I learned this the hard way as a parent of two neurodivergent kids. We followed a fast ABA referral because it is what insurance approved without a fight. The message our kids heard in those rooms was simple. Do it now. Hold it in. Quiet hands. Wait for the token. Over time, that taught them to push past hunger, noise, pain, and bathroom needs just to finish a task.
What that lesson looked like years later
My child started saying “I am fine” while their jaw was tight and their eyes were wet. They skipped water in sessions and ate late at night. They held pee to avoid leaving the table. They hugged new people because an adult asked, even when their shoulders raised. Staff called it flexibility. At home it was anxiety, shutdowns, and long recoveries.
“I can ignore it. Can we finish now?”
That sentence still lives in my chest. It was not resilience. It was a child asking permission to abandon their body cues to please adults.
We did not get there by accident. Doctors push ABA because insurers greenlight big blocks quickly. OT and Speech were capped or waitlisted for us. The system rewarded what was easy to bill, not what helped our kids notice and voice their needs. When we finally shifted, Occupational Therapy focused on regulation and interoception. Speech Therapy built language and AAC for “too loud,” “I need a break,” and “my tummy hurts.” Feeding therapy protected safety and pace. Our kids began trusting their bodies again.
Signs your child may be learning to ignore needs
If your child goes quiet in sessions, skips snacks, avoids bathroom breaks, or agrees to unwanted touch, treat that as information. If a “great day” is followed by headaches, late-night eating, or hiding at home, the plan is not working for your child.
What I would do differently now
- Ask every provider how they respond to overwhelm. You should hear pause, comfort, sensory support, and a real option to stop.
- Request OT and Speech evaluations in writing. Ask for a sensory plan, interoception goals, and language or AAC to name body needs.
- If meals are tense or your child gags, seek feeding therapy that avoids pressure and moves in tiny steps. No “one more bite.”
- Protect consent. Practice and honor “No,” “Stop,” and “I need a break.” Require staff to respond kindly and immediately.
- Start smaller. Shorter sessions, predictable breaks, choice of activities, and one or two steady people.
- Track real life. Log sleep, appetite, bathroom habits, mood, and willingness to go within 24 hours of sessions.
- Push insurance using functional needs. Safety, communication access, and regulation at home and school are medical needs. Ask about out of network when only large ABA blocks are offered.
If your child has trouble staying focused in therapy, you do not have to build longer sitting. Change the environment and teach language for needs first. It can feel overwhelming to change course. You are not alone. A quick approval is not the same as the right care. Choose partners who help your child notice, trust, and voice their needs. That is the path that finally helped our family.
