How Monica Ruffalo Found a Career and a Calling in ABA

Until recently, Monica Ruffalo, MA, BCBA, lived in Twentynine Palms, Calif., a small desert city in the southern Mojave Desert, home to one of the country’s largest Marine Corps bases. It was not, by any stretch of the imagination, an applied behavioral analysis (ABA) hub. The nearest and only board certified behavior analyst (BCBA) within 25 to 50 miles was Monica herself.

She is also the parent of a child with autism. 

Over the past three years, the former Marine Corps signals intelligence analyst has risen to be a clinical director at Center for Social Dynamics (CSD). She started as an entry-level registered behavior technician, then BCBA and clinical leader before stepping into her current role as a clinical director—all while her husband remained on active duty and raising her own special needs son.

What she built from all of it with CSD’s support is something she never planned, and wouldn’t trade for anything.

The Moment Everything Changed

After serving in the Iraq War and leaving the Marines in 2011, Monica began pursuing a biochemistry degree on a pre-med path. She was deep into MCAT preparation when her son, Aaron, now 13, was diagnosed with autism. 

“When I met his first BCBA,” she recalls, “I just thought she was the most amazing person on the planet.”

That’s when she made a life-changing move.

She set the MCAT aside and enrolled in a master’s program in ABA at the University of Arizona, completing her coursework online while doing her supervised hours and practicum in person at a Tucson clinic. It was a demanding career endeavor to take on while simultaneously learning to be the parent her son needed.

It wasn’t easy.

There was a night that she still goes back to. Aaron was four or five years old having a meltdown that had been going on for hours—the kind of intense, unrelenting distress that parents of kids with autism know bone deep. They were in their early thirties and just trying to hold everything together, working, studying, and life. Finally, her son fell asleep. And Monica fell apart.

“I was just crying and crying. I didn’t know what to do, thinking ‘are we going to have to put him in a home?’ I was crushed, just crushed,” she recalls. “We sat there a while and talked and decided let’s just hit therapy hard. Let’s get him into ABA and see what happens.” 

She pauses and smiles. “That’s when everything happened.”

How CSD Nurtures Its Own

Monica’s early work experience prior to CSD was a formative shock. Aaron is gentle and sweet, his hardest moments the long, wailing meltdowns. The Tucson clinic where she interned supported autistic clients with high support needs, including teenagers her own size with severe maladaptive and aggressive behaviors—presentations for which, at the time, she had no real framework 

One day, a teenage girl came in overstimulated and obsessively on her phone. When her mom suddenly snatched it away, the girl bolted, bit a doctor, and Monica and a colleague had to physically restrain her.

“I melted and cried for hours,” says the stoic Marine vet quietly. “Just seeing someone in that level of distress. It hit me so hard emotionally. I feel for my clients so deeply, and I think that’s what makes me good at my job.”

Her husband’s military career transferred the family from Arizona to Virginia, where Monica worked as an in-home registered behavior technician (RBT) before orders brought them to California and she joined CSD. 

She came in as a behavior technician and rose to clinical leader, completed her course, passed her BCBA exam, and was promoted to clinical director (CD). This role oversees programming and parent training, runs assessments, and collaborates with outside providers. Typically, a CD manages a caseload of around 40 clients and around 30 behavior specialists.

Three years into her CSD journey, she says wholeheartedly, she has no plans to leave.

A big part of what keeps her is the people and CSD’s culture. She names her mentors at CSD—Jennifer Ryden, Charlene Hansen, Joseph Finn—with obvious warmth.

“When I first started and got stuck on something, I would check in with the people I look up to and lean on. We don’t always have the answers, and that’s far better than just offering a bandaid.”

Monica encourages every RBT and Clinical Leader she supervises to explore CSD’s free tuition assistance and professional development programs early. While the GI Bill covered her own education, she has watched CSD embrace team members’ growth through the support of its  Dreams Come True tuition reimbursement program, of which she is a huge advocate.

 “We are like family here. It sounds cliche, but it’s true.”

“If you feel like your company is invested in you, you’re going to be more invested in the company, in the clients, and in the work. We are like family here. It sounds cliche, but it’s true.”

Monica also values that CSD requires clinical leaders who get their BCBA to formally apply and interview for promotion to clinical director, even after years in post. “You still have to earn it and that helps maintain clinical quality.”

CSD also offers CSD University coursework as part of the official promotion pathway, which teaches the necessary skills to be a successful, high-quality clinician and supervisor.

Understanding the Parent Journey

Monica’s deepest conviction as a clinician is that involving the parent or caregiver is the most important variable in ABA outcomes. This didn’t come from a textbook. It’s personal.

