How can parents prepare their child for starting ABA therapy?

My mother always said worry is a mother’s worst trait, and my neighbor exemplified this last spring when she called me after she and her husband had made the decision to sign their son up for ABA (applied behavior analysis) therapy. She was very worried because in two weeks she would have to take her son to the clinic where he would begin this intense work, and she hadn’t yet started to prepare him (or herself) for what was to come. She had read enough about the therapies and spoken with enough specialists to know that this was the way to go, but then the papers would arrive and she would be overcome with worry about how to implement what the therapists were doing with her son in the clinic to what he did in the rest of his life.

Honestly, that was a question that really stopped me in my tracks. It is the right question that almost no one ever asks.

The majority of discussions around ABA therapy revolve around the specifics of different programs and methods (such as Applied Behavior Analysis, Verbal Behavior, etc.) as well as provide information around the amount of research that has been conducted around ABA and the typical outcomes for children of different ages in ABA. However, the several weeks leading up to a child’s ABA program are an important first chapter of a child’s ABA program and the way that this first chapter of a child’s ABA program unfolds will, in many ways, set the stage for the rest of a child’s time in ABA.

Start with your child, not the paperwork

Of course, the child will get assessed, you will fill out the paperwork and the therapist will call to set up the first session on a certain day at a certain time. However, in the meantime, the child’s nervous system will prepare for something new: A new environment!

The child’s nervous system can also prepare for novel environments and situations before they even occur. This means that the child’s nervous system can bring alarm or anxiety to unfamiliar settings, even if they are familiar with the building or general area where the therapy will be taking place. The child may know the building and general area where the therapy takes place, but still be affected by the unfamiliar smells, people, and routines of the therapy space. To best support the child in therapy, it is important to connect with the child’s nervous system and begin to support the child’s ability to navigate unfamiliar spaces in a positive way. This can help to decrease the child’s anxiety and allow for growth and learning in a meaningful way.

The Ways to Prepare.

• Drive by the clinic a few times, or look at photos together on the website if they’re available
• Talk about it in simple, concrete terms: “We’re going to a place where you’ll play and practice things with a helper”
• Use a visual schedule at home showing therapy as a regular part of the week, not a random event
• Let your child bring a comfort item if that’s something they respond to

Some examples of how to prepare your child for the ABA sessions to come and reduce anxiety while traveling to the first ABA session:

You’re not over-preparing your child for ABA. You’re just giving them a chance to get used to what’s going to happen at ABA. A child who is given time to prepare for a new place and hears the name of that place over and over again is going to do a lot better on the first day of ABA than a child who is taken to an entirely new place with no prior knowledge of the location.

The Worst-Case Scenario.

Here’s a comparison that I find helpful to view side by side.

The difference between these two columns is not dramatic in and of itself but it adds up.

Questions to Ask Your Child’s Provider

You’d be surprised at how many parents go into an intake meeting and have no idea how to ask the questions that they really want to have answered after the meeting. And I think this is because, during the intake meeting, parents are so focused on trying to absorb as much information as possible about their child’s treatment that they can space out themselves and not even realize it until they get in the car after the meeting. Information that is important enough to take in during the meeting is important enough to go back to and review after the meeting.

Fight the reflex.

Some things that you might ask your child’s provider during the intake meeting for their therapy. This meeting is typically about 20-30 minutes where parents can find out more information about their child’s treatment and what kind of things they can expect in future sessions with the child. A lot of information is typically presented in these meetings, and it is common for parents not to remember most of it by the time they get home from the meeting and typically within a week or two the information from the meeting will have been forgotten. It is also common for parents to ask a lot of questions during the meeting and then not even think about those questions after the meeting. In order to best prepare yourself for your child’s treatment it is a good idea to write down a few questions to ask the provider during the intake meeting. Such as:

The biggest question of all is what you are supposed to do at home with the new behaviors that your child learns in therapy. Most ABA programs expect parents to reinforce the new skills learned in sessions and expect children to use their new skills in all environments. This can be very helpful to have an idea of what to expect in terms of how to work with your child at home before you start sessions. Ask your therapist for examples of how you can work with your child at home. Also, ask your therapist to explain the reasoning behind specific techniques. This will make you a much better partner in your child’s therapy than simply following along with what your child’s therapist tells you to do.

