When a Client Hits You During a Session: A Safety and Response Guide for RBTs Working with Children (Ages 5-12) with Autism

Being hit during a session can be upsetting. Your next action should follow the client's written safety and behavior plans, your training, and your supervisor's direction. This guide is for RBTs working with children ages 5 to 12; it does not replace a client-specific plan.

RBTs participate in assessment and implement the plan under supervision; the BCBA assesses the behavior's function and selects the intervention. The RBT Ethics Code (2.0) asks you to follow your supervisor's direction (2.02), do no harm (2.01), and use only interventions you are trained for (2.04). The RBT Test Content Outline (3rd ed.) covers data collection and graphing in domain A.

Follow the written crisis plan, protect yourself and the client from harm, and get help when you need it. An RBT should not improvise extinction, withhold assistance, or continue a demand because a general guide calls it a standard protocol.

Use the steps below to prepare for sessions, follow the written plan, document what happened, and communicate with your supervising BCBA. Ask for clinical direction when the plan is unclear or you cannot implement it safely.

Practical Strategies You Can Use

1. Know the behavior intervention plan (BIP) before the session starts. Every client with a history of aggression should have a written BIP that includes specific instructions for how to respond when aggression occurs. Read this plan before every session. Know what the antecedent strategies are (what you do to prevent the behavior), what the consequence strategies are (what you do immediately after the behavior), and what your safety protocol is. If no BIP exists or you have not been trained on it, you must contact your supervising BCBA before the session begins. The RBT Ethics Code (2.0) prohibits you from implementing interventions you have not been trained to deliver.

2. Follow the communication and safety responses in the written plan. Use the calm communication you have been trained to use, and get help if you are hurt or cannot keep people safe. Whether attention is provided, a demand is paused, or a session stops is determined by safety needs and the client's written plan, not by a universal response to hitting. Do not retaliate or improvise a punishment procedure.

3. Use the safety procedures you have been trained and authorized to use. Step back and get help. Do not grab, hold, or restrain the client unless the procedure is in the documented plan and your supervisor has verified your competence to use it. The RBT Ethics Code addresses unfamiliar interventions in 2.04 and restrictive procedures in 2.05. Ask your supervising BCBA to clarify or arrange training before you are expected to use a physical safety procedure.

If anyone is seriously hurt or in danger, call your local emergency number (911 in the US), then tell your supervisor. A bite that breaks the skin needs same-day medical evaluation. So does a head injury, or any injury you cannot judge. Human bite care and head injury guidance are available from MedlinePlus.

4. Follow the written protocol for escape-maintained aggression. Safety first: step back, get help, and follow your client's written behavior plan. Whether a demand continues after aggression is decided by the BCBA in that plan, never by default. If the plan says to continue the demand after a brief pause, follow it exactly as written.

5. Follow the written protocol for attention-maintained aggression. Whether and how attention changes after aggression must be specified by the BCBA in the plan. Do not withhold help when someone is hurt or in danger. Some plans use differential reinforcement, such as reinforcing an alternative communication response. Implement only the procedures you have been trained to use, and ask your supervisor about anything unclear.

6. Collect data immediately after the incident, even if you are shaken. The RBT Test Content Outline (3rd ed.) covers describing behavior in observable and measurable terms (task A.5). After an incident of aggression, record the time, the antecedent (what happened right before), the behavior (describe what the client did, such as "hit my left arm with open hand"), and the consequence (what you did immediately after). If you are using a frequency count, ABC data sheet, or scatterplot, complete it as soon as it is safe to do so. This data is critical for your BCBA to analyze the function of the behavior and adjust the intervention plan. If you do not collect data, the team cannot make informed decisions.

7. Report promptly and follow your agency's incident procedures. The RBT Ethics Code asks you to direct questions and concerns to your supervisor (2.06) and, when a client is at risk of harm, to report it to your supervisor, follow your organization's policies and document what you did (2.07). As practical guidance, tell your supervising BCBA about an incident the same day, even if it seems minor; follow any more urgent agency or emergency procedure first. Explain what happened, what you did and what the client did afterward. Say if you feel unsafe or need the plan reviewed. The same-day wording here is guidance, not a quoted BACB deadline.

8. Use antecedent strategies to prevent the behavior before it occurs. Use the prevention strategies your BCBA includes in the plan. If the BIP includes antecedent strategies such as offering choices, using a visual schedule, providing frequent breaks, or delivering high rates of reinforcement for compliance, implement those strategies with fidelity. Many incidents of aggression can be prevented by increasing the density of reinforcement, reducing the difficulty of demands, or providing the client with a functional communication response (such as asking for a break using a picture card or verbal request). Ask your supervisor to review prevention and response strategies together; no single approach is best for every client.

What to Do This Week

Day 1: Before your next session with this client, re-read the behavior intervention plan (BIP) if one exists. Identify the section that describes what you should do if aggression occurs. If no written plan exists, email or text your supervising BCBA today and ask for clarification. Do not run the session without a clear protocol.

Day 2: Review your data collection system for this client. Make sure you have a way to record aggression quickly and accurately during sessions (such as a frequency tally sheet, ABC chart, or electronic data app). If you do not have a system, ask your BCBA to provide one or to show you how to use the existing system.

Day 3: Ask your supervisor to rehearse the response in the client's written plan with you. Practice only the communication and safety procedures you have been trained to use, and clarify when to get help or stop.

Day 4: During your session, implement the antecedent strategies specified in the BIP (such as offering choices, delivering reinforcement frequently, or providing a break before the client escalates). Notice whether the frequency of aggression changes when you increase prevention strategies. Collect data on both the antecedent strategies you used and the client's behavior.

Day 5: After your session, write a brief summary of what happened and send it to your BCBA. Include: (1) what antecedent strategies you used, (2) whether aggression occurred, (3) what you did immediately after, and (4) any questions you have. This communication habit protects you, supports the client, and strengthens your professional skills.