I remember the intake like it was yesterday. The coordinator smiled and said a trainee could start this week to get her hours. My stomach sank. My child was being folded into someone else’s training plan because it fit a billing system.
We got here fast. Our doctor recommended ABA right away. Insurance approved a big block of hours before lunch. OT and speech were “limited” or “waitlist.” That bias steered us toward a program that could staff quickly with learners, not toward what actually fit our kids.
Here is what it looked like in real life. New faces every few weeks. Plans that shifted with each trainee’s checklist. My kids worked hard to please adults. Then they shut down at home. The data said progress. Bedtime told the truth.
Your child is not a practicum. Training hours are not a childhood plan.
Short fact: The common entry role in ABA, the RBT, requires a 40 hour course and a competency check, then supervision by a BCBA (BACB).
If your child has trouble staying focused in therapy, a trainee may push sitting time harder. What often helps is movement, a quieter room, or chew tools. If your child communicates with scripts or an AAC device, your child deserves partners who model language and wait. Not pressure on command. If meals are tense, gentle exposure and safety beat “just one more bite.”
We finally asked why our kids looked fine at the table yet melted in the car. The answer was relationship and fit. Learning is relational. New trainees reset trust. Insurance pays the hours either way. Your child holds the cost.
What I wish I had done sooner
- Ask who will be in the room. Names, licenses, and real experience with AAC, feeding, and sensory needs.
- Require your consent before any trainee observes or practices with your child.
- Cap the team at two steady people. Decline swaps that ignore your child’s regulation.
- Start small. Run a short trial and track sleep, appetite, recovery time, and willingness to go.
- Request OT, Speech, and feeding evaluations in writing. Ask for goals tied to daily life at home.
- Choose caregiver coaching. Tools that work in your kitchen beat perfect charts in a clinic.
When we shifted to OT and Speech, things softened. An OT mapped sensory needs and adjusted routines. A speech therapist built functional language and AAC during play at home. Fewer hours. Fewer strangers. More calm that lasted.
It can feel overwhelming to push back when the fastest option is loud. You are not alone. Coverage is not care. If a program treats your child like a training slot, pause. Ask hard questions. Protect consent, comfort, and communication. Your child deserves steady people, respectful methods, and goals that matter in your daily life.
