This comparison draws in part from “Prioritizing Assent and Choice for Children with Emotional and Behavioral Disorders” by Johanna Staubitz, Ph.D., BCBA-D (BehaviorLive), and extends it with peer-reviewed research from our library of 27,900+ ABA research articles. The decision framework, BACB ethics code references, and cross-links below are synthesized by Behaviorist Book Club.
View the original presentation →The clinical approach to interfering behavior in children with EBD has evolved significantly over the past two decades, driven by advances in trauma-informed care, the growing research base on assent and choice-based instruction, and ethical scrutiny of the historical use of aversive and restrictive procedures with vulnerable populations. The following comparison contrasts traditional behavioral intervention approaches with the compassionate, choice-based model current best practices recommend for EBD populations. Both approaches share a commitment to evidence-based practice; they differ in how they conceptualize the therapeutic relationship, incorporate client voice, and select among intervention options.
| Factor | Evidence-Based Approach | Traditional Approach |
|---|---|---|
| Conceptualization of interfering behavior | Traditional: interfering behavior as a learned response maintained by reinforcement contingencies; target behavior for reduction | Compassionate/choice-based: interfering behavior as communication and potentially as trauma response; function requires thorough assessment including trauma history |
| Role of assent | Traditional: assent may not be systematically obtained; compliance assumed once consent is given by guardian | Compassionate/choice-based: ongoing assent is an explicit clinical target; behavioral indicators of assent monitored continuously and respected |
| Primary behavior reduction strategy | Traditional: extinction with differential reinforcement; may include response cost or time-out in restrictive settings | Compassionate/choice-based: DRA, NCR, and antecedent modification as first-line strategies; extinction used only when trauma history is ruled out and less restrictive alternatives exhausted |
| Role of choice in intervention | Traditional: choice not systematically incorporated; instructional sequences are clinician-directed | Compassionate/choice-based: choice embedded at task, reinforcement, and goal levels; student preference assessed regularly and used to structure sessions |
| Cultural responsiveness | Traditional: cultural context may not be explicitly incorporated; intervention standards applied uniformly | Compassionate/choice-based: cultural context explicitly assessed and incorporated; behavioral expectations evaluated against cultural norms; disparate identification patterns considered |
| Outcome measurement | Traditional: behavior frequency and intensity; skill acquisition rates | Compassionate/choice-based: behavior data plus engagement quality, therapeutic alliance, affect, and quality-of-life indicators |
The ABA Clubhouse has 60+ on-demand CEUs including ethics, supervision, and clinical topics like this one. Plus a new live CEU every Wednesday.
Use this framework when approaching prioritizing assent and choice for children with emotional and behavioral disorders in your practice:
Does the data support a need for intervention? Is there a meaningful impact on the individual's quality of life, safety, or access to reinforcement?
YES → Proceed to assessment NO → Document reasoning, monitor
A functional assessment should guide intervention selection. Avoid defaulting to standard protocols without individual analysis. Consider environmental variables, setting events, and private events.
YES → Select evidence-based approach matched to function NO → Complete assessment first
Goals should be co-developed. Assent and informed consent are ethical requirements. The individual's preferences and values matter in selecting both goals and methods.
YES → Proceed with collaborative plan NO → Engage in shared decision-making
This course covers the clinical and ethical dimensions in detail with structured learning objectives and CEU credit.
Prioritizing Assent and Choice for Children with Emotional and Behavioral Disorders — Johanna Staubitz · 1 BACB General CEUs · $0
Take This Course →We extended this decision guide with research from our library — dig into the peer-reviewed studies behind each approach, in plain-English summaries written for BCBAs.
280 research articles with practitioner takeaways
279 research articles with practitioner takeaways
258 research articles with practitioner takeaways
1 BACB General CEUs · $0 · BehaviorLive
Research-backed educational guide
Research-backed answers for behavior analysts
All behavior-analytic intervention is individualized. The information on this page is for educational purposes and does not constitute clinical advice. Treatment decisions should be informed by the best available published research, individualized assessment, and obtained with the informed consent of the client or their legal guardian. Behavior analysts are responsible for practicing within the boundaries of their competence and adhering to the BACB Ethics Code for Behavior Analysts.