In both research and practice, gaining assent from participants is an ethical imperative in applied behavior analysis. Recent guidance for including assent-based procedures has been provided in the literature (Breaux & Smith, 2023). However, limitations for decision-making when working with individuals who have developmental disabilities and complex communication needs (CCN) may require further guidance given the range of different considerations, such as use and proficiency with an augmentative and alternative communication system (AAC). Thus, this article provides an overview of considerations for individuals with greater support needs, a framework for evaluating assent in clinical practice, suggestions for measurement, and suggestions for future research.