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- [00:00]
A
Foreign.
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B
Hey, everybody. Welcome to ABA Inside Track, the podcast that's like reading in your car, but safer. I'm your host, Robert Perry Crews, and with me, as always, are my fabulous co hosts.
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C
Hey, Rob, it's me, Diana Perry Cruz. I was just checking to see, but this is, as currently planned, the last episode of 2025. So.
- [00:33]
A
That's right. That's the last time you heard Diana. Second, next is me in the good old 2026. Do you know what I always do?
- [00:39]
B
What do you always do?
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A
I always bump a year. So next year I'll start writing 2027 first.
- [00:44]
C
Yeah, I always mess that up too.
- [00:46]
A
Yeah, I'm like, that year didn't even exist.
- [00:48]
C
Do you want to say your name?
- [00:49]
A
Oh, yeah, sorry. I'm Jackie McDonald, not Perry Cruise.
- [00:52]
B
Okay. Hooray. We did it, everybody. I loved Jackie. Your mic technique today seems to be I'm gonna sit far away from my microphone and lean in when it's time to talk.
- [01:02]
A
Lean in. I feel like leaning today. Resting, resting my body on the. On the table.
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B
We moved things around so everything's a little discombobulated.
- [01:11]
C
Trying it out.
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B
I guess I gave Diana a hard time because she was too quiet and voice check. And now she's very loud. Anyway, what is this podcast about? It's not about whatever this is. It's a podcast about behavior analysis and behavior analytic research where every week we pick a topic and then discuss it at length. And, you know, if you can't tell by my talking about things related to topics, I think I just want to go. I want to leave. And I don't know, should I be forced to stay? What do you all think?
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C
No, no, no.
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A
The answer is actually yes, you have to say because. Because, I mean, actually you don't. We could reschedule.
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B
That's true.
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A
So, no, you're right. We could reschedule this, but let's not.
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B
No.
- [01:56]
A
If we can help it, we shouldn't.
- [01:57]
B
Because you know what? I'm going to. I'm going to go to my values. I'm going to get my act hat on. It says act on it and it says values as well because it's a big hat. It's like one of the cowboy hats, got lots of space.
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A
I'm not wearing that.
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C
It's really dorky looking.
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B
You really dorky hat.
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A
I'm not wearing that hat at all.
- [02:11]
B
It says values. And my value is disseminating meaningful research just like it is all of our values to other behavior analysts out there. And as much as I might Want to just not just go off and do something else. It is important to stay so that everyone knows that if this were to happen in your day job with your clients, you would want them to be able to leave. Because we need to make sure everyone has a way to demonstrate assent to whatever it is they're doing. Usually for behavior analysts, it means you're working with people doing clinical work, some sort of either behavioral treatment, skill acquisition. Maybe it's mental health work, maybe it's social skills. Whatever it is, though, everyone needs a great way to understand and operationalize what ascent is, isn't. And how do we respond to that in a meaningful way? So that's what today's episode is about. And we won't be modeling it because I'm stuck here talking about this.
- [03:01]
A
Oh, well, hey, guess what? The door is not locked.
- [03:04]
B
It is closed, though that's for sound reasons.
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A
You could open it.
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C
Yeah, you can leave and then the.
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B
Sound would really be terrible.
- [03:09]
C
We'll handle this.
- [03:10]
B
No, no, no. I do love this subject, and I want to talk about it. So I will. I will choose to stay.
- [03:17]
A
I actively drove over here, parked my car, got out, and did not know your garage anymore, so I had to ring the doorbell.
- [03:24]
B
What is that code? Jack, you want to say what that code is?
- [03:26]
A
Hey, I don't know if anyone wants.
- [03:29]
B
To come visit the studio whether we're home or not. We do not. We do not consent to that or assent, either one. And I think that's going to bring up one of our topics, which is consent versus Ascent. How are they different? We'll be talking about some relevant research articles on the practice of ascent, the reasons for ascent, and some ideas of what guidelines do or do not exist. So why don't we start with what those articles will be?
- [03:55]
C
Okay, I can do that for you. We have two articles to talk about today. They are Consent and Ascent Practices in Behavior Analytic Research by Mead, Jaspers, Kelly Ward, Fernand, Joslyn and Van Dyke. That was published in Behavior analysis and practice 2025, as well as Dignity and Respect why Therapeutic Ascent Matters by Flowers and Dawes. And that was in Behavior analysis and practice 2023.
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B
One way to get ascent is to bring someone flowers and dolls to.
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A
If you change that. Dolls to dogs.
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C
Yeah, that's the plan.
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B
All right, so this is a topic I feel like we've. We've hinted at or we've tangentially talked.
- [04:38]
C
We had. No, we've had a full episode.
- [04:40]
B
Oh, we did. We did. Okay. You think I would.
- [04:43]
C
I'll Tell you about that in the pairing section. Well, I will. I want to mention it now in that we didn't include the Morris et al. 2021 article in this, like in the articles I just talked about, because we talked about it in that episode. But that's a great article that everyone should be referencing when they're talking about Ascent. It was mentioned, but if you're like, why didn't they. This huge oversight. It's just because we've already talked about it previously.
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B
Very nice. But why do we want to talk about it again? Just it's that important. We don't have the guidelines we need.
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A
Yes.
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C
I don't know. It's a really important topic, so I think that it warrants revisiting. I don't know who added it to the list. It wasn't me. But it doesn't mean that I don't want to talk about this topic. So that previous episode was. Was titled Assent and Self Determination. So we kind of came at it from that angle as well. But I think that like the ongoing question in our field, no one is disagreeing and we can back up and talk about what consent and ascent are. No one's disagreeing that we should be asking for and honoring consent and assent in our practices. But it's always this like remaining question of, yeah, we want to do that, but sometimes it's kind of hard to know do we have Ascent or how should we be getting ascent or what does Ascent or dissent look like with a population that has communication challenges? And if that's the case, then what guidelines do we have that are, you know, field wide to. To decide on what. What means Ascent and how we should be utilizing that both in clinical practice and in research practice. So I definitely think it warrants revisitation because we didn't talk specifically about that before. And I don't know that we're going to have all the answers for you today, but some very smart people have been writing about this, so we wanted to highlight their work. There's your answer.
- [06:34]
B
I'm so. I apologize. Dana, how could I ask you to come on the podcast you're a co host of and discuss the topic? My bad.
- [06:42]
A
This was my topic idea and the reason I wanted to talk about it is because I am on an IRB board and I also do research as a scientist and a researcher and there is varying discussions about what Ascent means and different IRBs.
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C
Yeah.
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A
Think about it differently. And so that is why I thought it would be nice for our field to have this rediscussion Right. As researchers. The last one we talked about clinically, it was very clinically based. But this one, you know, the research really talks about clinical. I mean, research and what that means for us as behavior analysts.
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C
Yeah.
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B
Well, Jaggy, I also am on an irb.
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A
I know, I recommended you.
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B
I am a community member, which means I am not a researcher. I read a lot of research though, but I'm mostly focusing.
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C
Do you.
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B
Yeah, I'm mostly focusing on the context of research really, just from that safety perspective. I try very hard, even if sometimes, sometimes it is behavior analytic research, a lot of time it is not. But I really try to just focus on the components of participant and safety. I don't try to think about the science of it all. I try to just wear the. Is this useful for the participant? How might this harm or help them?
