First ABA Therapy Session: What to Expect and How to Prepare

TL;DR: Your child’s first ABA therapy session isn’t a typical “therapy session” — it’s the beginning of the assessment and relationship-building process. The first 2–4 weeks involve the BCBA evaluating your child’s skills, interviewing you, observing behavior, and the RBT building rapport through play (called “pairing”). Expect tears, uncertainty, and a lot of play. Don’t expect structured teaching right away. Your main job: share everything you know about your child, be honest about your concerns, and give the team time to build a relationship with your child.

The day is finally here. After months of waiting, evaluating providers, and navigating insurance — your child’s ABA therapy is about to start. You might feel relieved, anxious, hopeful, overwhelmed, or all of the above.

Here’s what’s actually going to happen — day by day, week by week — so you can walk in prepared.

Before the First Session

What the Provider Has Already Done

By the time your child’s first day arrives, several things have typically happened behind the scenes:

Insurance authorization has been obtained for the initial assessment
A BCBA (Board Certified Behavior Analyst) has been assigned to your child’s case
An RBT (Registered Behavior Technician) has been selected and matched to your child
Intake paperwork has been collected from you (medical history, developmental concerns, previous evaluations, goals)
The BCBA has reviewed your child’s existing reports, diagnosis, and your intake forms

How to Prepare Your Child

Keep it simple and positive. For verbal children: “Someone new is coming to play with you today!” or “We’re going to visit a fun place where you’ll play with new toys.” Don’t over-explain or create anticipatory anxiety.

For nonverbal children: Maintain your normal routine as much as possible. Changes in routine can create anxiety before the session even begins.

Don’t prep your child to “perform.” Don’t practice eye contact, saying words, or any other skills. The therapist needs to see your child’s natural behavior — that’s how they design the right program.

What to Have Ready

For in-home sessions:

A semi-quiet space for therapy (doesn’t need to be a dedicated room)
Your child’s favorite toys, snacks, and activities accessible
A list of your child’s preferred items (ranked from most to least preferred)
Any communication tools your child uses (AAC device, picture cards)

For center-based sessions:

Comfort items from home (favorite toy, blanket, snack)
Change of clothes (just in case)
Any medications your child takes during the session timeframe
Drop-off and pickup plan

Week 1: Assessment and Pairing Begin

The BCBA Assessment

During the first 1–2 weeks, the BCBA will conduct a comprehensive assessment. This typically includes:

Parent interview (1–2 hours): The BCBA will meet with you (in person or virtually) to discuss:

Your child’s developmental history
Current skills across all areas (communication, social, daily living, play, behavior)
Challenging behaviors — what they look like, when they happen, what you’ve tried
Your family’s priorities and goals
Your child’s preferences, routines, and sensory needs
Medical and educational history

Be thoroughly honest. This isn’t a test of your parenting. The more the BCBA knows — including the hard parts — the better the treatment plan will be. Mention the 3 AM meltdowns, the foods your child will and won’t eat, the strategies that backfired. All of it matters.

Standardized assessment (2–4 hours across multiple sessions): The BCBA will administer a formal skills assessment — usually the VB-MAPP (Verbal Behavior Milestones Assessment and Placement Program) or ABLLS-R (Assessment of Basic Language and Learning Skills-Revised). This involves:

Presenting your child with items, activities, and social situations
Observing what skills they demonstrate independently
Testing across domains: language, social, play, daily living, motor skills
Documenting skill levels to establish baseline and set goals

This looks like play — and much of it is. The BCBA is creating situations to observe your child’s abilities, not drilling them on tasks.

Behavioral observation: The BCBA observes your child in the therapy setting to understand:

What triggers challenging behaviors (antecedents)
What the behaviors look like (specific, observable descriptions)
What happens after the behavior (consequences)
Possible functions of the behavior (attention, escape, access, or sensory)

If challenging behaviors are significant, the BCBA may conduct a formal Functional Behavior Assessment (FBA).

The RBT Begins Pairing

While the BCBA is conducting the assessment, the RBT begins pairing — building a positive relationship with your child. During the first week, expect:

Lots of play. The RBT follows your child’s lead, offering preferred toys and activities with no demands.
No structured teaching. This surprises many parents. But teaching requires trust, and trust takes time.
Possible tears. Some children cry when a new person enters their space, especially if they have separation anxiety or stranger anxiety. This is normal and usually resolves within a few sessions.
The RBT observing and learning. They’re learning your child’s preferences, communication style, sensory needs, and behavioral patterns.

What this looks like: The RBT sits on the floor near your child. They pull out bubbles. Your child watches. The RBT blows bubbles. Your child smiles. The RBT offers a turn. Your child takes it. No “say bubble first.” No “look at me.” Just shared enjoyment.

