Assent

Assent and consent have different authority

Informed consent comes from the person with legal authority after required information, understanding, and voluntariness. Assent communicates willingness from a person who cannot legally consent when assent applies. A parent or representative can provide consent without speaking for the person’s willingness.

The current BACB ethics page says the Ethics Code applies to BCBA and BCaBA certificants and applicants. BACB’s glossary definition says assent may be required by a research committee or service organization, which provides assessment parameters.

Assent needs an accessible form

Ask how the person shows yes, no, pause, discomfort, uncertainty, and “different choice.” Responses may use speech, AAC, sign, gesture, movement, facial expression, approach, distance, or another established form.

Silence, stillness, eye contact, lack of escape, task completion, or absence of a crisis should not be assumed to show willingness. Check communication access, motor demands, language, sensory conditions, pain, power differences, and prior learning.

Explain the activity before asking

Use language and supports the person understands. Explain what will happen, who will be present, the expected time, available choices, possible discomfort, how to stop, and what happens after a decline.

Show materials or the setting when useful. Offer a smaller trial, another time, another provider, a support person, or another method. Avoid asking for assent after the activity has already become difficult to leave.

Watch throughout the service

Assent can change from one session or moment to the next. Recheck when the activity, goal, person, setting, intensity, risk, or health status changes.

The BACB Ethics Code PDF requires assent when applicable and addresses consent, client involvement, communication, risk, and evaluation. It does not turn one initial signal into permanent permission.

A partner response makes assent real

Define what staff do after willingness, uncertainty, withdrawal, or distress. For nonurgent activity, a withdrawal signal should pause the procedure. The team then checks communication, health, pain, environment, understanding, goal fit, and available alternatives.

If staff record “no” and continue unchanged, the data show a signal without a responsive assent process. Supervisors should observe partner behavior as carefully as client behavior.

A fictional art-session example

Fictional child Zahra chooses between painting, clay, or ending the activity. Zahra’s agreed willingness signal is bringing the selected material closer. Moving the material away or selecting “stop” on AAC means withdrawal.

Across six offered art periods, Zahra selects an activity in four. During those four, Zahra withdraws twice. Staff pause within five seconds in one of the two events: 1 of 2, or 50%.

After retraining, staff pause within five seconds in 5 of 5 later withdrawal events and offer the agreed options. The measure describes staff response, not whether Zahra’s assent was freely expressed or whether art therapy was beneficial.

Emergencies and required reports use another route

Immediate safety help, medical care, mandated reporting, or another legal duty may proceed without assent under the applicable authority. The team should explain what is happening when possible, preserve communication and dignity, use the least intrusive lawful response, and restore choice as soon as conditions allow.

An emergency exception should not become a routine-service shortcut. Record the event, authority, actions, notifications, review, and prevention work.

Document the process rather than a checkbox

Record the governing source, person authorized to consent, consent status, why assent applies, individualized signals, explanation method, observed responses, partner actions, changes, and review date. Limit access to sensitive records.

Useful measures include activities with an accessible assent process, withdrawal signals followed by the defined response, unresolved signal disagreements, and client reports. Documentation completeness cannot prove that willingness was voluntary or honored in practice.

Train and audit the partner response

Training should use the person’s actual communication forms and realistic situations. Staff can review examples, rehearse pausing, practice offering alternatives, and receive feedback. Include supervisors, caregivers, substitute staff, and community partners who will implement the process.

Observe across people and settings. A response that works with a familiar parent may be missed by a new technician. Treat missed signals as partner and system errors to correct, and invite the person or a lived-experience reviewer to evaluate whether the response feels genuine.

Practice guidance is still developing

Breaux and Smith propose practical assent-based procedures, including individualized nonvocal withdrawal responses and AAC access. They also describe a limited evidence base. Treat the framework as practice guidance that needs evaluation, client participation, and governing-source review.