Client assent in ABA therapy

By: Cristina Martínez

M.B.A, M.S, BCBA, LBA

Client assent in ABA therapy

The BACB Code of Ethics clearly specifies the need to obtain consent from parents and/or caregivers for the implementation of ABA therapy. The 2022 update of this document moves towards establishing client assent as a fundamental element in the practice of ABA therapy. And we say it moves forward not only because it takes a step further on the road towards respecting the client, their preferences, their interests, but also because it ensures that the client is involved in their own intervention process and that they are motivated and committed. Ultimately, we are talking about guaranteeing the best possible results with our work, and that the goals set are achieved in less time and with greater effectiveness.

It is important to recognize the difference between parental and caregiver consent and client assent: Client assent can be given verbally or non-verbally and is of an ongoing nature. Parental consent is legal in nature and is often given on behalf of children, most of whom are minors, hence the complexity of client assent, given that, regardless of the client's age and communication skills, their opinion is essential in designing and implementing ABA therapy.

The responsibility to place the client's interests and safety above all other elements at all times is not exclusive to ABA professionals. In fact, it is a joint effort in which parental involvement is essential. It is imperative that everyone involved in the therapeutic process appreciates the importance of client assent, is trained, and develops skills around its measurement. So that:

• listening to the client is very important. Communication strategies may vary according to each individual, and the identification of verbal, extraverbal, or attitudinal signals may be the key to understanding what the client wants to transmit;

• client assent also implies its withdrawal. Therapists, analysts, and caregivers must continually watch for clues that may indicate that the client is not comfortable with what is happening. In such a case, they should ask whether the proposed activity was extremely difficult, whether the stimulus was aversive, or whether reinforcers were used appropriately;

• early assessment of the potential effects of a particular activity should be incorporated as standard practice. This ensures that steps can be taken to modify the task to make the client as comfortable as possible;

• it is advisable to consider several options for the activities that are planned. Some may fit better with a client’s interests, and in this sense, we show respect and compassion towards the client;

• open and transparent communication should be established, so that all variables involved in the implementation of therapy are clearly stated. In this sense, defining guidelines that will help them understand expectations and anticipate goals of the process is essential;

• intensive work must be done on pairing. The therapist or analyst must become a reinforcer themselves, and thereby ensure that the client receives both their presence and the work they do in a rewarding way;

• it is basic to promote naturalistic teaching and fun learning. Beyond their importance for the generalization of the skills worked on, these elements guarantee that a client is naturally and happily involved in the therapy in which they are the protagonist.

A client is an autonomous being, and this is a right that must be respected. At ABS, we are committed to providing our services with the highest quality. In doing so, we ensure that the impact of our presence in the lives of families is positive... and, for that, we must put the client first. We are aware of this, and make sure that each of us not only puts it into practice, but advocates for it.

Client assent in ABA therapy

Client assent in ABA therapy

Client assent in ABA therapy

Cristina Martínez

AbS TEAM

AbS TEAM

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