Week 2–3: Treatment Plan Development

The BCBA Writes the Plan

Based on the assessment, the BCBA creates your child’s individualized treatment plan. This includes:

Baseline data — where your child is right now across all skill areas
Treatment goals — specific, measurable objectives (e.g., “Child will independently request 5 different items using 2-word phrases in 3 out of 4 opportunities”)
Recommended hours — how many hours of therapy per week, based on assessment results
Teaching strategies — which ABA methods will be used for each goal (DTT, NET, PRT, etc.)
Behavior intervention plan — if applicable, strategies for reducing challenging behaviors and teaching replacement skills
Parent training goals — what you’ll learn to do at home

You Review and Approve

The BCBA should meet with you to review the treatment plan before finalizing it. This is your opportunity to:

Ask questions about any goal or strategy you don’t understand
Add or modify priorities based on your family’s needs
Discuss the recommended hours and how they fit your schedule
Understand how progress will be measured and when you’ll receive updates
Clarify the BCBA’s supervision schedule — when and how often they’ll observe sessions

Don’t be a passive recipient. You know your child best — your input makes the plan better. See our 10 questions to ask your BCBA for guidance.

Insurance Authorization

The treatment plan is submitted to insurance for authorization of ongoing therapy hours. This typically takes 1–4 weeks. Most providers begin services during the assessment/authorization period to avoid gaps.

Find ABA providers near you who create thoughtful, individualized treatment plans.

Week 3–4: Teaching Begins

The Transition from Play to Learning

By week 3–4 (sometimes sooner for children who pair quickly), structured teaching goals are gradually introduced:

The RBT begins embedding teaching trials into play activities
Demands are introduced very gradually — one small request for every many moments of free play
Every demand is immediately followed by reinforcement
The ratio of play to demand stays heavily in favor of play

What this looks like: The RBT and your child are playing with cars. The RBT holds a car your child wants and waits. Your child reaches. The RBT models “car.” Your child attempts the word. The RBT immediately gives them the car and says “Great job! You said car!” This took 3 seconds. Then they play freely for another 5 minutes.

What the First Real Sessions Look Like

A typical early therapy session (center-based, 4 hours):

Time	Activity
9:00	Arrival, greeting, warm-up play
9:15	Natural Environment Teaching — targets embedded in play
9:45	Free play / sensory break
10:00	Structured learning at table (DTT) — 10-15 min max for young children
10:15	Group activity with peers (if center-based)
10:30	Snack time — daily living skills practice
10:45	Play-based learning
11:15	Sensory break / outdoor play
11:30	Brief structured learning
11:45	Free play, transition to pickup
12:00	Parent communication at pickup

Read our detailed guide on what a day of ABA therapy looks like.

What to Expect Emotionally

It’s Normal to Feel…

Relieved — therapy has finally started. Guilty — “Should I have done this sooner?” Anxious — “Is this the right choice?” Sad — watching your child struggle or cry during early sessions is hard. Frustrated — “They’re just playing. When does the real therapy start?” Hopeful — seeing your child connect with the RBT for the first time.

All of these feelings are valid and normal. Give yourself grace during this transition.

Give It Time

The first month is foundation-building. You won’t see dramatic skill changes in week 1. What you should see:

By week 2: Your child is more comfortable with the RBT
By week 4: Your child is engaging with the RBT voluntarily
By month 2: Early signs of progress on simple goals
By month 3: Measurable progress with data to show it

If you see no progress and no plan adjustment by month 3, talk to the BCBA. Read about how long ABA therapy lasts for realistic timelines.

Common First-Week Concerns

”My child cried the entire first session”

This is common, especially for young children, children with separation anxiety, or children who struggle with new environments and people. The RBT is trained to handle this calmly. It usually improves significantly within 3–5 sessions. If crying persists beyond 2 weeks with no improvement, discuss adjustments with the BCBA.

”The therapist just played — no teaching happened”

That IS the teaching — right now. Pairing builds the relationship that makes all future learning possible. Skipping pairing to “get to the real work” creates resistance that slows everything down.

”My child has more tantrums at home after starting therapy”

This can happen initially as your child adjusts to a new routine, new people, and new expectations. It typically resolves within 2–3 weeks. If it persists or worsens, discuss with the BCBA — they may need to adjust the pace.

”I don’t know what’s happening in sessions”

Ask. You have every right to know what’s happening in your child’s therapy. Request session summaries, observe sessions (in person or via video if available), and schedule regular check-ins with the BCBA. Communication is a green flag — learn what else to look for.

Frequently Asked Questions

How should I explain ABA therapy to my child?

Keep it age-appropriate and positive. For young children: “You’re going to play with Miss [name] today!” For older children: “You’re starting a program where you’ll learn new skills and play games. Your teacher [name] is really nice.” Avoid framing therapy as something they “need” because something is “wrong.”

Can I stay during sessions?

This varies by provider and setting. Many in-home providers welcome parent presence. Center-based programs may have observation windows or scheduled observation times. Ask about the policy — and advocate for being present if it matters to you.

What if my child doesn’t like their therapist?

Give pairing 2–3 weeks. If your child shows no improvement in comfort after genuine pairing efforts, talk to the BCBA about a different RBT match. Not every personality combination works, and good providers will accommodate.

When will I see the treatment plan?

The BCBA should share the treatment plan within 2–4 weeks of starting, after the initial assessment is complete. You should review it together and have the opportunity to provide input before it’s finalized.

What if I disagree with the goals?

Speak up. The treatment plan should reflect your family’s priorities alongside clinical assessment. If the BCBA sets goals you don’t agree with, discuss your reasoning. A good BCBA will listen, explain their clinical rationale, and work with you to find alignment.