“Aaron would not be doing as well as he does if my husband and I hadn’t gone out of our way to learn as much as we possibly could,” she says strongly. “Skills generalize when the people at home know how to use them, and tend to vanish the moment a technician walks out the door if no one else has been practicing them.”

She also knows firsthand that there is a meaningful gap between knowing what you’re supposed to do and actually doing it in the moment. 

“At home, do I always have the patience to do it the right way? Absolutely not,” she laughs. But as she explains to clients, when you use prompts and the most intuitive approach it usually leads to successes.

“ABA works,” she emphasizes, speaking as both a clinician and parent. “But I’m always honest with families. Yes, we know what we’re supposed to be doing. But are we always going to do the right thing? No. We all have those moments.”

Monica understands the deeper emotional weight of caregiving.  “A lot of my stress as a parent is the anxiety over the far future and what’s going to happen,” she says contemplatively. “We all think it. I don’t think we ever get rid of those feelings.”

“So, so many of us are going through the same experiences. None of us are doing this alone. It’s a community.

What she says helps is knowing she’s not carrying it alone. Every time she gets to sit with a family and say that out loud, she says something eases in her, too. “So, so many of us are going through the same experiences. None of us are doing this alone. It’s a community.”

It’s also why Monica would love to see the field move further in a direction that CSD is already heading, supporting the belief that no one is more of an expert on their child than the parent or caregiver.

“I would love to see ABA as a whole shift to more of a caregiver-led model, where parents are helping run things. Coaching parents and caregivers how to do this and then stepping back—that would free up so much capacity for everyone, and the outcomes would be better for it.”

Winning Over the Skeptics of Online ABA

Monica says from experience about half the families she contacts to schedule their initial virtual assessment push back immediately, and her response is always the same: there is no pressure and no agenda.

“I tell them we’re just going to show up and we’ll hang out online and I’ll observe and assess them, and if they run around, they run around. Nobody’s going to cry. I’m just going to note what I see so I can formulate the best skills and behavior training.”

She says those parents almost always come out of the online session saying it went much better than they expected. What changed her own mind was watching what online virtual therapy does for parent involvement. 

In an in-home session, she says it’s easy for a caregiver to get distracted or hang back. On a screen, they’re present, engaged, leaning in and being coached in real time. 

“We can say, yes, you did that absolutely right. We can see their kids and see their success. Virtual therapy gives us the chance to coach parents through things instead of just being in the home doing it ourselves.”

Monica is also clear that when CSD’s proprietary Virtual Readiness Pathway Assessment Tool indicates virtual therapy isn’t the right fit, an in-home recommendation is the better call for the family in front of her.

The Gap That’s Hard to Close

While living in Twentynine Palms, Monica had a direct view of the ABA access gap for rural and military families, when her insurance did not cover virtual ABA. Non-coverage often means the families most likely to be geographically isolated are the ones blocked out of the online ABA delivery platform that’s best suited to reach them.

She saw the human cost of this close up. A local house cleaner with two autistic children at her wits end had no access to ABA services. “She was messaging me and I could tell she was super stressed.”

Ethically, Monica couldn’t advise her on therapeutic approaches with her children. She could, though, point her to books and online courses, such as Alan Kazdin’s parent management resources, and quietly mention the option of requesting a humanitarian military reassignment to a base with nearby services. 

“But it’s hard on military spouses. They end up turning down moves or promotions because the services their kids and the family need simply aren’t there.”

What She’d Tell Someone Starting at CSD Today

Monica is a big proponent of CSD’s career support that provides for its team technicians and clinicians: 100% tuition funding, and structured professional development progression, and the mid-level Clinical Leader pathway that lets you grow clinical skills with real supervision before you’re fully on your own. 

She recommends all of it to the behavior specialists and clinical leaders she oversees, and means it.

What Monica also tells them is that when the work gets hard, when you hit a wall and start questioning whether you can keep going, there are people on CSD’s team you can trust and lean on. Monica says this is a game changer. “Every time I hit that point, it helps me come back to the same place of knowing in my heart that I couldn’t do anything else. This is the only thing I see myself ever doing.”

Asked what her son would think if he could understand all that she does, Monica doesn’t hesitate, except to compose herself with tears starting to well. “He’d be proud, I’m sure of it,” she beams. He knows how much his dad and I love him.” 

Then a pause.

“Everything I’ve done since he was born has been for him. But I’d be lying if I said I don’t also get something out of it. I love helping families. It makes me feel good too.”

Then Monica offers what she most wants parents to hear at the beginning of this journey.

“When we find out we’re going to have a child, we all have a picture of how it’s going to go. Just let yourself rethink that picture. Redefining what your normal looks like is totally fine. If it turns out different than you planned, you just need to know it’s going to be okay. It will be okay.”