What I Wish I Knew Before Following the Standard Recommendation
As a parent, you want the best for your child. When my two neurodivergent children received their diagnoses, I felt immense pressure. Our pediatrician immediately suggested ABA. Insurance quickly approved many hours. Like many parents, I said yes. I was scared to wait. I just wanted to help my kids.
The clinic seemed very orderly. There were clipboards and schedules. Yet, staff often changed. My children appeared calm during sessions. But at home, the struggles grew. Sleep became elusive. Mealtimes turned tense. The solution offered was always the same: add more hours. Never change the approach itself.
“If the room feels safe, my brain can listen.”
I wish I had paused then. I wish I had asked why one specific therapy was pushed so much faster than others. Here is what I learned through years of struggle. **ABA is often recommended because it fits the insurance system.** Large agencies can staff it quickly. Doctors are often rushed. They reach for what gets approved right away. This does not mean it is the best path for your unique child.
Insurance companies often prefer covering ABA. This is because licensed therapies like Occupational Therapy (OT) and Speech Therapy (ST) can cost more per hour. They require highly specialized training. So, insurance may resist covering enough OT or ST. (Journal of Child Psychology and Psychiatry). This financial reality can heavily influence the recommendations you receive.
What finally brought real change to our family was different. We found licensed Occupational Therapy and Speech Therapy. These professionals focused on regulation and authentic communication. They understood that the environment matters first. Lights were softened. Extra noises were quieted. Two minutes of heavy work or calming movement set a new tone. Our speech therapist honored every way my children communicated. Speech, gestures, pictures, and AAC were all valid from day one. Our family stress dropped. New skills began to show up in our kitchen and car, not just in a clinic chair.
If your child struggles to focus in therapy, try changing the space first. Headphones, softer lighting, a weighted lap item, or a simple first-then card can make a huge difference. If a new person walks in without warning, you are allowed to reschedule. You are protecting your child’s trust. You are not being difficult. If meals become shaky after sessions, stop all pressure around food. Ask for responsive feeding support that prioritizes comfort and consent.
What I would do now instead of saying yes on the spot
- Email your pediatrician. Ask: “If coverage were equal, which mix of OT, ST, or feeding therapy would you start, and why?” Ask them to add that note to your child’s chart.
- Book full Occupational Therapy and Speech Therapy evaluations. Request weekly parent coaching in writing. This ensures strategies come home with you.
- Set a short trial period. Six to eight weeks of OT and ST. Track sleep, appetite, mood, and your child’s willingness to return for 24 hours after each session.
- Build a two-minute start routine for new activities. Use the same seat, softer light, two calming movements, then a short preferred task.
- Protect communication at all costs. Keep AAC, pictures, gestures, and speech available from minute one. Your child never has to earn their voice.
- Ask for consistency from your providers. Request one primary therapist and one backup. Aim for the same day, same time, and same room whenever possible.
It can feel daunting to push back against the system. Please know that you are not alone. You are allowed to pause and reconsider. You are allowed to choose care that starts with comfort. You are allowed to honor your child’s unique voice. Let your child’s body and signals guide the plan. Let their comfort, not a billing code, set the pace for their progress.