- [07:53]
C
Oh my God. How big is that hat?
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B
It's. I mean, it says values and act and I'm here to help.
- [07:59]
C
Is it the same hat? It's a top hat.
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B
It's a. Yeah, it's a top.
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C
It's really tall top hat.
- [08:03]
A
This is all. Yes, it's a square top hat. So each little side has a word on it.
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B
Yeah, obviously I got it for Christmas. It was great.
- [08:10]
A
But last year, yeah, I'm going to.
- [08:12]
B
Need a new one this year. I got more stuff to put on my hat. But even just thinking about safety in research for individuals who putatively can give consent, you know, I am an adult between, you know, 18 and 64 and I am not a prisoner and I'm in like a workspace, you'd think, oh well, they can just say, sure, sounds good. But even there, there are a lot of protections that need to be taken into account. Because guess what, if a scientist comes up and says, I've got some science, it's going to help the world. Don't you want to help? Most people will be like, of course I want to help the world. That doesn't mean that you've given informed consent. However, as we'll talk about with some of these articles of some research that we all learned as undergrads, it's like, isn't this fascinating, kids? And then you put your consent and ascent hat on and you're like, actually this was terrible, terrible research.
- [08:57]
C
Yeah.
- [08:58]
A
Well, why don't we define what consent and ascent is while we as we start. And I'm going to use the definitions from the ethics code for behavior analysts, because that is who we are. So informed consent. This is taken directly from the BACB 2020 page 7 involves communicating about and taking appropriate steps to confirm understanding of 1 the purpose of the services or research 2. The expected time commitment and procedures involved 3. The right to decline to participate or withdraw at any time without adverse consequences 4. Potential benefits, risks, discomfort, or adverse effects 5. Any limits to confidentiality or privacy 6. Any incentives for research participation 7. Whom to contact for questions or concerns at any time and eight. The opportunity to ask questions and receive answers. That is Consent, assent according to the ethics code. Same page, Same page is Assent is vocal or non vocal behavior that can be taken to indicate willingness to participate in research or behavioral services by individuals who cannot provide informed consent because of their age, like they're under 18 or intellectual impairment. Okay, so typically in research, informed consent is completed by the parent or caregiver and assent is completed by the participant if the child, if it's under 18 or there's a capacity for impaired understanding.
- [10:32]
B
I think where it also gets complicated is when we're talking about consent and assent in research. Specifically, we are talking about usually more formalized practices, but you still should be getting consent and assent, even in practice. However, the guidelines and the expectations do change a little bit when we're talking about, say, treatment in a school setting. For example, most kids don't necessarily. Well, I mean, have, have we ever, as parents consented to go to school? We're sort of just like, I think kids go to school and we send them. So it's assumed we're consenting to go to school.
- [11:04]
C
We're sending them, we're just sending them.
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B
Yes, but again, do we know what they're doing all the time? And you know, schools do a lot to try to reach out. But I know there are schools that are better at that and there are schools that are worse at that. You know, what is it your child's learning? Some states have very different expectations around that. So, you know, it does get more complicated than just the idea of. Sounds good to me. Shrug. Send your child. But again, more often than not, a sin is going to be something that you need to be thinking a lot about for practice. Whereas in research you need to be thinking about both. And ideally, you're doing both at all times.
- [11:34]
A
Right. If you're doing something beyond educational practices, informed consent should be part of your educational repertoire. But ascent should be something that you're always thinking about.
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B
Yeah. At least in America, your child will have an individualized education plan if they're doing anything other than what the general education environment is just going to do that. You are sort of consenting to. By continuing to send your child to school and.
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C
Right.
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B
You know, going to your parent teacher conference and hearing about what's going on.
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A
And sadly, we need to talk about this in the. In the context of research, because there have been many and numerous research studies that have violated the autonomy, dignity, and integrity of individuals that were under the surmise of research. Right. So the article, I love that they just start off with that. Right. So primary examples in our field were John Watson with Little Albert. He was exposed to many adverse reactions. Right. Ended up being scared of white coats. Later on in his career, his life. His. His career.
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B
His life of career, John Watson may also have been scared of white coats.
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A
You know, in the 1920s. And then we all learned an undergraduate about the Milgram experience. Experience where you were fake shocking people. And they got to very, very high doses. And so that, you know, there is a form of coercion that shouldn't necessarily have been part of experience. And. And the participants said that they had a lot of adverse reactions to that.
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B
Yeah. And mostly you only hear about that experiment and idea of, like, humans can be so compliant. And that's all we'll say about this, as opposed to, was that really an appropriate experiment? Have we learned something so important from, you know, these. These participants being lied to? And there's a lot of rules around. How do you use deception in research?
- [13:14]
A
Right now. Yes, now there is. So prior to the 1970s, there wasn't many. There wasn't many safeguards in place until the Belmont Report was created. And it delineated basic ethical principles such as respect for persons, beneficence, and justice that had to be upheld in research involving human participants.
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C
And you should have dressed up as those three for Halloween.
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A
Yeah. Oh, my gosh.
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C
Right? Those are great. Like, costumes Next year. Okay.
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B
What does beneficence look like?
- [13:48]
C
No, it's just you wear a superhero outfit and you put it on the front. Yeah. I guess I'm gonna need to get an embroidery machine for all of these costumes or hats that say so many things.
- [13:57]
B
I got a label maker. Is that good?
- [13:59]
C
No, go ahead. I love Belmont Report.
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A
A label maker.
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B
It's a good label.
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A
And so the Belmont Report is lengthy, but if you are doing any research at all, you are required to read the Belmont Report and answer questions related to it before you do research.
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C
I remember what year it came out, but.
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A
1979. 1979. Yeah.
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C
It's, like, way later than you think it would be. It seems like something that would have been in existence since, like, World War II. World War II.
- [14:28]
A
The NEUR reports were.
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B
Were.
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A
They were created right after World War II. Right. Because of what happened during World War II. But the. The Belmont Report was a direct relation to research that was being conducted at Belmont Hospital. Yeah. But anyway, so as part of the Belmont Report. Right. They proposed specific procedural applications on how to obtain informed consent, how to assess risks and benefits, how to select participants, and then in order to do research, they established an IRB or an institutional review board, and created the common rule, which is what the IRB follows, to protect participants from those that are considered part of a vulnerable population and those that are not. Right. But more so for those that are considered a vulnerable population. And this is a big part of the consent and assent process. Right. And of what we know right now. So all institutional review boards require informed consent, no matter what type of research you're doing. If it involves participants, active participants, informed consent is required. Not all research requires ascent, however. So it is up right now. It is up to the IRB to determine whether assent is required, or the IRB can specifically waive the ascent of the participants. Right. So more conservative IRBs may ask you to write in how you're going to demonstrate assent if the participants can't write or vocally speak. Right. Or the IRB can actually just waive assent altogether if they feel like the participant can't assent to the procedures and they feel like the experiment is socially necessary. Right. And so there's where it gets a little gray.
- [16:14]
C
Right.
