Preparing for ABA Therapy: What to Expect in the First Month

TL;DR: The first month of ABA therapy is foundational — it’s when assessment happens, goals are set, rapport is built, and the treatment plan is created. Your child won’t be “doing ABA” on day one; instead, the BCBA will assess their skills, the therapist will build a relationship (pairing), and you’ll collaborate on goals that matter to your family. Understanding what happens during this critical first month helps you set realistic expectations, prepare your child, and be an active partner from the start. This guide walks through every step: intake, assessment, goal-setting, the first sessions, and what to do when things don’t go perfectly.

You’ve been on a waitlist. You’ve navigated insurance. You’ve chosen a provider. And now it’s actually happening — ABA therapy is starting.

You’re nervous. Your child is probably nervous too (or doesn’t know what’s coming, which has its own challenges). You have a hundred questions: What will they do? How will my child react? How long until we see progress? What if my child hates it?

Here’s the reassuring truth: the first month is designed to go slowly. No one expects your child to sit at a table and work on flashcards on day one. The first month is about getting to know your child, building trust, and creating a plan that’s right for your family.

Before Therapy Starts

What You’ll Need

Document	Why
Autism diagnosis report	Confirms eligibility; informs assessment
Insurance authorization	Specifies approved hours and services
Medical records	Medications, allergies, seizure history, relevant medical conditions
Previous evaluations	Speech, OT, psychological testing — anything that provides information
School records	IEP, report cards, teacher observations
Your observations	What you want therapy to address; what your child does well; what’s hardest

Preparing Your Child

For children who understand explanations:

Use a social story: “A new person is coming to our house to play with you and help you learn new things.”
Show photos of the therapist if the provider shares them
Preview the schedule: “They’ll come on Monday and Wednesday after lunch.”
Be honest: “They might ask you to do some things. They’ll also play games you like.”

For younger children or children with limited understanding:

The pairing process (below) handles this — the therapist builds the relationship through play
Maintain your child’s regular routine as much as possible
Have preferred toys and activities available

Preparing Your Home (for In-Home ABA)

If therapy will happen at home:

Designate a therapy space (a room or area with table and chairs, good lighting, minimal distractions)
Have your child’s preferred toys and activities accessible
Clear a space for therapy materials
Plan for siblings (they’ll need to be supervised separately during sessions, especially initially)
Inform anyone in the household about the schedule

Preparing Yourself

Write down your top 3-5 concerns or goals (what do you most want ABA to help with?)
Be ready to share detailed information about your child: likes, dislikes, triggers, calming strategies, communication abilities
Block time for the initial parent meeting (usually 1-2 hours)
Know that the first session won’t look like “therapy” — and that’s intentional

Week 1: Assessment Begins

The BCBA Assessment

In the first week, the BCBA (Board Certified Behavior Analyst) will conduct a comprehensive assessment. This typically includes:

Standardized skill assessments:

Assessment Tool	What It Measures
VB-MAPP (Verbal Behavior Milestones Assessment)	Language, social, play skills across developmental milestones
ABLLS-R (Assessment of Basic Language and Learning Skills)	544 skills across 25 areas
AFLS (Assessment of Functional Living Skills)	Daily living skills, community skills, independence
Vineland	Adaptive behavior (communication, daily living, socialization, motor)

Preference assessment: Identifying what motivates your child (toys, activities, food, social attention). This is critical — reinforcement drives everything in ABA.

Behavioral observation: The BCBA watches your child in different contexts — play, transitions, demands, social interactions — to identify behavior patterns and skill levels.

Parent interview: Extensive conversation about:

Daily routines and challenges
Communication abilities and methods
Behavioral concerns (frequency, intensity, triggers)
Social skills and relationships
Daily living skills (eating, dressing, toileting)
Medical history and current medications
Your family’s priorities and goals

What Assessment Looks Like to Your Child

Your child probably won’t know they’re being “assessed.” The BCBA will:

Play with them and observe
Present activities and see what they can do
Try different approaches to see what works
Interact casually while noting skills and challenges

This should feel natural and low-pressure — not like a test.

Week 2: Pairing and Goal-Setting

Pairing: Building the Relationship

Pairing is the process of the therapist (RBT) associating themselves with everything your child loves. This is the most important step in early ABA.

What pairing looks like:

The therapist plays whatever your child wants to play
They follow your child’s lead
They provide preferred items, activities, and attention freely
They don’t make demands (or very few)
They become the “fun person”

Why pairing matters:

Your child learns that the therapist = good things
Rapport and trust are established
Motivation to participate in future activities is created
The therapist learns what your child likes, how they play, and how they communicate

How long pairing takes: Usually 1-2 weeks of primarily play-based sessions. Some children pair quickly; others need longer. Rushing pairing undermines everything that follows.

