Association for Behavior Analysis International

The Association for Behavior Analysis International® (ABAI) is a nonprofit membership organization with the mission to contribute to the well-being of society by developing, enhancing, and supporting the growth and vitality of the science of behavior analysis through research, education, and practice.


50th Annual Convention; Philadelphia, PA; 2024

Event Details

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Symposium #449
CE Offered: BACB — 
Diversity submission Assent-Informed Treatment: Scaling Compassionate Care in a Large Organization
Monday, May 27, 2024
11:00 AM–11:50 AM
Convention Center, 100 Level, 113 A
Area: AUT/OBM; Domain: Service Delivery
Chair: Tamara S. Kasper (Kasper Enterprises/Caravel Autism Health)
Discussant: Lilith Reuter Yuill Yuill (Comprehensive Speech and Therapy Center)
CE Instructor: Tamara S. Kasper, M.S.
Abstract: Obtaining client assent to treatment with neurodivergent individuals may help improve autonomy, self-determination, self-advocacy, trust, clinician rapport, quality of life, and treatment outcomes. Social validity is a core component of interventions based on applied behavior analysis; thus measures of engagement and quality of interactions should be collected regularly throughout treatment. The purpose of the presentation is to share the challenges and successes in making these changes organization-wide. Process-level guidance for maximizing choice and autonomy for recipients of ABA services will be shared. A 10-step process for implementation of assent-informed treatment which includes ongoing feedback loops that aim to ameliorate intrusive/restrictive interventions and reduce risk of client victimization in this neurodiverse population. A risk-benefit analysis will be shared that can be used to determine if honoring withdrawal of assent may not be appropriate. An expert in developing and setting up processes and systems to make organization-wide change will serve as discussant.
Instruction Level: Basic
Keyword(s): Assent, OBM, Training
Target Audience: "Basic" Attendees should be knowledgeable of programming for autistic individuals and have a desire to implement assent-informed treatment in their practice or organization.
Learning Objectives: At the conclusion of the presentation, participants will be able to: (1) identify at least 3 reasons why obtaining and honoring client assent is important (2) identify methods to identify and shape assent-informed treatment in practitioners (3) identify at least 5 components to consider when conducting a risk-benefit analysis around assent withdrawal
Diversity submission 

Maximizing Motivation: Transforming Applied Behavior Analysis (ABA) Through Assent

TAMARA S. KASPER (Kasper Enterprises/Caravel Autism Health)

Increased emphasis on client assent refocuses the importance of establishing/maintaining motivation, promoting self-advocacy, and building autonomy. The Ethics Code for Behavior Analysts (2022) challenges us to define and measure assent and assent-withdrawal for all clients. The development of standard practices within a large organization is critical to establish methods to proactively notice, measure, and systematically shape indicators of assent and assent-withdrawal as a point of initiation of therapy and throughout treatment (Rajaraman, Gover, Cammilleri, Donnely & Hanley, 2022). The development of an assent-based treatment standard and 10-step training program will be reviewed. The successes and challenges of implementing assent-based treatment strategies and the necessity for individualization across clients, clinicians, learning environments, and clinics, which may present with diverse needs and cultural contexts, will be shared. Analysis of data on happiness/engagement/self-advocacy (Engagement Scale) and assent withdrawal (Calm and Disruptive Withdrawal of Assent) and the impact on existing clinical quality metrics will be presented.

Diversity submission Navigating Assent Withdrawal: Training Clinicians in a Risk-Benefit Approach
KAREN NOHELTY (360 Behavioral Health)
Abstract: All individuals are capable of providing assent and withdrawing assent to treatment. However, situations may arise where caregivers or guardians may proceed with provision of strategies regardless of an individual’s assent. While some situations may lead to a clear rationale for proceeding with strategies regardless of client assent (e.g., when there is a clear safety risk), in many circumstances the course of action may be unclear. This presentation will outline a risk-benefit analysis approach to determine if assent withdrawal should be honored. The approach incorporates a variety of factors, including the impact on the therapeutic relationship, potential short- and long-term side effects, training needs, and potential effect on quality of life. Strategies for training clinicians in these and other assent-protocols will be discussed. Incorporation of assent-based strategies organization-wide will be reviewed toward the overall goal of equipping clinicians with concrete skills to integrate assent-based strategies into their standard of care in a way that balances client autonomy and joy, acquisition of meaningful skills, and long-term impacts.



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