The Infinite Impact of Technology - My Reasons for Pivoting to Software Engineering
Published: 2022-03-31 16:40:46

I was born before the internet and technology took over, and I'm grateful for that. 

It's not a nostalgic clinging to the past that I can credit for that gratitude, but rather the fact that I'm caught in an endless loop of amazement. Playing video games on a TV was mind blowing to me as a kid because of the fact that I remember a time before that was normal. 

With each new piece of technology that amazement never left. I remember being shocked when my dad showed me how his pager worked. Cell phones came along a little while after and it hit me again. Now, as an adult, I see what's happening with AR/VR, machine learning, and AI and I know the ride is nowhere near over. 

When I was around 12 years old my parents bought me a book on programming. I had absolutely no idea what it was talking about but I kept going back to it over and over again. I never got anything substantial out of that book, but my fascination with the inner workings of technology never left.

As much as I was fascinated by technology, the thought of making it my career was never fully explored by the time college rolled around. Whether it be fate, circumstance, or a combination of both, I wound up studying psychology and ultimately entered the field of Applied Behavior Analysis (ABA).

ABA is a set of scientific principles that leverage the fundamentals of learning and motivation in order to change behaviors of social significance. ABA is most well known for its effective use in the treatment of autism and other developmental disorders. I spent nearly 15 years in the field and came to know its inner workings quite well. However, the industry hasn't evolved in ways I expected especially in terms of technology.

Before I go further, I need to admit that I didn't see the value in the iPad when it first came out. When it was released I felt it was just an oversized cell phone without much utility, and even though I was fortunate enough to receive one for Christmas I didn't use it much.

_Then I brought it to work with me one day._ 


![Steve Jobs first iPad](https://dev-to-uploads.s3.amazonaws.com/uploads/articles/dm7lwis92tlusq9qdd0c.jpeg)

You gotta understand that working with children with autism has its own unique challenges, chief among them being fleeting attention and motivation. However, the response I got when I started incorporating an iPad into my sessions was incredible. Suddenly, gaining the attention of my clients and keeping them motivated was **much** easier and sessions were more productive as a result. 

I fully expected to see an onslaught of applications aimed at supporting this niche, but that never happened. Don't get me wrong, there have been tools like [Proloquo2Go](https://www.assistiveware.com/products/proloquo2go) and [CentralReach](https://centralreach.com/) that have done great things, but there's so much more that can be done. 


![Proloquo Screenshot](https://dev-to-uploads.s3.amazonaws.com/uploads/articles/5q1me420ywj722pz7cqf.jpeg)

When I didn't see what I thought should exist, I began working out my ideas and hired freelancers to help start putting things together. That has been a very slow process, due mainly to the fact that it has been self funded. 

Around the same time, the company I was working for decided to transition from pen/paper data collection to data collection using tablets. The software exported data in a format that was difficult for employees to manage and the developers recommended we learn to write macros to format the data as needed. I had no idea what a macro was, but I volunteered to give it a shot. 

In retrospect, I think that's the moment everything changed. I felt like that 12 year old kid again, only this time I had the mental faculties of an adult and access to Google. Once I realized what was possible I was hooked. I spent as much time as I could spare working on it for three months, but it was worth it. The end result allowed the company to know everything they need to know about a program in order to make clinical decisions quickly. A process that used to take several weeks suddenly took a matter of minutes. It was a game changer. 

The more I thought about how technology could impact the quality of care the more I felt it was necessary. [According to the CDC](https://www.cdc.gov/ncbddd/autism/data.html), 1 in 44 children in the United States are diagnosed with autism annually. With roughly [3.5 million](https://www.cdc.gov/nchs/fastats/births.htm) births per year, that's approximately 80,000 diagnoses annually. Additionally, the [average annual cost](https://www.beaconhealthoptions.com/autisms-cost/#:~:text=A%20recent%20study%20estimates%20the,four%20years%20of%20treatment%3A%20%24240%2C000.) for ABA services is $60,000. Typically, ABA services begin around 3 years of age and terminate when the child starts school (around 6), which means that **approximately 2 billion dollars** is spent on ABA treatment annually in the United States. 

So who pays for that?

In California, insurance companies were mandated to provide coverage for ABA services back in 2012 and most states have followed suit. Although that has ensured access to care, it has also created a dynamic with pressure to keep the cost of care low. 

When all is said and done, there is a clear need to increase the quality and portability of care while decreasing the cost of that care. I believe technology is the means to make that happen and my hope is my shift to software engineering can expedite that goal.