Six months in, our third ABA therapist quit. The first left after a few weeks. The second lasted a bit longer. Each goodbye came with a new intake, a fresh binder, and promises that this time would be different. My kids were tired of meeting strangers in our living room. I was tired of rebuilding trust that never had a chance to stick.
“Do I have to teach the new helper my favorite game again?” my child asked.
Here is what actually happened. The clinic reassigned us quickly because insurance had approved lots of hours. The new tech shadowed for two short days, then ran sessions solo. Sensory notes were missed. Breaks became rewards. Meltdowns rose. We watched skills that mattered at home slip while the data sheets kept growing.
Turnover is not a small hiccup for relational learners. Your child needs safety with a person before skills can show up. Constant staff changes reset that safety. Insurance reimbursed the hours anyway. Stability was not part of the billing code.
Our pediatrician meant well, but the recommendation came fast because it was easy to authorize. OT, speech, and feeding support were capped, delayed, or called “waitlist only.” That imbalance pushed us into a model that could staff long schedules with rotating technicians. It did not serve our kids.
If your child loses focus in sessions, a new face makes it harder. If your child uses AAC or scripts, every switch means re-teaching how to listen and respond. If your child needs movement, the new person may miss the cue and push through. The fallout lands in your home, not on the clinic’s spreadsheet.
What I wish I had done the week our third therapist quit:
- Pause the schedule and run a short trial with one consistent provider only.
- Request OT and speech evaluations in writing, with goals tied to home routines.
- Ask the clinic for a written plan on staffing stability, notice for changes, and how new staff will be trained on your child’s sensory and communication needs.
- Track real life: sleep, recovery time after sessions, appetite, and willingness to join.
- Push your insurer for concurrent authorizations and caregiver coaching, not just clinic hours.
When we shifted to OT and speech, we saw slower, steadier gains that stuck. An OT mapped sensory needs and adjusted our routines. A speech therapist helped us build functional language and AAC in our kitchen. Fewer people, fewer hours, more calm. Our kids did not have to audition for a new adult every month to get support.
It can feel heavy to pause when everyone says “keep going.” You are not alone. If turnover keeps resetting your child, that is data. Choose providers who can stay, methods that respect regulation and communication, and goals that matter in your daily life. Coverage may be loud, but your child’s nervous system is the better guide.
