When my kids were first diagnosed, the first thing I heard was, “You need at least 20 hours a week of ABA therapy.” Some clinics even recommended forty.
It sounded intense, but everyone made it seem non-negotiable. Doctors said it was necessary. Insurance approved it. ABA providers promised it would make the biggest difference. As a parent, you hear those words necessary, recommended, approved and you think, “Okay, this must be what’s best for my child.”
So we signed up. It was so easy to sign up. Felt like a well oiled machine waiting to process my child and his behaviors.
For a while, it felt like we were doing the right thing. Every hour was carefully tracked. Data was collected. Progress reports looked impressive. But at home, I saw something different.
My kids were tired. They didn’t want to go. They were missing playdates, downtime, and just being kids. The more hours we added, the more disconnected they became. Therapy wasn’t helping them live better, it was consuming their lives.
That’s when I started asking questions that no one seemed to have real answers for.
Why so many hours?
Why does insurance pay for 20 hours of ABA but only cover a handful of OT or speech sessions each year?
The truth is, it’s not about what’s best for the child, it’s about what the system is built to fund. ABA is easier to bill and scale, especially when much of it is provided by entry-level staff under a supervisor’s license. Meanwhile, therapies that actually address communication, sensory needs, and emotional regulation often get pushed aside.
I’m not saying ABA never helps. What I’m saying is that no child needs to spend most of their week in therapy to prove they’re making progress.
Children need time to rest. They need space to explore, connect, and play. That’s where the real growth happens, in the moments that aren’t tracked or charted.
So, do we really need 20 hours of ABA a week?
For my family, the answer turned out to be no.