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A
Because shouldn't ascent always be part of our process? And in one way that researchers have tried to get around this is if you can't vocally express that you assent, they. Researchers have sometimes written in the IRB that they will look at, you know, facial affect, they'll look at willingness to come into the research room, they'll look at challenging behavior. And if any of those things look awry, then research sessions will be done. But again, that is researcher and IRB specific. Some researchers do. I mean, some IRBs do not require that.
- [16:48]
B
Yeah.
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C
And so it's. It's just leaving it up to the clinicians or the researchers in a lot of ways, and in terms of how they're going to individually define what dissent or ascent look like. And I think that as BCBAs like, that makes sense to us. Right. But it's still requiring that the BCBAs make those decisions individually. And there's no longer a sort of an oversight body that is ensuring that everyone's doing the same thing.
- [17:20]
A
Right.
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C
So if you're Like a good doobie, and you know what you're doing, and you're going to carefully and individually define ascent or dissent for your participants or your clients, then, like, those ways make perfect sense. Right. Those are the behavioral mechanisms by which you would define that. But it leaves the door open for someone who doesn't. Doesn't do that and doesn't then end up honoring that potential and a less conservative irb.
- [17:45]
A
So you have to have both. Yeah, right. Because if you have a conservative irb, they will ask you for those behavioral measures, but if you don't, then they won't. They'll be like, are you gonna waive it? Great.
- [17:53]
C
Yeah.
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A
Right.
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C
In clinical practice as well. Go ahead.
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B
This does. Oh, thank you, Kenna. And this does sort of feel a lot like one of those issues. Similar. Like when we talk about escape extinction, you know, the idea of, you know, sometimes you do need this, and we can maybe, you know, but. But my bet, we could do better. You know, do we need to do it this way? Same with Ascent. Of like, well, we can kind of all do some things or wave it if it's not appropriate. But I bet even at times when we waive it, I bet if we looked back at some of those cases, we could think of. I bet there was some way we could have measured Ascent. And I'm sure a lot of folks do, and they've come up with, like, really great ways to get ascent. But it's one of those areas that sometimes people talk about it, sometimes they don't. And any one individual researcher, practitioner, sort of doesn't know why. Was it an issue of. Well, it was totally great ascent practices, but my editor said, too long, can't put it in. Or did I just not do it at all? Or was it waived by the irb? And then I just did this, you know, great Ascent thing, but I didn't write it anywhere. We just kind of all vibed it, and that seemed good enough. Right. And technically, we met the letter of the IRB rules and the Belmont report and our ethical code. So it really becomes one of those things of. For all we know, there's awesome ascent practices happening all around us. But if nobody writes about it, talks about it, shares it, presents on it, disseminates on it, you sort of are left to doing what you think is best, which, as previous research before the Belmont report will show is plenty of people did that. And we still would consider that to be inappropriate or unethical research nowadays. Right. Because times change.
- [19:24]
C
If only someone had done a survey to find out.
- [19:26]
B
Oh, thank God, we've got some surveys.
- [19:28]
A
I do want to say one thing before you go to the survey, Jackie.
- [19:31]
B
You may.
- [19:32]
A
Thank you very much. I think in our field too we have to be especially careful because when we are doing research, we're not always just researchers. We're also the clinicians of the participants. Right. So there's that dual relationship at play. So we have to figure out where the fine line is between research and clinical work. And I know that has been hard for a lot of graduate students that are also running research with clients that they work at, where they work with. So that's something we need to be really mindful of. And, and how like are the participants actually giving a cent or is it a history of reinforcement with compliant behavior?
- [20:09]
C
Right.
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A
So some things to think about there.
- [20:11]
B
Yeah. So we mentioned Morris et al's 2021 paper, which was sort of the modern first, you know, let's bring it back around and talk more about ascent directly in, in our research in behavior analysis where looking at 23,447 articles in behavior analytic research.
- [20:29]
A
Gross. So many.
- [20:31]
B
It's a nice team, big team doing stuff. Less than 1% of those articles actually mentioned ascent anywhere. Ascent procedures and rarely was it specific. So even if they did mention it like there were 28 that said we used ascent procedures, period. 7 just mentioned that it was waived by their IRB. 124 said we did get a cent, period. 38% they had like a written or verbal procedure specifically for gathering a sentence. Like those would be the articles that would probably be the most of use when talking about how we can operationalize ascent. And the article kind of ends with some, some good suggestions. And I think we've seen Cody talk about, you know, some of the ideas for how one could make measure ascent as well as some other, other researchers, other practitioners. But there is that kind of big question like we already mentioned of do people just have ascent procedures and just for reasons we don't talk about it that much or does no one have an ascent procedure and for reasons we also don't talk about it that much? So that's where the mean Jaspers article kind of comes into play with a follow up survey that they did in 2020. Well, 23, 24 and published in 2025.
- [21:36]
A
So I'm only one year. Good work.
- [21:39]
C
Yeah.
- [21:40]
B
So it was a survey of BCBA researchers specifically on what are their consent and ascent procedures. And their goal was to answer five questions. They had 123 respondents on a survey that they made themselves with their own two little hands or they had more than two people doing this research. So lots of hands making this little research.
- [21:57]
C
Their own 10 little hands.
- [21:58]
B
10 little hands. And each, each question will kind of go over them, you know, briefly. But there are five sections to answer these questions. Number one being what are the demographic informations about the respondents to sort of see are there any patterns of who does or does not use certain types of consent and assent procedures, questions about their knowledge and training on what is required by consent and ascent requirements, how did they get that training, what is their IRB like? And this used a lot of Likert scales. I do appreciate how they sort of went back and forth with in our survey, this was a Likert scale. These were open ended responses. This was a mix so that they could do some nice thematic analyses as well as some quantitative analyses which I'm going to skip over some of the, the certain. There's a lot of statistics and the graph that I did not find the most helpful, but maybe you will. Question number three, asking questions about the practices and methods that are used by these researchers and not just about what practices they use, but also do those practices result in a confidence that their participants actually understood the consent and ascent procedures and as well as any feedback they've gotten about how good or not good those procedures were at gathering meaningful consent and assent practices from IRBs from editors of their manuscripts as well as sort of, you know, what happened when they didn't get what they considered meaningful assent and some questions about language considerations. Question four was all about what resources did they use to make consent and assent procedures. And in terms of both, you know, other resources and other researchers as well as the foundational ethics documents that they use to plan. And then question five is all about when they've had barriers and solutions, like what barriers have they had to making or using ascent and consent procedures and what strategies do they use when hitting those barriers. And then like a bunch of statistics which I wrote in my notes, like too many statistics. It was cool responses. I didn't, I found it to be very, very busy and hard to read that part of it that specifically that visual. The rest of the article I found very easy to read, but they sort of get to a part. I'm going to skip ahead a little bit to when they talk about demographics and looking at statistics. It was like, listen, we did a ton of statistics. Way too many statistics. Here's like a chart I thought it was when I looked at it when I hadn't Read the paper yet? And I just saw that, that, that graph. I said, was this like a computer program, like one of those old punch cards? Because it's just like dots and it's.
- [24:15]
C
Like a heat map style. So you can see like all the cross, cross tabs of all the varying demographics across the questions and then like which ones showed up as statistically significant. I thought it was a cool way to present it. I don't know how else you would be able to like visually take in that much data that quickly.
