Welcome to My Life: Increasing Client Participation and Autonomy Across School, Residential, and Day Habilitation Settings

Overview & Clinical Significance

Client participation in the development of their own programming is both an ethical imperative and a clinical strategy that improves outcomes. Across school, residential, and adult day habilitation settings, the research base is clear: individuals who are meaningfully involved in goal selection, plan development, and ongoing review of their programming are more motivated, more cooperative, and achieve better long-term maintenance of skills.

Yet meaningful participation remains underimplemented across service settings, often because practitioners lack concrete tools for building it or because system-level pressures deprioritize it.

The range of involvement looks different depending on the client's age, communication modality, cognitive level, and the setting. A young child in a school-based ABA program cannot participate in treatment planning in the same way as an adult in a day habilitation program — but both can provide meaningful input.

The task for the behavior analyst is to identify what form of participation is accessible and meaningful for each individual client, not to apply a uniform participation model.

The BACB Ethics Code (2022) Section 2.07 requires that BCBAs develop programming that is individualized to the client and that involves input from the client and their support network. This provision explicitly positions client participation not as an optional enhancement but as a component of ethical practice.

Funders, including developmental disability agencies and school systems, increasingly hold the same position — person-centered planning is mandated in many state regulations governing residential and day habilitation services.

Staff training research provides a useful practical anchor for this topic. Davis et al.

(2026) examined how the teaching interaction procedure supports staff learning of complex skills including those involving professional judgment. Their findings about instructional design for nuanced skills are relevant to training direct support staff in person-centered planning approaches — building genuine client participation skills in a team requires the same careful instructional scaffolding that any complex behavior-analytic skill requires.

Background & Context

Person-centered planning emerged in the disability services field in the 1980s and 1990s as a counterweight to provider-driven models in which services were designed primarily around system efficiency and professional convenience rather than individual preference. PATH, MAPS, and Circle of Support are among the most widely used person-centered planning frameworks, each emphasizing the primacy of the individual's voice, relationships, and goals in shaping the support they receive.

Behavior analysis has an evolving relationship with person-centered planning. Early ABA practice in residential and school settings was sometimes criticized for prioritizing compliance and skill acquisition over individual preference and choice.

Contemporary behavior analysis has substantially updated its approach, with assent, preference assessment, and choice-making now recognized as both ethically required and clinically beneficial. The alignment between high-quality behavior analysis and person-centered planning is stronger than the historical tensions might suggest.

The research on personality and psychological characteristics in individuals with intellectual disabilities, including work by van der Heijden et al. (2025) on personality trait profiles in people with mild intellectual disability, underscores that this population displays significant individual variability in psychological characteristics.

This variability reinforces the case for individualized assessment of how participation is structured rather than applying uniform protocols that assume homogeneity.

Communication access is a pivotal variable in client participation. Individuals who use augmentative and alternative communication, picture-based systems, or other non-verbal modalities must have those systems present and functional during any planning process that purports to include their input.

Asking an individual what they want during a meeting where their communication device is not available, or where the facilitation method relies on verbal fluency they do not possess, is participation in name only.

Setting-specific barriers to participation are real and should be addressed directly. In school settings, time constraints, IEP meeting formats, and the number of professional voices at a planning table can marginalize the student's input even when participation is nominally required.

In residential settings, the power differential between staff and residents can suppress genuine preference expression if staff are not actively trained to create conditions in which residents feel safe to disagree or advocate. Day habilitation settings vary enormously in the degree to which they are structured around participant-defined goals versus provider-defined activity schedules.

Clinical Implications

Clinically, building genuine client participation requires several overlapping skill sets: preference assessment to identify meaningful goals, choice-making instruction for clients whose choice-making behavior has been limited by their history, communication support during planning processes, and systematic inclusion of client input in ongoing program review. None of these components is self-implementing — each requires intentional clinical design and ongoing monitoring.

Preference assessment in the context of programming participation is broader than the standard stimulus preference assessments used to identify reinforcers. It includes identifying what activities the client finds meaningful, what skills they want to develop, what aspects of their daily environment they find most and least satisfying, and what relationships are most important to them.

This kind of preference exploration requires time, multiple methods, and sometimes the involvement of people who know the client well — family members, long-term support staff, community members.

Video modeling research offers a practical tool for building the participatory behaviors that clients need to engage in planning processes. Bartle et al.

(2026) found that the type of exemplars used in video modeling significantly affects procedural skill acquisition — a principle applicable to using video models of self-advocacy and meeting participation to teach these skills to clients who have not had adequate exposure to them.

For clients in residential settings, the clinical implication of genuine participation extends to the structure of their daily routines. Individuals who have meaningful input into their schedule, their activity choices, and the people they spend time with show better behavioral outcomes, fewer instances of challenging behavior, and higher reported quality of life.

This is not anecdotal — it is consistent with decades of research on the relationship between control, choice, and behavioral health in individuals with intellectual and developmental disabilities.

Assessment of barriers to participation should be conducted for each client and each setting. Some barriers are skill-based: the client does not yet have the communication or self-advocacy skills to participate effectively.

