How I Learned to Question Treatment Goals
As a parent of two neurodivergent kids, I spent years chasing ABA goals that looked impressive in a binder but felt hollow in our home. We were told this was the gold standard, approved quickly by insurance, and recommended almost immediately by our pediatrician. It took me far too long to realize that measurable does not equal meaningful, and that the quickest path to coverage is not always the best path for a child.
Here is what I saw: ABA goals often targeted surface behaviors that made adults more comfortable rather than helping my kids feel safer, communicate better, or regulate their bodies. Eye contact. Quiet hands. Sitting still. Perfect transitions. The data sheets went up, but so did anxiety. My kids looked compliant, not confident.
“If a goal teaches my child to look less autistic instead of feel more capable, it hurts.”
Insurance shaped our choices. ABA got a near-instant approval. OT and ST were a maze of waitlists, limited hours, and denials for the supports that actually matched our kids’ needs. That imbalance nudged us toward a program that promised results because it was easy to fund, not because it was the right fit.
Red flags I wish I had trusted sooner:
- Goals that prioritize compliance over regulation, communication, or autonomy
- Suppressing stims that help your child self-regulate
- Rewards for masking discomfort instead of addressing the cause
- Progress measured only by frequency charts, not well-being or generalization
- Little collaboration with OT or ST, or resistance to AAC
When we shifted focus, everything changed. OT addressed sensory needs, motor planning, and self-advocacy. ST supported functional communication and AAC, not just speech. The goals were collaborative and respectful. Fewer hours, more dignity, and real life getting easier. We had to appeal insurance decisions and push for evaluations, but it was worth it.
If you are in ABA now, you deserve goals that help your child feel safer, more regulated, and more understood. Ask for goals that build communication choices, support sensory needs, and honor consent. Insurance is not neutral. You are allowed to slow down, request changes, or choose a different path.
Your child’s humanity is not a behavior to fix. It is a person to support.