- [24:32]
B
Maybe it had been color and then it could have been an actual.
- [24:35]
C
Yeah, you wanted to color map and you mentioned.
- [24:38]
B
So you could sort of see where the articles and the demographics go together like that. Because it was just like, look at all this black and dark gray and light gray, different shades of gray. Nope, no clue. Don't know what this is. Don't want to read this. The rest of the article was great. I mean, maybe if they'd written a really terrible article and then had a cool visual, but they wrote a very good, easy to understand article. So I got to that table, I said, don't need this. Goodbye. Moving on. So when it comes to things like themes, we have most of our respondents working with children, 81% and about half, 52% working with adults. And 63% of respondents were working with individuals with intellectual, their developmental disabilities. So when it came to their first question, sort of talking about their procedures, 84% people said they were at really high confidence in their consent procedures. Ascent procedures, not as much. 60% said that they were highly, they were highly confident. So not as many, many of them had done around like 2.75 on average trainings about their consent procedures, usually with some sort of webinar. It seemed like city training was mentioned. If you've ever served on an irb, you've done city training. Probably Ascent was a little bit lower with a little bit over two trainings per person. Again, mostly asynchronous online trainings. They did a lot of trainings through their own institution, through Health and Human Services, a group Advancing Ethical Research Conference, and then a lot of work. So again, I think that comes up a lot. There's like certain trainings you do and then a lot of practice you get in your own work. When it came to how to obtain consent and assent, most people had a number of ways they could get consent. So like a little bit over two different ways. So on average people had a couple ways they could gain consent. 80% meeting with the consent providers, 70% using written consent forms made by their research team. 65% just used sort of the stock institution template to start with. And a lot of others would sort of just do things like ask participants for each phase of their study. They'd have a visual contract, or they just ask verbally. And about half of them said they were pretty highly confident that their consent providers understood the risks, the benefits, and the procedures that would be involved in participating, with 43% having medium confidence. So most people were pretty, pretty good with their consent procedures. Things kind of dropped a little. In some ways dropped a little bit for ascent practices, as we would expect, because it is not as well defined or, as you know, required quite the same way. Now, one thing that was interesting is there were multiple ways to obtain ascent. So way more ways. Researchers were saying, I get assent based the following ways. So 3.6 on average, different ways. Which means there's not as much coherence as to how do people get ascent. Which might be fair, because ascent is different than consent, and you're working with lots of different populations in which you use lots of different methodologies.
- [27:16]
A
And there's more training for consent than ascent.
- [27:18]
B
That's true. So if you have more training, more people using it, you sort of winnow it down to like, these are the two best ways, whereas ascent's like, I don't know, here's 10 different ways to get ascent. Which one's good? Nobody knows. Most of the time, though, people were using things like vocal ascent, hey, you want to do this research? Probably something like that. It's about 68%, 50% did a lot of just, I'm looking for signs of discomfort. 43% used a written ascent form developed by the team, which probably makes sense because a lot of times you would use less likely to use a written ascent form than, say, consent or some of those other methodologies. And, you know, some said, even if it gets waived by my irb, I still want to do ascent procedures. But there was a lot less confidence that people providing ascent, you know, actually fully understood the risks and the benefits of all the procedures. Only 47% had even medium confidence. Only 27% had high confidence. And 19% they even put it in. No, I don't. I'm not really sure. I'm not that confident that the participant understood the ascent procedures. Not too many times. Only about 21% of the time were projects rejected by an IRB or said they need revisions because of the consent procedures, which is good. Only 3% had a manuscript rejected. So again, manuscripts, usually by that point usually have gotten through the consent and ascent procedures. When it comes to ascent procedures though, that was much lower. Only 13% had had a proposal rejected because they either had poor or no assent procedures. 1% only ever got a manuscript rejected for the same reason. And 24% noted, I have never put my ascent procedures in these documents. 24% said, I always put these procedures in my document. 32% said, well, if it's something that's never been done or I've never seen in research, it's like a novel procedure, I'll put that in my, in my write up or in my manuscript. And then 27%, if the journal required it, which is, which is odd because I don't know how many, I mean I don't publish research, so I don't know how many are like very strict about, you've got to have in recent, in recent years.
- [29:06]
A
There's more that require it.
- [29:08]
B
Okay, so why would you not include consent and assent? Kind of paradoxically, sometimes the associate editor did or did not prefer that you put that in there. Sometimes your article was too long already.
- [29:21]
A
Yeah.
- [29:21]
B
And some said, you know what, I had it in my IRB application and then it just never got into the manuscript. So it was there and I could have put it in. And for one of those other reasons, I just did not do that. In terms of how often people were getting Ascent in research, 33% said, I'll get ascent before every single session. 28% said, I'm constantly looking for signs of ascent, so it's continuous ascent. 10% said, I don't usually get ascent. And 25% said, I do it at the very beginning of a study and then I do not going going throughout. So it's really all over the map in terms of how ascent and when ascent is collected or taken. And it sort of depended on the population of participants, what environment they were in, what was the question they were asking, were there clinical benefits? So again, a lot of reasons that one might or might not do ascent for all the reasons you'd expect in lots of different research studies across lots of different populations. Again, you know, the theme came up. A lot of, a lot of individuals, especially younger children, not really being able to give a scent. So even if they had procedures, feeling like ascent was that meaningful. Because how are you as a young child able to weigh the benefits and risks of the research you are in? You usually just kind of do what you are told and you either seem happy or sad about it. That's you know, sort of what childhood can be like in a lot of ways. So a lot of folks even using things like happy faces were saying things like I use it. And I'm like, I have no idea. Do they know happy face means good research, bad research, Right. Or am I just kids like happy faces. So they pointed to the happy face.
- [30:47]
C
And beyond just, just kids like folks with intellectual disabilities.
- [30:51]
B
Yeah. More broadly, that came up a little more. When they're talking about sometimes we just have these scripts we use. But knowing that an individual had, you know, poor listener comprehension skills, could they really be expected to understand what it is I just said? Are they just saying yes, do a history of compliance, masking any sort of meaning that goes to this? Sometimes they even said, you know, I got a cent. And then while watching the participant, I didn't get the sense they really wanted to be doing this research. And some saying things like when I, you know, when I know my participant might have trouble with, say, written or verbal comprehension, I try to make it as matched to their skill level as possible. I try to use other forms of communication. But again, I think everyone's take on it was ascent. Procedures aren't as good as they would need to be. And even when I have them in place, I can't guarantee that they are doing what they purport to do, which is inform an individual about risks, benefits, letting them know things like, hey, you could leave this research at any time. That came up a lot too. The idea of could you leave whenever as opposed to, oh, come and I'm there. I'm not going to get into some of like the resources. You know, a lot of people had lots of different resources, their professors, mentors. A lot of people seem like communities of practice sort of became the go to for many of the ascent and consent procedures. Having their lab team work together. Then a lot of people just noting things like it's hard to do. You know, some of the barriers to these procedures are there's just not a lot published about assent and you know, we don't have a lot of evidence about which procedures are the best procedures. And we don't have as much training as how do you get meaningful assent and how do we balance? Even when you know all this information, how do we balance, you know, the Bannerman question, right to choose and the treatment, you know, significance for the individual in just ascent, not, not just consent, but in the ascent.
