To combine narrative and rating-scale client feedback in ABA, preserve each exact source, question, response mode, context, and time. Code narrative themes transparently while retaining original meaning, uncertainty, minority views, and corrections. Relate themes to ratings without forcing agreement or converting comments into invented scores. Protect privacy and route each actionable finding to a qualified owner.

Define what each format contributes

A rating can support a consistent bounded comparison. Narrative can explain context, priorities, tradeoffs, unexpected effects, and desired change. State the decision each field informs and whether either format is optional. Give Esme accessible choices for providing one, both, neither, or a correction.

Preserve source and authorship

Store the exact prompt, response, date, setting, mode, access support, partner role, and version. Separate Esme's own words or selected message from proxy report, staff summary, and clinician interpretation. Keep translations and summaries linked to the original and identify who produced them.

Create a transparent coding guide

Define each theme with examples, exclusions, multi-code rules, uncertainty, and an other category. Train reviewers on the same sample and check agreement across favorable, critical, mixed, brief, AAC, and context-dependent narratives. Revise ambiguous definitions before using themes for a decision.

Retain the original narrative

A coded theme helps aggregation but never replaces Esme's response. Preserve original wording, accessible format, correction history, and context under appropriate access controls. Give report readers enough source-labeled examples or summaries to understand the theme without exposing identities or unnecessary sensitive detail.

Examine alignment carefully

Define what apparent alignment and discordance mean before review. A high rating plus a critical comment can reflect an overall acceptable plan with one serious issue. A low rating plus a positive detail can reflect a valued support within an unacceptable experience. Ask the client how the responses fit together; mathematical consistency cannot answer that question.

Handle missing formats

Report rating only, narrative only, both, neither, inaccessible, declined, and unknown states. Avoid restricting the analysis to clients who complete both formats unless that paired cohort is the explicit question. Show the full reporting funnel and the paired subset separately.

Protect narrative privacy

Free text can reveal health details, staff identities, locations, family information, or rare events. Limit prompts, viewers, exports, examples, search, retention, and secondary use. Route urgent information to the appropriate owner while protecting unrelated content. Explain the actual audience to Esme before collection.

Connect themes to action

For each actionable theme, record the supporting responses, qualified owner, interim protection, investigation, decision, implementation, client communication, confirmation, due date, and closure. A common favorable theme still needs no automatic clinical conclusion, while one serious report may require immediate individual follow-up.

Report mixed evidence honestly

Present ratings, distributions, narratives, themes, discordant pairs, missingness, corrections, and uncertainty together. State which conclusions come from direct client evidence, proxy evidence, or reviewer interpretation. Avoid using a quote as proof that every client shares the same view or that a plan caused an outcome.

Trace Esme's report from source to action

For Esme, trace every source-labeled ratings and narrative responses linked without forcing one into the other from the original event and access state through the frozen mixed-format client-feedback evidence table, calculation, display, qualified interpretation, decision, implementation, client communication, confirmation, and closure. Preserve source, author, version, time, correction, missingness, and uncertainty at every handoff. A dashboard or report can organize evidence; it cannot supply missing authority, client meaning, or causal support.

Build Esme's operational report record

Create one versioned mixed-format client-feedback evidence table for the goal-acceptability review. Record purpose, audience, qualified owner, cohort definition, unit, exposure, maturity, measure and access versions, direct and proxy sources, privacy, consent and assent when applicable, AAC, raw counts, formulas, missing states, corrections, claims, actions, due dates, confirmation, distribution, retention, and next review. Limit row-level access and copied narrative to approved roles and uses.

Work through Esme's example

Esme's cohort contains 16 usable ratings and 12 narratives; 10 clients supply both. Among those 10 paired records, three have a rating and narrative that appear discordant under the predeclared review rule. Report 16 ratings, 12 narratives, 10 paired records, and 3/10 flagged pairs. Review each flag with the client before changing any classification or plan. Preserve the frozen population, every intermediate state, raw counts, denominators, missing reasons, source labels, versions, corrections, actions, and open work. This fictional example demonstrates one reporting control. It supplies no universal threshold, validation result, legal conclusion, treatment effect, population estimate, or outcome guarantee.

Use Esme's evidence for a bounded decision

Before release, identify the exact decision and authorized owner. For Esme, document what the report supports, what it cannot answer, current protection, further evidence, implementation test, client-facing explanation, disagreement route, next review, and reopening rule. Hold a decision when its cohort, access, source, calculation, privacy, or version evidence is unreliable. Preserve urgent individual routes while aggregate review continues.

Review Esme's results without losing the denominator

For Esme, show counts beside percentages and retain eligible, immature, inaccessible, missing, unfavorable, corrected, overdue, suppressed, and reopened items. Segment only with compatible definitions and privacy-safe groups. Explain measure, cohort, access, collector, setting, and service changes before comparing. Keep direct client report separate from proxy evidence, clinical outcome, treatment integrity, attendance, authorization, and payment.

Address Esme's main reporting risk

Reducing Esme's detailed comment to a positive score can erase the condition or support that made the experience acceptable. Her table preserves text and rating as related but distinct evidence. Review cohort construction, direct access, authorship, privacy, missingness, calculations, versions, corrections, claims, and action response separately. Accurate arithmetic cannot rescue a report built from the wrong population or measure. One favorable aggregate cannot close a serious individual concern, and one critical response cannot describe every client.

Choose Esme's next reporting action

The reviewer confirms two contextual explanations with Esme and another client, leaves one pair uncertain, and records actions while preserving the original responses. Record the responsible roles, affected clients and reports, interim safeguards, corrected artifact, downstream recipients, due dates, validation evidence, accessible explanation, current state, and next governance check. Keep original evidence and report versions available. An auditable correction changes the current artifact and retains what readers previously received.

Apply current professional sources to Esme's report

For Esme, the BACB ethics hub identifies the current Ethics Code, which addresses understandable communication, client involvement, consent and assent when applicable, confidentiality, assessment, documentation, risk, and evaluation for covered people. BACB has no separate organizational jurisdiction. The BCBA outline is examination content and supplies no practice authority. The CASP public summary gives high-level context for ABA treatment of autistic people. An evidence-based ABA framework supports integrating research evidence, clinical expertise, client values, and context.

Use reporting evidence carefully for Esme

For Esme's report, the treatment-integrity practitioner guide, Essig review, impact study, and reporting review support explicit units, procedures, representative evidence, observer controls, and cautious interpretation. They create no universal client-experience threshold, reporting formula, or causal conclusion. Breaux and Smith offer assent-focused practice guidance in an evolving evidence base. ASHA supports continuous AAC access.

Close Esme's reporting review

Review the mixed-format client-feedback evidence table with Esme, the responsible clinician, measurement and operational owners, privacy and access roles, and the specialists named in the manifest. Verify that the cohort, access, sources, calculations, claims, actions, and limits remain understandable and reproducible. Preserve client corrections and open concerns. Keep this page draft and noindex until every required review is complete.

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