how challenging this is, I really see the same problem in corporate with companies that have tons of resources and activities, and they still struggle with this leadership piece.
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So by far, if a company wants to stand out from competition, if you create leadership for the operational side and on the clinical side, that is one of the big steps to have a better, more healthy clinic.
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I I could see that a hundred percent.
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And I agree with you that leadership has to be a taught skill because not everybody has that.
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They're going to school for the science and to work with children.
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Sometimes that leadership skill set is not taught because they're learning the science and the outcomes.
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So I think that that's really an important, especially for new BCBAs.
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I think that's really important.
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How can parents understand that they have the right to advocate for healthier systems and be part of that process as we were talking about before?
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So, how can they advocate that and support their child's BCBA, which in turn supports their family?
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For parents to see where they can have their impact in communicating with the company and the BCBA.
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I think the first thing that kind of hops into my mind is biology is so important to know what's happening biologically.
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And I know we always focus on the behavior, but it's amazing.
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I can completely change how I approach a day with a child if I know how many hours they slept.
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Just that little thing of Johnny only had two hours today makes it where I'm gonna try not to push him in a way that's gonna create a behavior.
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It's not that the child wants to not have good behavior, it's just the biology that they didn't sleep well.
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And I think those little subtle things of are they fed, how did they sleep, I think actually really helps a behavior analyst to really manage that day appropriately.
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So that's one on the behavior side.
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I mean, on the biology side.
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Now, the second piece is all parents are different, but there seems to be that patient doctor relationship where they drop their kid off and they're afraid to ask questions of what they observe.
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And so you don't have to be the squeaky wheel and demand of things, but it's okay to recognize when they work with this particular person, I am noticing this behavior afterwards.
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And it's not creating assumptions, but it's okay for you to be curious on what's happening, or when you notice any trends, Johnny's really starting to mumble a lot more.
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So I think those little context clues gives if I'm working on a kid who wants to learn how to speak with verbal communication, if I hear that there's more mumbling or more vocalizations, that gives me insight.
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Are some of the new programs working well or not?
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So I think giving those little tidbits of things you're noticing that's different, because a parent will really know the subtleties well before I do.
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And I think if they can give me contact tools early, I can definitely make pivots much faster.
00:18:36.480 --> 00:18:52.000
I like that you said that because so in your summation, is it enough, whether you call it parent training or parent collaboration, is it enough to do it then, or is it more important to have these, especially after a weekend where the schedule has been completely changed?
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As a parent who had a child that never slept for the first four years, I never slept for the first four years.
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Any sort of changes in the schedule from the weekends would throw him off on a Monday like there was no tomorrow until we got that rhythm and tried started to have him sleep.
00:19:06.960 --> 00:19:19.519
But so those type of things, like maybe there should be more of a touch point because the parents are gonna know more than sometimes the BCBA who's just walking in thinking it's another regular day for this child.
00:19:19.839 --> 00:19:20.799
Oh, yes.
00:19:21.119 --> 00:19:22.960
Parents have the data.
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A good company knows how to build a bridge where they can get that data in a very useful way and then communicate back the things to do to alleviate.
00:19:34.559 --> 00:19:40.799
There are the quote-unquote parent trainings, but you're correct, they're more collaborations that are mandated by insurance.
00:19:41.039 --> 00:19:47.119
But it's really about as the provider of BCBA, what are your touch points with the family?
00:19:47.440 --> 00:19:55.759
If all of your touch points are we need this, you need to do this, I don't think that's a great relationship moving forward.
00:19:56.000 --> 00:19:57.920
I like going back to systems.
00:19:58.079 --> 00:20:03.119
I'm a huge fan, whether it's the staffing for the first 90 days and having that robust.
00:20:03.440 --> 00:20:08.559
I think on the family onboarding, there needs to be a 90-day family onboarding.
00:20:08.799 --> 00:20:12.319
And that is, here are our rules, so some sort of handbook.
00:20:12.480 --> 00:20:16.000
So that's the structure, but then it's the soft stuff.
00:20:16.319 --> 00:20:21.519
So it's really telling the staff when you take kids out, just don't say they had a good day.
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Try to really dig into what went well that day.
00:20:25.359 --> 00:20:28.160
And it's okay to talk about what didn't go well.
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That way there's clean communication happening back and forth.
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The parent is not just leaving with generics.
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If they realize, hey, he's making progress with imitation skills.
00:20:39.279 --> 00:20:40.480
That could be a motivator at home.
00:20:40.559 --> 00:20:42.720
It's not about imitation and do the activity.
00:20:42.960 --> 00:20:49.279
I don't think we prompt our parents well because we don't give good specific information on what's happening.