- [32:39]
C
I was going to bring up the Bannerman article.
- [32:41]
B
Well, they, they, you can too. You can bring it in there. Again, it's a good one. To bring up. So some folks had strategies, some folks didn't. You know, you can certainly look through, through the article, and it did seem like people who had been doing a lot of research and had a lot of experience tended to use a sentence, consent practices more consistently that they were happier with than folks who had less experience, which, wow, I don't know if you need statistics to get that one, but you can feel statistics. And again, everyone really loved guidance from colleagues. So this does feel like an area where a are aware of ascent and consent, but they're not super happy with the state of how we get these practices. And they sort of feel stuck with. Well, I could just ask my friends what they think, but if enough of them feel the same way, we're sort of just making stuff up and hoping for the best. Which I don't mean to belittle the hard work that a lot of researchers are doing to make meaningful ascent procedures. But. But we are in sort of that wild west of people are doing stuff. But what is the stuff that matters the most? Yeah.
- [33:38]
A
And I think there what we could do better, right. We could make a platform where we could discuss research surrounding ascent. We could do more training around knowledge, around what laws around are around consent, what is standard practice, what is still unknown about ascent. And we could look at the research surrounding whether participants actually understand and what they are consenting to. Right. We could do a better job explaining that and showing that we should talk about the different ways that those more experienced researchers are gaining a sense so that the inexperienced researchers could then benefit from that. And then. So here, one thing that I wanted to talk about was we should be discussing it at length as researchers and clinicians. So I was just at a recent IEP meeting, one of our clients and one of the school districts was trying to figure out some behavioral objectives for the student. And they said, oh, we see that the student flops, like, but we don't see that you're taking data on that. And we said, no, we're not, because that means that they're not. They're dissenting to doing this. So we don't take data on that.
- [34:45]
B
We.
- [34:45]
A
We use that as a way to say, okay, they're not assenting to this procedure. And the, the school district BCBA was like, oh, I never thought about that. Right. So just even talking about ascent and dissent and what it means to. What it means to like, accept that even in this IEP meeting. Right? It was. They were like, oh. And they maybe likely never thought about it in that way. They Just saw it as like a problem behavior that we need to solve.
- [35:11]
B
Yeah, right. I wish I'd written down my anniversary of being like, I refuse to write an objective in an IEP that's like, we'll decrease rates of problem behavior. Because I haven't written any of those in a long time. I want to say I'm getting close to 10 years. I have no idea if that's true, though.
- [35:24]
A
I like that. I like that for you. I also think one thing we should be considering too, is teaching students the other skills around ascent, like choice, teaching denials, teaching self advocacy, teaching self control, teaching self management, so that when we do ask an ascent question, we know that they're actually doing. So I think you're going to talk about that. And so an initial step would really. Making sure that we are improving the methodologies around assent and looking at active methods versus passive methods. And they said that there were a few limitations in the study that Rob and I talked about. I don't actually think there are limitations, to be honest. So they were like, we made this up ourselves, the questions up ourselves. I'm like, that's okay. Nobody's asked these questions. Right?
- [36:13]
C
Right.
- [36:13]
B
Step one in research is ask a question no one's done a lot in. And then whatever survey you make was the best survey ever.
- [36:20]
A
Right. And you know, they couldn't follow up and ask further questions because it was anonymous.
- [36:25]
C
Sure.
- [36:25]
A
That's okay too. Right. Like this. I love that the limitations are things that I'm like. I was like, no big deal. That's okay. I know you have to write this.
- [36:33]
B
A lot of questions. A lot of questions. Good questions. A lot of areas.
- [36:36]
A
I think what we found from this survey was that behavior analysts actually do want to make sure we are asking for ascent and we want to do more research around how to do that effectively. Yeah. Yeah.
- [36:52]
B
Well, we've talked a little bit about the current state of consent and ascent. Let's take a little break, and when we come back, let's get a little bit more into the. The why of the ascent procedure and then see how does that inform what we can do now while we wait on some of those questions or how. When we start answering those questions. We'll be right back.
- [37:23]
A
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A
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- [38:33]
C
See you there.
- [38:41]
B
And we are back talking about operationalizing Ascent. But before we continue this discussion, I want to remind all of our listeners that ABA insidetrack is ACE and KWABA approved. And by listening, you're able to earn one learning credit. All you need to do is go to our website, ABA InsideTrack.com or click the link in your podcast player and enter in some relevant information to this episode, including some secret code words. I'm going to give you the first of those right now. And it is rent. R E N T Rent. All I know about rent is we're not going to pay. We're not going to pay last year's rent. This year's rent. Rent, rent, rent, rent, rent.
- [39:21]
A
Wow. It's a lot of rent there.
- [39:23]
B
Yeah.
- [39:23]
A
Okay.
- [39:25]
B
All right. How much time you'll listen this podcast? Is it 525,600 minutes long?
- [39:28]
C
I think it's longer.
- [39:31]
B
All right, now that we've talked secret code words, let's talk about Ascent more. So this is the Flowers and Dawes that you're going to be leading us through a little discussion of Diana Doors.
- [39:42]
A
I'm thinking of dogs when I say that.
- [39:44]
C
Okay, gotcha. Yeah.
- [39:45]
B
Yeah.
- [39:46]
C
So this is a really cool article. And one of the main questions that they were asking here was how do other professional organizations similar to ours address consent? And are there components that we can learn from that? The title is why Therapeutic Ascent Matters. But I also feel like we have talked a good bit about why Therapeutic Ascent matters, but they do kind of start us off there and then move into doing some pretty useful comparisons here. So their, their definition of Ascent was Ascent is an agreement to participate in service provision or research by a person who's not legally able to provide informed consent. And we've already reviewed informed consents generally done if you have, if you are a child, by a parent or guardian. But Ascent should be done by the person who's in participation in either the services or the research. And generally it is usually going to be an ongoing process. Specifically, if you are worried about the, you know, language capabilities of your participant in that getting an initial yes or no response on their participation is likely to be less useful for, for really understanding if they are wanting to be there. And then the BCBA for BCBAs, we have in our ethics code references to Ascent, but they also sort of have caveated it in saying that it's encouraged when applicable or when relevant for either services or for research. So that gives us some coverage there, but also some wiggle room in terms of how individual behavior analysts may interpret what that those statements mean. And I think that's why we're having these very important conversations here. So, of course, like I said, we're all in agreement. We think informed consent and assent are important, but to, to make sure that everyone knows why. There are a lot of benefits to this. So our authors here tell us that they give the client more control over the therapeutic process. They're going to provide opportunities to promote independence by including references to Ascent and honoring of Ascent. We're going to respect client dignity and autonomy. And also this can help to contribute to the refinement of the goals to be more therapeutic over time. So we're thinking about Ascent as a continuing process. We're like, oh, you didn't, you didn't like that you want to do it this way, right? Like, we can really modify, especially from like the, the practice service provision side, what those sessions look like. We certainly want to be thinking about whether the client can comprehend the information about the consent or the assent. And so they, they have a few recommendations on that. But again, like, they're like, oh, you could break down the informed consent into a checklist and like, pause and like, have the person have the chance to ask questions. But that really may not be appropriate for a lot of our clients that we work with. And if we are relying solely on the adult to provide the informed consent, they may not really know as well if, if the participant is going to want to consent. Right. So we are still kind of like in that same like, circle of trying to figure out who's assenting, who's consenting, and does everyone really understand? So they give us some comparison points here in terms of what the Ascent guidelines are for other fields that are similar. So they looked at what does the BACB have to say about this? What does the APA have to say about. So that's the American Psychological Association. And then what does the NASP have to say about this? Which I think is the national association of School Psychologists. Yes, I got it. Right. Okay. Yeah, yeah. So basically everyone like says different things in slightly different ways, but the school psychologists break it down the most across these three groups. So I will tell you that everyone has this point right here. Requires practitioners to seek assent. All three of these organizations lay that out specifically. Two different organizations require two other components requiring practitioners to provide an explanation of services and requiring practitioners to consider the best interest of the client. Both the APA and the NASP require those too. Components the BACB does not. And then after that, all of these varied guidelines are completely different across the three different organizations. So the only other one the APA has listed specifically is. Requires documentation of Ascent. Neither of the other two do that. Only the BACB recommends vocal or non vocal indication of agreement. I think most likely due to this specific populations that we often work with. And only the BACB also refers to other entities for the requirements, such as the irb. They say, make sure you check in there. The other two groups I mentioned do not do that. And then after that, it's only the NASP that lists a whole bunch of other more specific Ascent guidelines. So I'm going to let you know what those are.
