Profound autism presents unique challenges and opportunities for individuals and their caregivers. In navigating this complex landscape, Applied Behavior Analysis (ABA) therapy emerges as a vital tool for promoting growth and development. However, the conventional approach to ABA often overlooks the importance of assent-based care, particularly concerning individuals with profound autism. In this comprehensive blog post, we’ll delve into the nuances of profound autism, explore the principles of ABA, and advocate for a more inclusive and person-centered approach grounded in assent-based care.

Understanding Profound Autism

Profound autism, also known as severe autism or Level 3 autism in the DSM-5, is characterized by significant impairments in communication, social interaction, and behavior. Individuals with profound autism may exhibit limited or non-verbal communication, repetitive behaviors, sensory sensitivities, and challenges in understanding and responding to social cues. These profound challenges can impact every aspect of daily life, from forming relationships to accessing educational and vocational opportunities.

It’s essential to recognize that individuals with profound autism possess unique strengths, abilities, and perspectives that deserve acknowledgment and support. While their communication and behavioral differences may present obstacles, they also offer valuable insights into alternative ways of experiencing the world.


The Role of Applied Behavior Analysis (ABA) in Profound Autism

ABA therapy is a well-established, evidence-based approach that focuses on understanding and modifying behavior patterns to improve overall functioning and quality of life. In the context of profound autism, ABA offers a structured and systematic framework for addressing core deficits and teaching adaptive skills.

Key components of ABA therapy for individuals with profound autism include:

  1. Functional Assessment: A thorough assessment is conducted to identify the underlying factors contributing to challenging behaviors and communication deficits. This process involves gathering information from multiple sources, including direct observation, interviews with caregivers, and behavioral assessments.


  2. Individualized Treatment Planning: Based on the assessment findings, a tailored treatment plan is developed to target specific goals and objectives. These goals may encompass a wide range of areas, including communication, social skills, self-care, and independence.


  3. Targeted Interventions: A variety of evidence-based techniques and strategies are utilized to teach new skills, reduce problem behaviors, and promote positive behavior change. These interventions may include discrete trial training, naturalistic teaching methods, visual supports, and sensory integration techniques.


  4. Ongoing Monitoring and Evaluation: Progress is continuously monitored and evaluated to ensure that the treatment plan remains effective and relevant. Adjustments are made as needed based on the individual’s response to interventions and changing needs over time.

While ABA therapy has demonstrated effectiveness in improving outcomes for individuals with autism, its traditional implementation has raised valid concerns regarding ethical considerations and the need for a more person-centered approach.


The Importance of Assent-Based Care in Profound Autism

Assent-based care represents a paradigm shift in how we approach therapy and support services for individuals with profound autism. Rooted in the principles of autonomy, respect, and collaboration, assent-based care emphasizes the active involvement of the individual in decision-making processes and treatment planning.

For individuals with profound autism, who may have limited or non-verbal communication skills, assent-based care requires a deeper understanding of their preferences, needs, and capabilities. It involves recognizing and respecting their agency, honoring their communication modalities, and creating opportunities for meaningful participation in their own care.

Assent-based care in the context of profound autism encompasses several key principles:

  1. Respect for Autonomy: Recognizing the individual’s right to self-determination and honoring their choices and preferences to the greatest extent possible.


  2. Communication Accessibility: Using alternative and augmentative communication (AAC) methods to facilitate meaningful interaction and expression of needs and desires.


  3. Individualized Support: Tailoring interventions and support services to align with the individual’s unique strengths, challenges, and goals.


  4. Collaborative Decision-Making: Involving the individual, along with their caregivers and support network, in the decision-making process regarding their care and treatment.


  5. Empowerment and Advocacy: Empowering the individual to advocate for their own needs and preferences, and providing opportunities for self-advocacy skill development.

By embracing assent-based care principles, ABA therapists and caregivers can foster a more inclusive and empowering environment for individuals with profound autism. This approach not only respects the individual’s dignity and autonomy but also enhances the effectiveness and relevance of therapy interventions.


Dispelling Myths and Misconceptions About ABA in Profound Autism

Despite its proven benefits, ABA therapy has been the subject of criticism and controversy, particularly concerning its application in individuals with profound autism. Let’s address some common myths and misconceptions:


Myth #1: ABA is coercive and controlling.

Fact: While some historical approaches to ABA may have been rigid and authoritarian, contemporary ABA therapy prioritizes collaboration, consent, and respect for the individual’s autonomy. Assent-based care principles align with the ethical guidelines of ABA practice, ensuring that interventions are implemented in a respectful and empowering manner.


Myth #2: ABA seeks to normalize neurodivergent behavior.

Fact: ABA therapy aims to promote adaptive skills and independence, not to eliminate or suppress neurodivergent traits. In the context of profound autism, ABA interventions focus on enhancing the individual’s quality of life by addressing specific areas of need while respecting their unique characteristics and preferences.


Myth #3: ABA is only effective for certain types of individuals.

Fact: ABA therapy is a versatile and customizable approach that can be adapted to meet the diverse needs of individuals with profound autism. By tailoring interventions to align with the individual’s strengths, challenges, and goals, ABA therapists can facilitate meaningful progress and improvement in various domains of functioning.


Conclusion: Towards a Holistic Approach to Profound Autism

In conclusion, profound autism presents profound challenges, but also profound opportunities for growth, development, and connection. ABA therapy, when implemented with a focus on assent-based care principles, holds tremendous potential for supporting individuals with profound autism in reaching their full potential.

By embracing the principles of autonomy, respect, and collaboration, we can create a more inclusive and person-centered approach to therapy and support services. Let’s work together to nurture the potential of individuals with profound autism and create a world where everyone is valued, accepted, and empowered to thrive.



  1. American Psychological Association. (2020). Applied Behavior Analysis: Overview and Summary of Scientific Support.
  2. Centers for Disease Control and Prevention. (2020). Data & Statistics on Autism Spectrum Disorder.
  3. National Autistic Society. (2019). Understanding Severe and Complex Needs.
  4. Odom, S. L., Collet-Klingenberg, L., Rogers, S. J., & Hatton, D. D. (2010). Evidence-based practices in interventions for children and youth with autism spectrum disorders. Preventing School Failure: Alternative Education for Children and Youth, 54(4), 275-282.
  5. World Health Organization. (2021). Autism Spectrum Disorders.

    Early intervention is a cornerstone of success for children with autism. The benefits of timely and targeted support are immeasurable, setting the stage for a brighter future. With its individualized approach, expert team and comprehensive programs, Bertling ABA stands at the forefront of early intervention. Visit Bertling ABA’s website to learn more about their innovative programs and how they’re shaping a better future for children with autism.