Topic · AI ABA session notes

AI ABA session notes in BIRP and objective-target format — drafted on your Mac, treatment plan never shipped to a server

Q: Can TherapyDraft handle the RBT-writes / BCBA-reviews supervision structure?

Yes. TherapyDraft runs on the local Mac — each clinician's device is independent, so an RBT can draft a session note on their own Mac and share the text output with the supervising BCBA for review and co-signature through whatever note-management system the practice uses. The draft is plain text; it pastes into CentralReach, Rethink, or any EHR the practice runs. The BCBA's review and co-signature happen in the EHR, not in TherapyDraft. TherapyDraft's role is reducing the RBT's documentation time — typically 15–25 minutes per session — while keeping all session audio under local custody rather than uploading to a cloud AI vendor.

Q: Does using a local AI scribe affect compliance with BACB ethics requirements?

Using any AI tool to assist documentation is consistent with BACB's Ethics Code for Behavior Analysts as long as the BCBA or supervising clinician reviews, edits, and takes clinical responsibility for the final note. The Ethics Code requires accurate, complete documentation and protection of client confidentiality — neither requirement is violated by using an AI drafting tool that runs locally and whose output is reviewed before signing. Using a cloud AI scribe that uploads PHI to a third-party vendor is also generally permissible if a BAA is in place, but introduces subprocessor-chain risk that a local tool does not. TherapyDraft's position is that a local AI drafting tool satisfies the Ethics Code's documentation quality and confidentiality requirements more directly than a cloud tool because no PHI leaves the practice's local control at any step.

Applied behavior analysis session documentation has a specific structure that generic therapy-scribe tools don't handle well. ABA session notes need to name the target behaviors worked on, document the prompting hierarchy used, summarize mastery progress, and tie the session work back to the written behavior intervention plan — all in a BIRP or objective-progress format that insurance reviewers and BCBA supervisors can read quickly. A generic AI scribe will output a SOAP note regardless of what happened in the session. TherapyDraft is built for the note formats ABA practitioners actually use, and it runs on your Mac — because the behavioral treatment plans and session data for your clients, many of them minor patients, should not be sitting in a cloud vendor's storage.

TL;DR

TherapyDraft is a local AI note-drafting tool for M-series Macs. For ABA sessions, it drafts BIRP or SOAP session notes that name target behaviors, document the prompting hierarchy and mastery percentage, and tie the session to the written behavior plan — without uploading session audio, client behavioral data, or treatment plan information to any cloud service. Audio and drafts stay on the device. Solo plan is $39/month; Group plan for ABA practices with 3+ seats is $29/seat/month. 10-session free trial, no card required.

What ABA session notes need to capture that generic scribes miss

ABA documentation exists in a different clinical frame than psychotherapy documentation. An ABA session note is primarily a record of behavior-analytic work: which target behaviors from the behavior intervention plan (BIP) were addressed in this session, what happened when those behaviors were practiced, and what the data show about progress toward mastery criteria. The audience for the note includes the supervising BCBA, insurance reviewers, and sometimes a multidisciplinary team (special education, speech, OT) — each of whom is looking at different dimensions of the same record.

A well-formed ABA session note includes:

Target behaviors addressed. Named by their BIP labels (e.g., "requesting preferred items using functional communication," "tolerating interrupted preferred activities," "independent task completion within 2-minute intervals") — not described generically as "worked on communication skills."
Prompting hierarchy used. Full physical, partial physical, model, gestural, positional, or verbal prompt level — and whether the session was running the prompting hierarchy down (from more to less intrusive) or holding at a current level for fluency building.
Mastery data summary. Percentage of independent responses, number of trials completed, and whether the session performance approached, met, or exceeded the mastery criterion from the BIP. Trial-by-trial raw data lives in a separate data system; the narrative note summarizes the trend.
Behavior of concern occurrences. If any behaviors of concern defined in the BIP (aggression, self-injury, property destruction, elopement) occurred: how many, what context, what response was implemented per the crisis protocol, and whether the behavior required deviation from the session plan.
Parent or caregiver participation. If a parent training component occurred: which skills were modeled, coached, or discussed; parent's demonstration of the skill; and next steps for generalization outside sessions.
Session adherence to the BIP. Any modifications from the written protocol and clinical rationale — relevant for BACB ethical accountability and insurance billing accuracy.