- [45:01]
A
Thanks.
- [45:01]
C
Yeah, you bet. That's why I'm here. So they also consider Ascent independent from consent guidelines. They note that in their set of guidelines they require practitioners to consider the legal requirements for Ascent. They require practitioners to honor Ascent withdrawal when it is offered. They require practitioners to avoid overwhelming the client with options when choices are offered. They indicate that the client should participate in selecting and planning services. And they require assent for information disclosure. Okay, so in case you were like, I don't. I haven't really thought about what some of the other ins and outs of Ascent might be and how we might think about it or operationalize it. Here are some additional examples of breakdowns of varying components of Ascent. Yeah, yeah, yeah, yeah. So I really liked this. It's all summarized in a table in the Flowers and Dawes article, so you can certainly go check that out.
- [46:00]
B
What if a heat map, Would that.
- [46:02]
C
Be easier to read in this case? I think that the information was presented pretty clearly in the table itself. But I could. You could do a heat map.
- [46:11]
B
You know, I don't want to.
- [46:12]
C
Maybe if it was in color that would be more helpful.
- [46:15]
B
Yep. The number one problem in our journals Today, lack of color.
- [46:19]
C
So, yeah, I think I've summarized what my notes were by talking about the table to a good. To a good bit. And I recommend you refer yourself to the table. Now, do you guys want me to go in a little bit further into what we could do regarding how we might incorporate ascent into ABA therapy? Or should we save that for Dissemination Station?
- [46:40]
B
I think let. I think we can move into dissemination Station and sort of put all of that, plus some of our future research questions that some of the articles sort of brought up. One thing I do want to say that I really appreciated about this article is there is something so helpful by looking at practices across specialties, because for so many BCBAs, when we're talking about Ascent, I think most of us are thinking about the clients we work with. And for the majority of BCBAs, that means you're probably working with autistic young children who are going to have varying levels of communicative ability. Meaning we might think of ascent practices as either being something that gets waived or the caregivers agreed as part of the treatment plan. So we don't use ascent as much or really just focusing on nonverbal forms of assent, which are important to be able to identify. But looking at the NASP requirements as well, I think broadens our field's idea. And I know there are BCBAs who probably do all of what's in the NASP ascent guidelines because of their practice, but I'm speaking.
- [47:38]
C
Yeah.
- [47:39]
B
You know, very, very broadly and simplifying a little bit. Just thinking about ascent as more than just looking for signs of they're coming into the experiment room or they don't come into the experiment room. That's all we can do, really. Thinking about all of the other components that could go into an ascent procedure and why one might want to explore those, because again, if you're a school psychologist, most of your treatment is going to take a different form of practice than for most BCVAs.
- [48:05]
C
Yeah.
- [48:06]
B
Which is going to have a different process of ascent. But why not think about all the ways we can get ascent and then rather than just sort of pigeonhole any one group into this is how you get ascent. In this field, we think about what are the best ways to get ascent based on the individuals that we're caring with, like who they are, rather than what work we as adults are doing with them.
- [48:25]
C
Yeah.
- [48:26]
A
So. So I'm going to make the train sound because it sounds like we're already there.
- [48:29]
B
Yeah, we're.
- [48:31]
A
We're there.
- [48:32]
B
All right. So we're in the dissemination station. So we're going to take a little bit from the articles and a little bit from our own sort of reflections on reading these articles to talk about things like what are the practices we could use as a scent? How would we know? What questions do we still have?
- [48:44]
C
Yeah. So just to continue on with the Flowers and Dawes article, they mentioned three ways that we can be ensuring that we are providing opportunities for ascent and that and the training necessary for our clients in order to ensure that they can indicate ascent and descent. So the first one is targeting dissent specifically. So are we teaching the skills needed in order for our clients to be able to indicate yes or no? They, they, they give us like some ethical guidelines I guess here in saying that the challenge often it for BCBAs is that we may be tasked with targeting escape maintain behavior that is targeted for decrease and it can look a lot like dissent. Right. And so the challenge here is to try to figure out how we can ensure that our clients have a sense to participate in the services or the research and that we're still honoring if they appear to need a break from that participation. Right. And so within, you know, several of these guidelines, it also notes that I. Let me, let me actually tell you, in the school psychology guidelines it says that the essent is not necessary for services that are legally required or viewed as beneficial for the student by the parents or the adults. Just noting that as well because it is kind of like a, a fine line here, right? Well, if your student is just saying that they don't want to do anything, they don't want to come to school, right? They don't want to participate, they don't want to be, you know, involved in their education. Like you hear that sometimes. Are all of those levels of dissent need to be honored or can it be that there is, you know, something sort of specifically said, but to say I need a break from this, right? Like I am, I need time away from you, my teacher, even though I am, you know, overall understanding that I have to participate in an educational setting. So they said, why don't we have one of our early targets be teaching something very specific psychomotor skill that indicates ascent and descent. So if they're non, non verbal or non vocal, we can still teach a yes no response with sign, right? Or head nod or a head shake or touching a picture, etc. We can all think of lots of ways to do that, right? So teaching that is a fundamental initial skill or a break response or a, you know, time time away response or something so that our Clients can indicate to us when they need a break. I think that that makes sense. Then they also say, hey, let's back up here and think. If your client is attempting to escape from all of your therapy sessions or indicates what appears to be descent in all of your therapy sessions, let's revisit what your therapy sessions look like. Maybe they are overall aversive and you can do things to make that setting and situation less reverse, less aversive for your client. I'm always reminded of the Carbone et al. Article which I think is from 2007, that talks about the CMOR and how it can get established in an educational setting. And suddenly it's not that one hard task that's aversive. It's everything about coming to school or seeing your teacher or seeing your desk that's now aversive. Right. So revisiting what that looks like, maybe you can make some big changes in that setting. More generally, they can make it less aversive and lessen the, the EO for escaping from that setting. And then they also note if there are dangerous behaviors that need to be addressed. That has to be our foremost priority for the safety of the student and for those around them. So that is always going to be kind of at the top of the list when we are in this decision making model on how we're going to define dissent and asset. Yes. Okay. And so then, so that's number one, like let's think about dissent. Are we training students to properly ask? Number two is overall communication skills. Right. And this, this fits in here in that clients with lower language levels may not be able to fully provide ascent according to those traditional measures. So looking beyond what those traditional vocal responses might be to sort of larger behavioral measures is important. We can define it individually. And this is something again, I think like, yep, we all know, we all know how to do that. Right. They also talk here about, in the Morris et al. Article and lots of other places too, how you could use a concurrent chains approach or arrangement in order to help establish a scent or preference that remains a great option for finding out from an individual who maybe can't verbally tell you what their preference is. And then third, they talk about social validity, which I love, I love that this got brought in under this context because we can think about social validity as an ongoing part of the ascent process all along the way. Because like you said, Rob, like parents need to bring their kids to school or bring their kids to the therapy session or bring their kids to research in order to have that continue. Continue. So that is a measure of social validity. Right. And it's also a measure of ascent. And then the same for the child. Right. Are they. If they were initially happy to come with you, and now they're not, well, something went wrong there. So let's try and back up and figure out what it was. Maybe we need to pause what we're doing and re establish rapport, etc. So social validity is a great way to think about the ongoing measures of ascent that we have. So I love all those suggestions.
