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We Are All about Value Based Learning!

Assent is related to consent but it expands even more into clients’ autonomy and understanding of their involvement in therapy.

Assent can be defined as the expression of remission or agreement(without persuasion) to participate in the treatment plan.

Behaviors that demonstrate assent include: 

  • Saying “yes” in their preferred form when asked to do an activity

  • Engagement in the activities without prompting or coercion

  • Looking toward materials or clinician (eye contact is not a required as a sign of assent)

Samples of gaining assent: 

  • A visual schedule that can be changed by the client
  • Staff based the session flow on their client’s decisions for activities
  • Giving clients space and time to process sensory input

Assent withdrawal can be defined as the presentation of objection or resistance to participate in the treatment. At any time during treatment, a cłient may withdraw assent Clients show assent withdrawal through a variety of verbal and nonverbal behaviors.

Society has conditioned us to believe that maladaptive behaviors are a problem and can be fixed. However, we should be viewing the “interfering behaviors“ as assent— withdrawal and as communication. Yes, there IS a problem. The client is not the problem, but something in the environment, the activity, or the staff’s approach Is the problem. 

Here are some fundamental principles to implementing a value – based model:

  • Teaching self – advocacy statements through Functional Communication Training
  • Choices are maximized during the sessions
  • Creating intrinsic motivation vs extrinsic motivation. Their wants, needs, and interests are prioritized during planning and the clients help create the goals
    • Compliance training = extrinsic motivation
    • Client creating goals = intrinsic motivation
  • Reinforcement of escape – maintained behavior: These behaviors are honored as though it were communication
  • Changing the environment and contingencies to obtain more assent behavior
  • Avoiding full –physical prompts: We avoid training submission by not using full – physical prompts. If you would not use a full – physical prompt on a neurotypical client, why should you do it with any client?
  • Using reinforcement over punishment procedures: this is part of the BACB Ethics Code. Using effective reinforcement and functional communication are the best ways to avoid physical prompting. Compliance is not the goal, client’s independence is.