A generic SOAP scribe that doesn't know ABA's documentation framework will draft an Assessment paragraph that says "client made progress on behavioral goals" — clinically useless, and likely to be kicked back by an insurance reviewer who needs to see named targets and mastery data. TherapyDraft's ABA template structures the draft around target-behavior labels, prompting-level documentation, and BIRP format that satisfies both insurance and BCBA-review requirements.

The RBT-to-BCBA supervision loop and documentation

In most ABA practices, the session is delivered by a Registered Behavior Technician (RBT) working under the supervision of a Board Certified Behavior Analyst (BCBA) or BCaBA. The RBT conducts the session, collects data on a trial sheet, and writes the session note. The BCBA reviews and co-signs the note. Documentation quality is both an ethics requirement (BACB Ethics Code) and a billing condition — Medicaid and commercial insurance require that behavior-analytic services be documented with named target behaviors, prompting levels, and mastery-progress summaries in order to justify continued services.

The documentation burden falls primarily on the RBT. An ABA session for a child with autism may involve 20 or more discrete skills across communication, self-help, social, and academic domains — all of which need to appear in the session note in a structured way. Writing that note accurately and completely after a 2–3 hour session is time-consuming, and the clinical risk is that an RBT short on time writes a thin, generic note that misses the specificity insurance requires or that the BCBA's quality review rejects.

TherapyDraft reduces that burden by drafting the narrative note from the session audio, pre-populating target-behavior fields from what was discussed during the session, and structuring the output in BIRP format sized for the practice's chart-of-record. The RBT reviews, corrects the mastery data summary (supplementing from the actual trial sheet), and pastes the final note into the EHR for BCBA co-signature. The time saved per session is typically 15–25 minutes — meaningful at the scale of 4–6 sessions per day.

Why ABA client data shouldn't live in a cloud AI vendor's storage

ABA services are delivered primarily to children diagnosed with autism spectrum disorder and other developmental disabilities. That client population means most ABA practice PHI involves minor clients — and minor PHI carries heightened HIPAA protections that adult therapy PHI does not. Beyond the regulatory framing, the content of ABA session audio is sensitive in ways that go beyond what the narrative note captures:

A 2-hour ABA session involving a child and parent contains the family's behavioral dynamics, the parent's account of home behavior incidents, descriptions of the child's functioning in environments outside the session, and the names and context of behaviors that the family may not want documented anywhere beyond the clinical chart. A cloud AI scribe retains that audio as its own business record, independently accessible by legal process directed at the vendor. The family signed a HIPAA authorization for the practice's records — they did not necessarily understand that audio of their family session would be held by a technology subprocessor whose records could be independently subpoenaed.

TherapyDraft keeps that audio on the practice's own hardware. The session note is drafted from audio that never leaves the Mac. The vendor-record problem disappears at the architectural level because there is no vendor with a copy. See what a BAA actually covers for why a signed BAA with a cloud scribe does not solve this problem — a BAA governs how the vendor handles the data, but it does not prevent the vendor from producing records in response to legal process directed at the vendor itself.

The Group plan for ABA practices

ABA practices are almost always multi-seat by design — at minimum, a supervising BCBA and two or three RBTs. TherapyDraft's Group plan at $29 per seat per month is built for this structure. A practice with one BCBA and three RBTs pays $116 per month for all four seats; the same four people on individual Solo plans would pay $156 per month. The Group plan adds a shared template library — useful for ensuring consistent BIP-aligned target-behavior language across all RBTs' notes — and a per-clinician aggregated activity summary that lets the BCBA see session counts and documentation completion rates without accessing individual session audio. Audio stays on each individual clinician's device; the Group plan does not centralize or aggregate session recordings across seats.