- [54:20]
B
I mean, I do like the idea of just more practice and, and giving practitioners more opportunity to sort of develop, you know, whether it's bespoke concurrent chains procedures or just like a quick and dirty concurrent chains with the key components of a treatment process. Because I do think that is lack. I think we all learn what are concurrent chains in the context of. Let me answer these questions about schedules of reinforcement. And then maybe we see it mentioned in a couple studies.
- [54:46]
C
But the pigeon has two lights.
- [54:48]
B
Yeah, but I think if you ask the average practitioner, hey, if I needed you to like whip up a quick concurrent chains preference assessment for your student around the different treat options, I think many folks would be like, I could probably theoretically do that. But I haven't done that with any of my clients. And I don't know if it's a good use of time and resources to add that in because they seem. I'm looking for other signs of ascent. Right. I'm looking for signs that they seem happy or they come readily every single time. And I don't think anyone is trying to be lazy or pull the wool over anyone's eyes around ascent. But there is a piece of, well, if they come every time when it's time for treatment, why isn't that a fair form of ascent? Which is true. But I think we are looking at those indirect forms of ascent. And I think we're also not necessarily. We can't say for certain. We're not conflating assent with compliance, which.
- [55:35]
A
Gives us a false sense of security that we're doing a good job. Right.
- [55:39]
B
Yeah. So I'd love to see more sort of like practical, like, hey, you need to make a concurrent change procedure. Like, when do you need to do that in your treatment? Is it all the time? Is it just for treatment for say, you know, interfering behaviors? Should it be for skill acquisition? Is what, you know, when is it important? Because we're always talking about, if we add one more thing, you have to have a concurrent change procedure as a part of your program, there are going to be settings that's very possible, like research. I don't see any reason you wouldn't have that in there if you're talking about treatment options, you know, But I'm sure there'll be times, definitely in practice, it becomes a lot harder to say, and we have to put in this procedure. And if the child says, I don't want to do the treatment today, okay, at what point are we saying, I'm glad you assented or I'm glad you dissented to treatment, but it doesn't matter because you have to do this because you have to be in school or you have to engage in this skill. So I do think we need to both get people better at putting together concurrent chains and then having real conversations about when do we care and when do we not care?
- [56:35]
C
We always care.
- [56:36]
B
We always care. But, but I, I mean, I mean that colloquial, like, I know you don't want to do this and it doesn't matter that much because there are other factors that we need to be taking into account and how does that play into the procedure. But I think just making sure everyone can do it if they needed to, I think would be very, a very important skill for the average practitioner to just be like, okay, I can put this in place, I can do it. And that's a better way to show active assent. And if you're doing choice making procedures, that's probably, if you could do that, that's probably quicker. That's going to have more generalization for the individual. But, you know, for our students who struggle with choice making, or there's just such a history of compliance in the past that we need to teach an alternate response to sort of break the chain of behaviors that they engage in where they're just being compliant all the time. So that would be something I'd love to see, you know, just, just more practice on and more, you know, what's the best way to make sure people are using those? And then we, then we can answer those questions of when to how, you know, but yeah, how to.
- [57:27]
C
Sounds like we need a flowchart.
- [57:28]
B
I mean, yeah, that would be pretty awesome. How about y'? All? Where do you see as sort of like, these are good practices for tomorrow or these are questions that we need to answer those first?
- [57:39]
A
I think that we need some more research around what ascent looks like across different populations, what are different strategies? And I think then we need some training. Yeah, that was my big take home is that. And thinking about, like, I know I have been subject to. They. Well, I ask them every time they want to come and they say yes. I feel great about that, but that might be giving myself a false sense of security.
- [58:02]
C
Right.
- [58:02]
B
It could be worse, but it's not necessarily the best.
- [58:05]
A
Yeah. So. Yeah.
- [58:07]
C
Can people identify. Right. Those like behavioral indicators of dissent. Right.
- [58:12]
A
So.
- [58:12]
B
Oh, see that feels like an easy. I don't know if it's easy study.
- [58:15]
C
Nothing's easy.
- [58:15]
B
A quick, a quicker study of how good are people at actually registering dissent and then responding to that dissent. Because I bet those are two, those would come out as two separate things and people understand.
- [58:29]
C
Was it actually dissent?
- [58:30]
B
Yeah, exactly. Maybe they just saw something interesting in the moment.
- [58:34]
C
Nothing's easy.
- [58:34]
B
Yeah. Is it a shifting preference? Is a temporary shifting preference or is it I hate your treatment plan. Get me out of here.
- [58:41]
A
Yeah, that's what I would do.
- [58:42]
C
Yeah. I guess I'm thinking of like if you can't see, then you need glasses. Right. So like that part is kind of like a non negotiable. But then when you go to the eye doctor you have choices like, does this look better to you? Does this look better to you?
- [58:58]
B
That's so hard. That's like the hardest test.
- [59:00]
A
I agree. And then you're so stressed because you're going to have those glasses for a full year.
- [59:04]
B
Expensive.
- [59:05]
A
Mine are really expensive. Cuz I have very bad vision.
- [59:07]
B
Jackie's the only human being I know who has worse vision than me.
- [59:11]
C
Yeah.
- [59:11]
A
So it's always like I'm gonna spend like $900.
- [59:16]
C
Well, in my metaphor, you, you know, you have a say in what that's going to look like. Literally look like. Right. And then you also ideally also get choices about like the outside part of the glasses. So like which frames do you like? Right. Which one is, you know, the best for you? So like there's, there's pieces of that that are like this is kind of a need. Right. And you're going to need the glasses and we're going to go ahead and get the glasses. But then what? The, the planning process of the glasses and the, the eventual like look of the glasses should have client input on it. So I feel like there might be some parallels there as we're thinking about therapy or treatment and then the ascent process.