00:20:49.519 --> 00:20:51.440
So those are the soft skills.
00:20:51.599 --> 00:21:10.160
Those pickup and drop-offs, sometimes a note every month to evaluate, keeps both people in the loop and encouraged to keep communicating because they can now really ping on when something is going the right way or the wrong way and be very proactive.
00:21:10.559 --> 00:21:11.039
100%.
00:21:11.519 --> 00:21:19.279
Which leads to this next question because consistency in staffing is so important for the child.
00:21:19.519 --> 00:21:40.240
When it comes to consistent staffing and a family, and how that affects how the family feels about you as an ABA agency, by the way, that's like that consistency and the how the child how well the child does or how well the child could progress, what systems?
00:21:40.480 --> 00:21:44.799
Because that's probably one of the main things, and it goes back to burnout.
00:21:45.279 --> 00:21:47.200
A lot of times it goes back to burnout.
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What can centers do?
00:21:48.880 --> 00:21:59.680
And what can families do when you have your child going well and then your RBT quits and it's three months before you get another person, it really can affect the child and the family.
00:22:00.000 --> 00:22:01.039
I love the question.
00:22:01.200 --> 00:22:04.400
I'll start on the provider side and go back to the parent side.
00:22:04.559 --> 00:22:09.039
Outside of insurance and getting paid for services, it is the most important thing.
00:22:09.359 --> 00:22:21.279
Because without staffing that are growing and feel invested into the company and the child, you're just going to have chaos.
00:22:21.759 --> 00:22:33.200
So for all companies and BCBAs, you have to realize employee life cycle is an ongoing living system.
00:22:34.400 --> 00:22:44.880
From the first time you make contact with a person until the day that they leave with offboarding, it's constantly understanding what is really working and not working.
00:22:45.119 --> 00:22:47.599
When I had my center, there wasn't as much competition.
00:22:47.680 --> 00:22:49.599
So we were able to bring people in.
00:22:49.839 --> 00:22:53.599
And I've worked at well over a thousand just at that clinic alone.
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And you start to realize patterns.
00:22:56.079 --> 00:23:01.359
And so if you want to build a good curriculum, you really need to know.
00:23:01.680 --> 00:23:07.519
Let's say you hire 10 people, and a lot of them have similar resumes, similar GPAs.
00:23:07.759 --> 00:23:11.279
Why did this one only make it three weeks?
00:23:11.519 --> 00:23:15.839
And then this one is a case manager and wants to be a BC.
00:23:16.079 --> 00:23:19.920
I think we spend so much time just saying the people have it or don't have it.
00:23:20.160 --> 00:23:22.720
And to me, that is completely not the case.
00:23:22.960 --> 00:23:33.519
It's all about really understanding how people learn, because they learn differently, and then giving them something that gives them confidence early in the journey.
00:23:33.839 --> 00:23:51.920
So going back to that first 90 days for a staff, I want them in the first 30 days to fall in love with at least one concept or understanding the clients that they're working with and really understand the importance of their work.
00:23:52.400 --> 00:24:00.799
Because without that internal, that's what gets a RBT up in the morning after they've been had a rough day the day before.
00:24:01.119 --> 00:24:04.559
If you don't know you're having impact, you're just not going to show up.
00:24:04.720 --> 00:24:08.400
And so I think that's where a lot of companies drop the ball.
00:24:08.559 --> 00:24:15.279
They're not building intrinsic motivation, which to me is the only way you survive the early days of early therapy.
00:24:15.759 --> 00:24:26.240
So from a parent's perspective, I think the simple thing is it's hard to actually know behind the walls if the therapist is really being helpful or just like a happy face.
00:24:26.720 --> 00:24:34.640
But when you can see any type of positive, meaning they thoroughly engage with your child, right?
00:24:34.880 --> 00:24:35.839
They bend down.
00:24:36.319 --> 00:24:39.359
You can tell that they are investing the time and energy.
00:24:39.680 --> 00:24:41.839
Just indicate the things that you've noticed.
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Hey, Johnny's getting better at imitation.
00:24:45.039 --> 00:24:47.039
You guys are doing a great job.
00:24:47.359 --> 00:24:52.000
That kind of helps them to realize that, hey, I'm getting better at this.
00:24:52.240 --> 00:24:57.119
I think that's a way the parent can give feedback to help that internal matrix.
00:24:57.200 --> 00:25:01.920
So more staff stay longer, especially when they start early in the ABA journey.
00:25:02.400 --> 00:25:04.240
I do think that's important.
00:25:04.319 --> 00:25:12.559
And I know not every parent chooses in home, so you don't always see everything, especially a VT that's there the whole shift with the child.
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