Please note, this is just a suggested support plan and can be edited as needed.

I, [Parent’s Name], hereby acknowledge and agree to the implementation and adherence to the Behaviour Support Plan (BSP) developed for my child, [Child’s Name], in accordance with the Behaviour Analyst Certification Board (BACB) Professional and Ethical Compliance Code. By signing this document, I affirm my commitment to the following terms and conditions:

1. Understanding of the Behaviour Support Plan: I have thoroughly reviewed and understand the contents of the Behaviour Support Plan, which outlines the assessment, goals, strategies, and interventions designed to address my child’s behavioural challenges.
2. Consent for Implementation: I provide my consent for the implementation of the Behaviour Support Plan by the designated behaviour professional(s) involved in my child’s care. I understand that the plan will be implemented consistently and according to the principles of applied behaviour analysis (ABA).
3. Commitment to Collaboration: I understand the importance of collaborative efforts between myself, the behaviour professional(s), and other relevant individuals involved in my child’s support team. I agree to actively participate, share relevant information, and engage in open and honest communication for the benefit of my child’s progress.
4. Confidentiality and Privacy: I acknowledge the sensitive nature of the information shared during the development and implementation of the Behaviour Support Plan. I agree to maintain strict confidentiality and respect the privacy of all individuals involved, including the behavior professional(s), my child, and other team members.
5. Compliance with BACB Code of Ethics: I recognize the importance of the people implementing the program needing to adhere to the BACB Professional and Ethical Compliance Code throughout the implementation of the Behavior Support Plan. I will ensure that my actions and interactions align with the ethical guidelines and principles set forth by the BACB.
6. Evaluation and Monitoring: I understand that regular evaluation and monitoring of my child’s progress and the effectiveness of the Behaviour Support Plan are essential. I will actively participate in ongoing assessments, data collection, and progress review meetings as required.
7. Modifications and Updates: I acknowledge that the Behaviour Support Plan may need modifications or updates based on my child’s changing needs and progress. I agree to collaborate with the behaviour professional(s) to make necessary adjustments and communicate any concerns or observations promptly.

By signing below, I confirm that I have read, understood, and agreed to the terms and conditions outlined in this Behavior Support Plan Acknowledgment and Agreement.

Parent:

[Parent’s Name] [Parent’s Signature] [Date]