- [59:56]
A
Love it.
- [59:56]
B
Yeah.
- [59:56]
C
Thanks.
- [59:57]
B
Yeah. Or some, some more information on things like prerequisites like, you know, because we talk sort of about. There's a broad sense of sometimes you can say you don't need ascent, sometimes you can't. Which I, I think there's much less binary in terms of who your clients, your participants are in terms of determining, like, what of all the ascent practices are going to be the most and least helpful to the individual in terms of getting their needs met, making sure they're a part of the treatment plan or the. The research plan.
- [60:26]
C
Yeah. So more guidance.
- [60:27]
B
Yeah.
- [60:28]
C
I'm glad we're talking about this as a field is a very, very important topic. And the fact that they're, you know, everyone is having to kind of like, make their own decisions with this, without a lot of guidance is not a place I want our field to be. Because in the past when we've been there, some people have made bad decisions. So the more that we can establish some. Some guidelines, I think the better. So we're on the right track.
- [60:50]
B
Yeah. I think it's exciting that other fields have different guidelines, too. That just makes it a little easier to come up with new ideas because we're not stuck with. Everyone's got two ideas and that's all we have across the practitioner board. And we're really in trouble.
- [61:01]
C
We have a lot of smart people in our field, so. And one of the best things you can do as a smart person is look to what other people have done before.
- [61:08]
B
You know that there's other people who might be smarter than you.
- [61:12]
A
Not possible.
- [61:13]
C
All right, can I tell you pairings? Is it time?
- [61:15]
B
Yeah, sure. Let's do it.
- [61:16]
C
All right. It's time for pairings. Pairings is part of the show where I tell you about past episodes. You might want to check out if you found this one interesting. So we have talked about variations on this topic a good bit. Let me tell you where you could find those episodes.
- [61:30]
B
I'm just moving my hand. Don't worry about me.
- [61:32]
C
Oh, okay.
- [61:33]
B
That is not a. It's not a sign of dissent at all.
- [61:35]
C
I didn't know it was confusing.
- [61:37]
B
Wow.
- [61:37]
C
Yeah. Episode 236 is the one we talked about before where we. The title is Ascent and Self Determination. That was with Haley Steinhauser and Alex Kishbaugh. Episode 251, we talked about self determination and IEP planning. Episode 204, trauma informed applications of ABA with the two Rajaraman and Jen Austin. Episode 290, skill based treatment with Corey Whelan. Episode 231, emotional behavior behavioral Disorder treatment. But really we talked a lot about the Enhanced Choice model, which is why I'm bringing that up with Joanna Stabitz. And then episode 276, concurrent chains arrangement, and episode 270 social validity assessments. I also like to recommend a snack to go with the pairings. And so the snack today is pasta. And then I've all delivered you your plate of pasta, and now I'm standing over you, and I have the little cheese grater.
- [62:33]
B
Yeah, you're thinking of the Olive Garden one, right?
- [62:34]
A
Yep.
- [62:35]
C
This is the Olive Garden cheese grater.
- [62:36]
A
And here it is.
- [62:37]
C
And I just want you to tell me when.
- [62:38]
B
I never want them to stop.
- [62:40]
A
Same.
- [62:40]
B
I just, like, keep it going. I want to see the panic in their eyes.
- [62:43]
A
I make it awkward. Same. I make it really awkward.
- [62:46]
C
I'm like, no.
- [62:47]
A
I always.
- [62:47]
C
I'm like, okay, okay, that's enough.
- [62:48]
A
I'm like. I'm like, keep going.
- [62:50]
B
Yeah. Talk about signs of compliance. You're like, I'm so sorry. I. I need any.
- [62:54]
A
Keep going. I'm like, keep going.
- [62:56]
C
Yeah.
- [62:56]
B
I'm like, I just want it all over. Let's go.
- [62:58]
C
That's the consent part of this meal, or the ascent part of this meal is, how much Parmesan do you want on the top? And you don't have to have any. You can say no.
- [63:04]
B
That'd be consent for us, though, because we're adults. But our children, they can only assent to the Parmesan being placed on their other plate.
- [63:12]
C
That was pairings. Please enjoy.
- [63:15]
B
And as a parent, I like to be like, no, fill that.
- [63:17]
C
Fill.
- [63:17]
B
I want everyone Parmesan. Don't you dare stop. I don't care what he says. I'm the guardian. I'm in charge of Parmesan in this household.
- [63:26]
C
That doesn't really happen.
- [63:27]
B
No. No, it does not. What are we doing? Oh, we're wrapping.
- [63:32]
C
Yeah, we should maybe do the last ending now.
- [63:34]
B
I'm just thinking of Farm Shop. I can't end the podcast.
- [63:36]
A
Coward and end.
- [63:37]
B
All right, well, thank you all so much for listening. Apologies for getting off track with that delicious pasta Parmesan metaphor there. We hope you enjoyed our episode of ABA InsideTrack. Please subscribe. Leave us reviews on wherever you like to listen to your podcast. There's a couple places you can always join us, though. One is on our website, ABA InsideTrack.com where you can find links to all of the articles that we discussed today, as well as all of our previous episodes. You can also join us on patreon@patreon.com Aba InsideTrack, where you can subscribe at 3, 5, 10, or even $20 a month. All of that is definitely a huge help to keep our show going. But if you are subscribing at some of those higher tiers, you get some special bonuses as a thank you from us, including access to all of our listener choice and book club polls and access to those episodes either in video format, especially for the listener choice episodes, as well as free CES. For $5 you can get all the listener choice episodes and get those CES for free, as well as voting in those topics. And at the $10 level, you can get access to our quarterly book club episodes where you get full two hour episodes a year before the rest of the world gets those. And two CES just for being a subscriber. Again, that's patreon.com abainsidetrack and of course, if you're interested in those CES, you're going to want to know the Last Secret Code Word and it's Thursday. T H U R S D A Y It's a day of the week. I'm not sure why we wanted that to be the code word, but it's in the list.
- [65:05]
A
It's one of my favorite days with.
- [65:06]
B
Jackie's Thursday is your favorite day.
- [65:08]
A
Jackie 1 One of my favorite days.
- [65:10]
B
I love all seven days. What's your favorite day?
- [65:16]
A
This day okay with you all? Anytime I'm with you is my favorite day is Friday.
- [65:23]
B
That's good. I like Friday a lot.
- [65:25]
C
Because you like, you still do work, so you're still productive and then you have the whole weekend ahead of you.
- [65:30]
A
I like Mondays.
- [65:31]
C
Oh yeah, Just kidding.
- [65:32]
B
Get out of here.
- [65:35]
A
Then I can just do work.
- [65:36]
C
And usually we have pizza on Fridays.
- [65:38]
B
Oh, that is true. Okay, but don't, don't worry so much about Friday.
- [65:41]
C
Oh, sorry.
- [65:41]
B
Remember Thursday. All right. And some final thank yous I want to say. Certainly thank you to Dr. Jim Carr for recording our in our intro and outro music, Kyle Sturry for interstitial music, and Dan Thab of the podcast Doctors for his amazing editing work. We'll be back next week with another fun filled episode, but until then, keep responding.
- [66:02]
A
Bye Bye.