Some are environmental: the planning process is structured in a way that systematically excludes the client's input. Some are attitudinal: staff or family members implicitly believe the client cannot meaningfully contribute.

Each type of barrier requires a different intervention strategy.

Ethical Considerations

The ethical mandate for client participation rests on two distinct foundations: autonomy and beneficence. The autonomy argument holds that individuals have a right to participate in decisions that affect their lives, regardless of whether participation produces better outcomes.

The beneficence argument holds that participation produces better outcomes — more motivating goals, more effective programs, better generalization — and therefore the practitioner has an affirmative obligation to build it. Both arguments are valid, and together they create a strong ethical case.

The BACB Ethics Code (2022) Section 1.07 addresses the obligation to treat clients with dignity and respect. Conducting planning meetings about a client without the client present, or with the client present but their input systematically ignored, is a concrete instance of failing this standard.

The practical question for practitioners is not whether client participation is ethically required — it clearly is — but how to implement it effectively given the specific communication needs, cognitive characteristics, and history of each individual client.

Conflicts between client preference and caregiver or system priorities are common and ethically complex. A client in a residential program may express a preference for activities or relationships that their guardians or the residential provider find impractical, risky, or inconsistent with system priorities.

The BACB Ethics Code does not give behavior analysts authority to override guardianship structures, but it does require that client preferences be documented, advocated for, and addressed in the clinical record. When there is genuine conflict between client preference and guardian decision-making, the behavior analyst should document the client's expressed preferences alongside the decision that was made and the rationale.

Video-based assessment tools, including video feedback methods for training, have shown value in building complex skills in practitioners. Long et al.

(2026) documented that video feedback effectively supports skill development in nuanced assessment contexts. Analogously, training staff who work with clients in participatory planning using video models and video feedback can build the facilitation skills that genuine participation requires — skills that are difficult to develop through verbal instruction alone.

Assessment & Decision-Making

Assessment for client participation planning begins with a dual evaluation: what is the client's current repertoire for participating in their own programming, and what structural and systemic barriers exist in their current setting that limit the expression of that repertoire? The first question is a skills assessment; the second is an environmental and organizational assessment.

Both are necessary.

Skills assessment should evaluate the client's communication methods and their effectiveness in novel or unfamiliar contexts, their history with choice-making and preference expression, their experience with self-advocacy in any form, and their understanding of what treatment planning processes are and what role they can play. Some clients will need explicit pre-teaching of planning process concepts before meaningful participation is possible.

Environmental assessment should evaluate: How are planning meetings currently structured? Who speaks and for how long?

Are communication supports available and in use? How is client input solicited, recorded, and incorporated into decisions?

What is the physical arrangement of planning meetings — is the client seated centrally or marginally? What happens when the client expresses a preference that differs from what staff or family prefer?

Stress and physiological factors affect participatory behavior in ways that practitioners should consider. Research on stress markers in individuals with intellectual disabilities, including work by Sánchez-Luquez et al.

(2025) examining cortisol profiles, documents that chronic stress responses can manifest differently in individuals with intellectual disabilities than in the general population. Planning processes that are stressful or confusing — which formal meetings often are — may suppress the very participatory behavior practitioners are trying to elicit.

Structuring planning interactions to minimize stress, using familiar environments and familiar people, and pacing the interaction to the client's regulatory capacity all support genuine participation.

Decision-making about which participation strategies to prioritize should be individualized based on the assessment results. A client who has strong preferences but limited formal communication skills needs communication system development as a primary target.

A client who can communicate preferences but is consistently silenced by meeting dynamics needs system-level change — restructuring how meetings are run — rather than individual-level intervention.

What This Means for Your Practice

For practicing BCBAs across school, residential, and day habilitation settings, building genuine client participation into programming is both a professional priority and a practical challenge. The most useful first step is auditing your current programs: in what ways is client input formally solicited and documented?

In what ways are client preferences reflected in the specific goals, procedures, and schedules that make up their program? The gap between nominal participation and genuine participation is often larger than practitioners initially recognize.

From there, identify the most accessible point of intervention for each client. For some, a structured preference exploration process — using available communication methods, familiar formats, and trusted interlocutors — can surface preferences that have never been formally assessed.

For others, the primary need is building self-advocacy skills that enable the client to express preferences more reliably. For still others, the primary target is the team and system, not the client — restructuring meetings, training staff in facilitation, and changing documentation templates to center client input.

Exercise data collection and its relationship to social outcomes have been examined in populations including those with ADHD. Gao et al.

(2026) demonstrated that structured interventions targeting social functioning produce more consistent outcomes when the specific social behaviors targeted are well-defined and measured consistently — a principle that extends directly to participatory planning. When client participation is defined specifically and measured — which preferences were solicited, how they were recorded, what decisions they influenced — the practice becomes accountable in a way that generic person-centered planning language does not.

Supervisory attention to client participation quality should be an explicit component of BCBA and RBT supervision. Supervisors who review not just skill acquisition data but also documentation of client preference solicitation, client input in programming decisions, and client participation in meetings are modeling the professional priority that the ethics code assigns to this domain.