For practices with more seats — a larger clinic with 10–20 RBTs under multiple BCBAs — the Group plan scales linearly at $29/seat. Compare to cloud scribes: Mentalyc's per-seat pricing for group practices starts at similar levels but includes the cloud-storage architecture that puts behavioral treatment plan data and session audio in a third-party vendor's custody. TherapyDraft's Group plan keeps every RBT's recordings on their own device, under local custody, with no central cloud store that an adversarial legal process could reach through the vendor.

See the full pricing comparison for a per-seat breakdown across cloud competitors.

Pricing

Solo plan: $39/month or $349/year — unlimited ABA session note drafts, all format options, all EHR paste presets, inference attestation log, one-shot template matching from your own example notes. Group plan: $29/seat/month for 3+ seats — all Solo features plus shared template library and per-clinician activity summary. Free trial: 10 sessions, no credit card required. Full pricing on the pricing page.

Related questions

What note format do ABA session notes typically use?

ABA session notes commonly use BIRP (Behavior, Intervention, Response, Plan) format for the narrative progress note submitted for insurance billing and clinical review. Within a session, RBTs also collect trial-by-trial data and ABC (Antecedent, Behavior, Consequence) data on a separate data sheet — that data is entered in a dedicated data-collection system (CentralReach, Rethink, ABA Toolbox) rather than derived from audio. TherapyDraft drafts the narrative BIRP session note from the session recording; the raw trial data is entered separately. The narrative note is the piece most benefited by AI drafting because it is the most time-consuming to write and the most visible to insurance reviewers.

Can TherapyDraft handle the RBT-writes / BCBA-reviews supervision structure?

Yes. TherapyDraft runs locally on each clinician's device — the RBT drafts a session note on their own Mac and shares the text output with the supervising BCBA for review and co-signature through whatever EHR the practice uses (CentralReach, Rethink, or any standard EHR). The BCBA's review and co-signature happen in the EHR, not in TherapyDraft. TherapyDraft's role is reducing the RBT's documentation time while keeping all session audio under local custody rather than uploading to a cloud AI vendor whose records could be independently reached by legal process.

Why does the ABA client population create heightened privacy considerations?

ABA services are delivered primarily to children diagnosed with autism spectrum disorder and other developmental disabilities — minor clients whose PHI carries heightened HIPAA protections. Session audio from an ABA session involving a minor and their family includes parental disclosures, family dynamics, and behavioral incident narratives that the treating team understands as clinical-context material. A cloud AI scribe retains that audio as an independently subpoenable record outside the practice's own chart — a vendor-custody problem that is more acute for minor PHI than for adult PHI, given the layers of parental-access and minor-privacy rules that vary by state.

Is the Group plan ($29/seat) the right tier for an ABA practice?

For ABA practices with 3 or more clinicians — typically a supervising BCBA plus 2+ RBTs or BCaBAs — the Group plan at $29 per seat per month is the most economical option and includes the shared template library useful for consistent target-behavior documentation across RBTs. Session audio stays on each clinician's individual device; the Group plan does not aggregate audio across seats. See the pricing page for the per-seat math at different practice sizes.

Does using a local AI scribe affect compliance with BACB ethics requirements?

Using an AI tool to assist documentation is consistent with BACB's Ethics Code as long as the supervising clinician reviews, edits, and takes clinical responsibility for the final note. The Ethics Code requires accurate, complete documentation and protection of client confidentiality — neither requirement is violated by an AI drafting tool that runs locally and whose output is reviewed before signing. TherapyDraft's position is that a local AI drafting tool satisfies the Ethics Code's confidentiality requirements more directly than a cloud tool because no PHI leaves the practice's local control at any step. The privacy page documents the network-sandbox entitlements that enforce this guarantee at the macOS level.