Assent in Applied Behavior Analysis

Assent is an individual’s agreement to participate in educational and clinical interventions. Some practitioners have argued opportunities for assent (and dissent) should be presented and reinforced with all individuals across all contexts, irrespective of circumstance or benefit. Yet as verbal behavior, assent is constrained by contingencies of reinforcement and the individual’s ability to appraise benefits and risks of a treatment decision, or capacity. Some opportunities for assent may be necessary and beneficial for the individual, whereas others may conflict with their learning goals, the preferences of their caregivers, and the ethical obligations of professionals who support them. We are concerned a newly proposed approach, “assent-based ABA,” departs from a humanistic, behavior-analytic account of assent, diminishing therapeutic learning opportunities. In this paper, we examine assent in ABA programming, addressing issues of capacity, assent and dissent, autonomy and the best interest standard, voluntariness versus coercion, and social validity. We outline our concerns with “assent-based ABA” and conclude with practical considerations for assent in ABA programming.