I’m going to preface this review by advising you to look at the responses from PAT to other negative reviews. Instead of taking feedback they resort to personal attacks without even realizing how negatively this makes them, as a business, look. That behavior is an accurate depiction of the kind of people in management at PAT. Multidisciplinary: Upon starting my employment at PAT, I was actually very excited to be able to work among a team of clinicians from different disciplines; however, it is very clear that OT and Speech came first, and they are less than warm or welcoming to ABA as a whole. There was constant tension between ABA and the other disciplines. I was always eager to ask other disciplines questions that are outside of my scope of practice, but they did not return professional courtesy and would often insert themselves into ABA sessions without consent, sometimes sabotaging the intervention in process. When I brought this up the frequency of interference decrease, but there was clear tension any time a child was engaging in challenging behaviors. A clinic that offers ABA should be a safe place for these kids to work through these behaviors and learn alternative strategies, but it often feels just as judgmental as if the child was having a tantrum in a grocery store. The “collaboration” at PAT is surface level and performative, so when met with criticisms about being multidisciplinary they will tell you they arrange offices to promote collaboration and promote language that hints at multidisciplinary approach, but that’s where it ends. New ABA staff are scheduled to shadow speech, OT and PT sessions, but no other disciplines shadow ABA sessions upon hire. This was brought up to management, who insisted it would be changed in the next group of new hires. Well, the new hires just started, and ABA staff are still shadowing other disciplines while other disciplines are not required to shadow ABA. This contributes to an overall misunderstanding of what ABA is and what exactly happens or is worked on in ABA sessions (which doesn’t help the tension). The location leads have been informed by multiple people of the breakdown in communication and cooperation between ABA and other disciplines. We were told we are being heard and they are attempting to fix it, but after a couple false starts, I am obviously not sticking around to find out for myself. The clinical hierarchy is confusing and arbitrarily enforced. Location directors expect ABA staff to come to them with concerns but do nothing to foster a relationship with BTs or RBTs so understandably, they tell their BCBA their concerns. This is met with site wide emails (directed at one person) instead of talking to the individual (and maybe asking if/why they don’t feel comfortable coming to location directors). I cannot speak for the other locations, but Winston’s office is reminiscent of middle school with the cliques and inability to resolve conflict without petty and passive aggressive jabs (or even just avoid it with open communication and transparency). Ableism: All the disciplines, including ABA, engage in raging ableism towards the clients they are supposed to be serving. Our job as clinicians is to help these kids gain independence, autonomy and increase self-advocacy skills, not make them pretend to be a neurotypical child. Speech and OT clinicians are incredibly handsy with the kids, often grabbing them by their upper arm or their wrist to lead them around. When I brought consent and assent up as a concern, I was told a lot of them may not know what assent is (how is this okay and not a huge red flag?) Anyone working with neurodivergent children should absolutely understand assent and how important it is to teach the kids that their words matter, and they are allowed to refuse someone touching them. Because of the lack of collaboration SLP and OTs often reinforce maladaptive behaviors or ignore contextually appropriate behaviors example: ignoring a client saying they didn’t like the food they were trying to get them to eat but proceeding to end the task when they get up and scream while throwing food away (if we reinforce the language then likely the behavior won’t escalate to screaming and eloping to throw food away). There is one OT at PAT that I feel does a great job with her clients and her clients enjoy sessions because she is fun and allows them to behave like children do (not expecting them to simply sit or stay in one place and follow every directive she throws at them). She alone, is the reason I still have faith in OT and it's benefits. The speech therapist currently on staff is a NIGHTMARE and I would advise her not to work with kids anymore, as she clearly does not like them. She often says things about kids in her sessions being “bad” or having to tell them she is the adult, and they are the child, so they need to listen. There have also been instances of her withholding food and water from clients as “motivation” to complete the tasks she’s asking, but I’m not sure how she doesn’t view this as abuse. I could write an entire review about the SLP alone, but I’ll leave it at keep your kids away from her. ABA: I’ve worked at ABA companies in home, in school, in the community as well as in clinic and PAT is by far the worst ABA company I’ve ever worked for. Winston’s ABA department was an expensive babysitting facility at best when I started. I will say that the BTs and RBTs in Winston were very receptive to feedback and made a lot of growth, but there are still a lot of things to learn. The “training” provided by PAT for new ABA staff leaves a LOT to be desired especially since they often hire staff with no prior experience in ABA. I wouldn’t advise against hiring inexperienced staff because everyone must start somewhere, but there is absolutely no way a new behavior tech can spend 1 week shadowing OT/Speech/PT sessions, 1 week observing ABA sessions (approximately 5 sessions), complete online training modules and then be expected to be prepared for solo session. It is not fair to the kids and their families to be put in sessions with clinicians who do not have the fundamental skills to provide ABA services. Best case scenario, the kid makes no progress and worst-case scenario the staff implements interventions incorrectly and causes regression in the client’s progress or escalates their behaviors. As a parent I would let my child go without services before ever sending them to PAT for anything. There is a ton of conflicting information given by the same people. I was told in my interview that BCBAs did 20% supervision, this is also what the clinical director told parents during intake assessments. The owner has planned caseloads based on 10% supervision and you can try to do 20% (if their treatment plan even allows it), but they will continue to push kids on your caseload until it is “full” which is based on 10% supervision. Finally, they are replacing an in person BCBA with yet another BCBA doing primarily telehealth (with in person supervision 1-2 times a month). In my opinion telehealth supervision is never an adequate long-term solution for clients or behavior techs, but especially in this clinic. This leaves Winston with not 1 single person in the clinic to turn to for support and a clinic full of techs who have really shown great progress and almost all verbally expressed feeling much more supported having a BCBA in person to answer questions on demand, model interventions and just be available to help whenever needed in session. The owner is clearly driven by money, as so many ABA clinics unfortunately are, so the client’s interest will always take a backseat to his ultimate goal.