Our first referral and why it felt off
Both of our kids were referred to ABA within days of evaluation. The doctor said it was standard. Insurance approved it fast. OT and ST were waitlisted and “not medically necessary” for now. It felt like a funnel. More hours. More forms. Fewer choices.
“ABA is the gold standard. More hours means better results.” We heard that line a lot. It sounded official. It was not our reality.
We started with 30 hours a week. Compliance was the goal. Tokens, tally marks, and sitting still. Our kids learned to perform at the table, then melted down in the car. They stopped singing and started scripting. Home got louder, not calmer. The skills did not carry over to real life.
What we saw and what we wish we knew
If your child has trouble staying focused in therapy, the plan often adds more drills. If your child flaps, the goal might be to reduce it, not to ask why it helps. We kept asking for play, for co-regulation, for breaks. We were told to trust the process. We watched our kids shut down.
Insurance kept saying yes to ABA and no to the supports we asked for. We finally pushed through to try OT, ST, and feeding therapy. OT looked at sensory needs and motor planning. ST used play and natural moments. Feeding therapy slowed meals down and reduced stress. Our kids connected more at home. We saw fewer tears and more curiosity.
Short fact: Occupational therapy can help sensory regulation and daily living skills for autistic children (American Occupational Therapy Association).
Practical steps that helped us
- Ask for a full evaluation for OT, ST, and feeding therapy, not just ABA.
- Request goals that honor your child’s autonomy, communication, and joy.
- Start with fewer hours and track sleep, behavior, and connection at home.
- Sit in on sessions. If you cannot observe, treat that as a red flag.
- Appeal insurance decisions. Ask for single case agreements or out-of-network coverage.
You are not alone
It can feel overwhelming. You want help today. You also want your child seen as whole. Trust your gut. If your child leaves therapy exhausted, it is data. If play and co-regulation help, lean in. You get to choose what fits your child, even when the system pushes one path.
Our lesson was hard. We lost time. We also found what worked. Your family can too.