Home is where consistency lives (whether you’re ready or not)

After a few hours on the weekends and a few hours during the week, your child goes home to

Most ABA occurs in a clinic setting separate from a child’s and family’s daily life; that is, a few hours a week of ABA in a clinic some distance from home as compared to 24/7 home. So the behavior analyzed and shaped in ABA can occur at home. And the person most consistently able to reinforce a child’s newly learned behaviors is the child’s parent.

Just because you are not a Behavior Analyst does not mean you cannot support your child’s learning in home environment. You will want to get a sense of what your child is working on in ABA therapy and then figure out ways to reinforce same behaviors at home and support your child when he/she is struggling with similar behaviors. Your therapist will be able to give you an idea of what your child is working on and then you can ask them to show you how to support same behaviors. You may also want to observe a session or two and see how your child works in a clinic setting and how a clinician would support your child in this setting. This will also give you an idea of how you can be consistent at home with your child’s learning.

If you are looking for quality ABA services for your child and family would greatly benefit from working with aba therapy danvers ma. Families from our area have reported very positive results from working with .

Lower your expectations. Temporarily, but seriously.

There’s nothing good about the initial few weeks of ABA for the child. They are often very hard.

In addition to whatever progress your child is making in ABA, children typically come home from ABA sessions a bit dysregulated. They can be less cooperative than they are at other times. Their nervous systems are being pushed in many ways, and it takes time for their systems to adjust to the increased demands of ABA. It is natural for a child’s nervous system to be challenged by ABA. It is normal for a child to be less cooperative at the end of a long day of ABA than he/she is at other times. It is normal for children to be dysregulated at the end of a long day of ABA. It is normal for a child to be upset or angry at the end of a long day of ABA. It is normal for a child to resist the homework that he/she is assigned at the end of a long day of ABA. It is normal for a child to be less cooperative with his/her parents at the end of a long day of ABA. There are many things that are normal about a child’s negative response to new circumstances. A child’s negative response to new circumstances does not necessarily mean that the child and his/her parents are making a mistake in pursuing ABA for the child. Just because a child’s negative response to new circumstances does not necessarily mean that the child and his/her parents are making a terrible mistake in pursuing ABA for their child. There are many parents of children with autism who are able to handle their child’s initial negative response to new circumstances without too much stress. I do not know how these parents do it. I wish that I could tell you that there was a way to prepare a child’s nervous system for the increased demands of ABA, but there is not. In the meantime, I can tell you that you are doing the best you can. That is all that any of us can do. The best thing that you can do for your child is to continue to support him/her in his/her ABA program. The best thing that you can do for your child is to continue to reinforce the behaviors that his/her therapist is working to increase. The best thing that you can do for your child is to continue to be his/her biggest supporter. You are your child’s biggest supporter. Continue to be that. That is all that you can do. That is enough.

Not great. But completely normal.

While it would be great to have some trick or method to prepare your child’s nervous system for ABA prior to starting, there is none known at this time. However, by having some idea of what to expect for your child’s possible increase in dysregulation, you can prepare yourself and avoid adding to your child’s stress by becoming frustrated with them.

One last thing worth saying

You are doing something very hard. You are trying to find a good provider and work with insurance and make time for all while trying to help your child regulate their emotions and deal with their own stress and anxiety. The fact that you are thinking ahead to preparation for ABA before it even starts and are reading this and considering it is already more than many families are doing.

My neighbor’s son was at his second session of ABA therapy and he reached for his therapist’s hand! His mom posted a picture to her phone and I got to see it.