Goal-Setting: Your Collaboration

After assessment, the BCBA will develop a treatment plan with specific goals. This should be a collaborative process:

What the BCBA brings: Assessment data, clinical expertise, knowledge of developmental sequences

What you bring: Knowledge of your child, family priorities, daily life challenges, cultural considerations

Goal areas typically include:

Communication (requesting, commenting, answering questions)
Social skills (play, turn-taking, interaction)
Daily living (dressing, eating, hygiene, toileting)
Behavioral (reducing challenging behaviors, teaching replacement behaviors)
Academic readiness (pre-academic or academic skills)
Safety (responding to name, stopping, danger awareness)

Good goals are:

Specific and measurable (“Will request using 2-word phrases in 80% of opportunities” — not “improve communication”)
Relevant to your family’s daily life
Achievable within the authorization period
Prioritized (not 50 goals at once)
Meaningful to your child’s independence and quality of life

See our guide to ABA therapy goal examples.

Find ABA providers near you who prioritize family collaboration in goal-setting.

Weeks 3-4: Therapy Begins

What Sessions Look Like

By weeks 3-4, structured teaching begins — gradually blended with continued pairing:

Session Element	What Happens
Pairing/warm-up	5-10 minutes of free play to re-establish rapport
Structured teaching	DTT, NET, or other techniques for skill targets
Play-based teaching	Learning embedded in play and natural activities
Breaks	Preferred activities between work periods
Routine-based targets	Practicing skills during snack, transitions, clean-up
Data collection	Therapist records responses to track progress

The balance shifts over time: Early sessions are 80% pairing, 20% teaching. As your child’s comfort and tolerance grow, this shifts toward more teaching — but play and reinforcement remain central throughout.

Common First-Month Challenges

Your child cries when the therapist arrives:

Normal, especially for young children with new people
Usually resolves within 1-2 weeks as pairing takes effect
The therapist should not force interaction during crying
If crying persists beyond 2-3 weeks, discuss with the BCBA

Your child won’t cooperate:

Expected early on — the therapist is learning your child’s motivators
Not a sign of failure or that ABA “isn’t working”
The BCBA will adjust the approach based on what they observe
Pairing may need to continue longer before demands increase

You don’t see immediate progress:

The first month is assessment and relationship-building
Skill acquisition usually becomes visible in months 2-3
Data collection has just started — there isn’t enough data yet for trends
Don’t compare to other families’ timelines

Your child seems great with the therapist but not with you:

This is common and doesn’t mean you’re doing anything wrong
The therapist is highly trained in reinforcement and prompting
Parent training will help you learn the same techniques
Consistency across people takes time to develop

Parent Training Begins

By the end of the first month, parent training should be starting:

The BCBA explains what goals are being worked on and why
You observe a session and ask questions
The BCBA starts teaching you specific strategies for home
You practice strategies with guidance

This is NOT optional — parent training is one of the strongest predictors of ABA therapy success.

Red Flags in the First Month

Concern	What to Do
No assessment conducted	Ask when the assessment will happen; it’s required before treatment
No parent interview or collaboration on goals	Advocate for involvement; you should be part of goal-setting
Therapy starts without pairing	Raise concern with BCBA; pairing is essential
Your child is consistently distressed throughout sessions (not improving by week 3)	Request a BCBA observation; approach may need modification
No data collection visible	Ask to see data; it should be collected every session
Therapist seems unprepared or unsupervised	Contact the BCBA; RBTs require regular BCBA supervision
You haven’t met or spoken with the BCBA	Request a meeting; the BCBA is your primary contact for treatment decisions

Frequently Asked Questions

How long until we see progress?

Most families see initial progress in skills within 2-3 months of consistent therapy. Behavior reduction may take longer (3-6 months), especially for deeply established patterns. The first month is primarily assessment and relationship-building — real skill teaching ramps up in month 2. Progress should be measurable through data, which your BCBA should share with you regularly.

What if my child doesn’t like the therapist?

Give it 2-3 weeks of consistent pairing. Most children warm up. If after 3 weeks your child is still consistently distressed, discuss with the BCBA — a different therapist may be a better personality match. Chemistry matters, and good providers will accommodate changes.

How should I act during sessions?

Follow your BCBA’s guidance. Some providers prefer parents observe initially; others involve parents from day one. Generally: be available but don’t hover, let the therapist work, save detailed questions for the BCBA, and use session time as an opportunity for sibling attention or self-care. As parent training progresses, you’ll be more actively involved.

What if I disagree with a goal?

Speak up immediately. ABA therapy should address YOUR family’s priorities. If a goal doesn’t seem relevant, ask the BCBA to explain the rationale. If you still disagree, request a modification. You have the right and responsibility to participate in treatment planning. Good BCBAs welcome parent input — it makes the program more effective.

Can I switch ABA providers if the first month doesn’t go well?

Yes — you can switch providers at any time. However, first distinguish between normal first-month challenges (adjustment period, learning curve) and genuine provider concerns (lack of assessment, no parent involvement, inconsistent treatment). Raise concerns with the BCBA first — many issues can be resolved. If the provider isn’t responsive to your concerns, switching is appropriate. Learn about choosing an ABA provider.

Take our matching quiz to find the right ABA provider for your family’s needs.