You may hear our team talk about assent. It's one of the most important ideas in how we practice, so here's what it means and why it matters.
Consent is the formal permission a parent or guardian gives for treatment. Assent is the child's own ongoing willingness to participate — moment to moment, in their own way. A young child, or a child who doesn't use spoken language, can't sign a form, but they absolutely can tell us whether they're a willing participant. Consent opens the door; assent is what we check every session, because a child's willingness can change from one activity to the next.
Assent-based care means watching for the signals your child is already sending. Signs of assent include leaning in, making eye contact or smiling, reaching for materials, and choosing to keep going. Signs of assent withdrawal include pulling away, pushing materials aside, covering ears, going quiet, or showing distress. Those are our cue to pause, adjust, or change course — not to push through. We treat a child's behavior as communication, and "I'm done" is a complete sentence.
Withdrawing assent doesn't end the session — it changes it. Depending on what your child is telling us, we might:
The point isn't to win the moment. It's to keep therapy a place your child wants to be.
Honoring assent isn't about letting a child avoid everything hard. It's about building learning around trust and motivation rather than pressure. Children learn better when they feel safe and have genuine buy-in — and the relationship is stronger for it. It's also central to where the field has moved: away from compliance-at-all-costs and toward care that respects the person.
It's a fair question, and the answer is yes. Assent-based doesn't mean we only do the easy things — it means we teach the hard things in a way your child can say yes to. We break skills into achievable steps, pair them with strong motivation, and earn cooperation instead of forcing it. Skills learned with a child's buy-in tend to last longer and carry over better, because they were never about avoiding a punishment in the first place.
Offering choices. Following your child's interests. Making tasks engaging instead of demanding. Reading the small cues that say "I'm with you" or "I need a break." When a child has a say, they become a partner in their own progress.
When we say we're an assent-based, ethics-first practice, this is what we mean — and it's backed by written policy, the same commitment behind our approach to body autonomy: physical guidance stops the moment a child resists. Your child's "yes" — and their "no" — guides the work.
This article is general information, not medical advice. Please talk with your child's physician or care team about decisions specific to your child.
