To reassess community participation after access or context changes, preserve Mako's earlier place, activity, role, relationships, communication, transportation, schedule, cost, environmental access, supports, health, safety, priorities, and experience. Version every material change, repair access first, and collect a focused sample of real opportunities. Compare phases only when eligibility, participation forms, and review windows remain explicit.

Lock Mako's earlier phase

Preserve chosen role, participation forms, people, access, communication, transport, schedule, cost, support, health, safety, scoring, and Mako's experience.

Version meaningful changes

Record activity, role, relationship, power, location, route, timing, price, communication, environment, policy, staff, support, health, safety, and priority changes.

Join flags to each event

Attach all applicable changes to the same event. Avoid summing category counts as unique affected opportunities.

Repair access first

Restore communication, transport, schedule, entry, equipment, sensory access, partner competence, privacy, health support, and safe exit before interpreting Mako's performance.

Compare a focused sample

Use comparable real opportunities and person-rated experience. State which changes occurred together and avoid assigning causality to one repair without a stronger design.

Build Mako's community-participation reassessment

Create one versioned record for the volunteer music program. Include Mako's chosen activity, place, role, people, participation forms, communication, transportation, schedule, cost, environmental access, supports, partner response, privacy, health and safety routes, eligible opportunities, person-rated experience, invalidity, missingness, correction, action owner, and reassessment trigger. Store purpose-needed information with role-limited access. Use one dated change register joined to event-level evidence. Preserve both phases and every applicable flag so overlap and missingness remain visible.

Validate Mako's evidence

Reproduce 15/20 earlier, 8/20 later, six schedule flags, five partner flags, four transport flags, four overlapping events, 11 unique changed events, and 10/12 after repair.

Connect Mako's evidence to an action

The program restores the workable schedule, clarifies partner response, and secures transport before the new sample. The conclusion stays limited to the current volunteer setting.

Work through Mako's example

Mako rates 15 of 20 earlier volunteer events workable and eight of 20 after changes. Six later events have a schedule change, five a partner change, and four a transport change. Four events carry overlapping flags, leaving 11 unique changed events. After repairs, 10 of 12 events are workable. Preserve every planned and eligible opportunity, chosen participation form, access version, support, partner response, unavailable event, correction, unresolved item, and experience rating. This fictional example demonstrates one assessment control. It supplies no diagnosis, treatment effect, ADA result, Medicaid eligibility, HCBS compliance finding, safety clearance, coverage result, or outcome guarantee for Mako.

Address Mako's main interpretation risk

Adding six, five, and four yields 15 flags although four events overlap. Calling eight of 20 reduced participation ability would ignore system changes and Mako's revised role. Review selection, access, transport, cost, schedule, communication, environment, partner availability, role quality, relationships, privacy, health, safety, person priorities, missingness, and design strength separately. Attendance, duration, eye contact, calm appearance, task completion, unsupported independence, staff approval, or contact counts cannot establish participation, belonging, consent, safety, or quality.

Keep Mako's clinical scope explicit

For Mako's community-participation reassessment, the CASP public summary provides high-level ABA behavioral-health-treatment scope for autistic people. The current BACB Ethics Code addresses competence, client involvement, consent and assent when applicable, assessment, risk, data, documentation, confidentiality, and evaluation for covered people. The BACB outline is examination content. These sources do not establish a universal community goal, legal entitlement, funding, emergency authority, or permission to replace Mako's priorities with staff preference.

Protect communication across Mako's community route

ASHA's AAC portal says AAC users should always have access to their tools or devices. A 2026 systematic review of AAC research for autistic adults and children found heavy emphasis on requesting and variable study quality and generalization evidence. Mako's assessment should preserve communication during travel, arrival, participation, relationships, privacy, breaks, refusal, repair, pain, and emergencies rather than measuring only requests in a teaching session.

Keep Mako's participation person-directed

The federal Administration for Community Living describes consumer control through person-centered planning, supported decision-making, and accessible transportation, with individual preferences and needs driving community supports. This broad public framework supports asking what Mako values and which access conditions help. It is not an ABA protocol, payer rule, or promise that a particular resource exists.

Scope community-integration law for Mako

The Justice Department's community-integration page explains the ADA Title II integration mandate for state and local government disability services and the conditions described in Olmstead. Its effective-communication guidance covers relevant Title II and Title III duties and asks entities to consider communication nature, length, complexity, context, and usual method. Applicability, reasonable modification, fundamental alteration, and remedy questions require qualified legal or access review; Mako's clinical assessment cannot decide them.

Use CMS community sources within their program scope

CMS's HCBS community-integration FAQ discusses person-chosen interests, routines, relationships, transportation, natural supports, staffing, and annual plan review for Medicaid HCBS settings. The HCBS CAHPS survey page describes a cross-disability experience survey for adults in state Medicaid HCBS programs covering services, communication, choice, transportation, safety, inclusion, and empowerment. These sources offer useful constructs for Mako; they do not govern every ABA service or substitute for the exact state program, payer, measure manual, or individual plan.

Preserve Mako's urgent route

For danger or a medical emergency in the United States, SAMHSA directs people to call 911 or go to the nearest emergency room. The community-participation reassessment should identify current emergency, medical, crisis, protective, and mandated-reporting routes for the actual setting. Routine data collection, payer contact, supervisor approval, or a planned session should never delay immediate safety action.

Choose Mako's next bounded action

Mako requests another review after the next performance cycle or sooner if role, relationship, access, communication, health, safety, or interest changes. Record the qualified owner, evidence, effective date, activity and role version, access and support arrangement, privacy and safety route, implementation check, accessible explanation, disagreement or complaint path, and reassessment trigger. Preserve earlier evidence when the context changes.

Close Mako's assessment

Review the community-participation reassessment with Mako, the qualified clinician, chosen supporters, community partners, access owners, and specialists named in the manifest. Confirm that chosen participation, physical presence, communication, access, support, partner behavior, clinical judgment, legal or payer action, safety, and person-rated experience remain distinct; every denominator is reproducible; AAC, privacy, basic needs, prescribed care, refusal, break, and safe exit remain protected; urgent needs received action; and conclusions stay bounded to sampled opportunities. Keep this page draft and noindex until every required review is complete.

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