Applied Behavior Analysis can be significantly enriched when children are included and encouraged to participate in their behavior plan. To build a learning foundation on relatable and ethical care, Helping Hands Family uses assent-based ABA therapy.
Assent involves a child voluntarily agreeing or willingly participating in an activity or intervention. Similar to consent, where a parent or legal guardian acknowledges and accepts a treatment or legal agreement, assent-based treatment ensures that we respect a child’s preferences and autonomy at the start of a behavior therapy plan and at various milestones.
Unlike typical forms of consent, which often involve verbal and/or written agreements, we may need alternative approaches to obtain assent from a child with autism. Two barriers to confirming assent that clinicians face are:
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- Children may not possess the prerequisite skills needed to fully understand a request for permission to participate in a session.
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- Children may not be able to verbalize their agreement for a proposed intervention or plan.
Acquiring client assent is an ongoing process. During the initial assessment, throughout the therapy sessions, and at each assessment, we request client assent by:
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- Asking for permission
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- Listening to feedback
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- Observing nonverbal cues
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- Noting a child’s willingness to participate
How Do We Obtain Assent?
To ensure that each child’s desires and preferences are respected throughout ABA therapy in Paoli, PA and our other clinics, here are several ways that we obtain assent:
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- Explain proposed activities or interventions in simple terms: Keeping each child’s age and developmental stage in mind, we use age-appropriate language and avoid confusing jargon to maintain transparency. If necessary, we use visual aids and other communication tools to ensure the child understands.
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- Ask if they voluntarily agree to participate in the activity or plan: We can acquire voluntary approval to participate in a new plan or activity with a simple yes, nod, or affirmative gesture. Even if the child cannot articulate an answer, we use other strategies such as providing various options and allowing them to choose which activity interests them most. This ensures the client remains an active and willing participant in their plan.
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- Clarify that they would like to continue and regularly evaluate feedback: As the lesson or plan commences, we remain open to adjustment by frequently checking in with our clients. We ask clarifying questions related to how they feel about the activities and regularly ask if they would like to continue. This additional questioning ensures our behavior therapy interventions remain ethical and enjoyable for the client. We also assess client feedback by evaluating their reactions to an activity. Positive reactions include:
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- Focused attention
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- Joyful participation
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- Authentic enthusiasm
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Signs of frustration, discomfort, and reluctance may signal adopting a new therapy approach.
Since child-led, play-based ABA therapy is a guiding principle at Helping Hands Family, when a client indicates that they would like to stop or try something else (withdrawing assent for that activity), our adaptive clinical staff accommodates by offering viable alternatives that are equally fun, educational, and engaging.
Family Involvement Positively Influences Outcomes & Promotes Assent
To provide ABA therapy that supports each child’s preferences and needs, inclusive family involvement is key for our autism services in West Chester, PA and throughout the northeast. Through initial assessment interviews and ongoing feedback from parents and caregivers, our ABA team remains well-equipped to:
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- Provide interventions that are motivating, relatable, and less restrictive for the client.
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- Address problematic behaviors, communication needs, or other developmental skills with heightened accuracy.
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- Maintain an ethical autism treatment plan that respects the needs and desires of each client as their goals and preferences shift.
At the foundation of each behavior therapy plan, child-led interventions, respect for each client’s wishes, and open channels of communication pave the way to ABA therapy that is respectful, ethical, and beneficial.
