Your child has been diagnosed with autism. You’ve heard about Applied Behavior Analysis (ABA) therapy. Your pediatrician recommends it. But what actually happens on day one?
For parents new to ABA, that first session can feel overwhelming. You might wonder: Will my child cry? What will the therapist do? How long does it take? Should I stay in the room?
These questions are normal. The first ABA session sets the tone for your entire therapy journey. Understanding what to expect helps you feel prepared, supports your child, and builds trust with their therapist.
What Happens Before Your First Session
Before your child attends their first appointment, Children’s Specialized ABA schedules an intake meeting. This typically happens over the phone or via video with a Board Certified Behavior Analyst (BCBA).
During intake, the BCBA asks detailed questions about your child’s medical history, developmental milestones, current behaviors, and family goals. They’ll want to know:
- When was your child diagnosed?
- What specific behaviors are you most concerned about (communication, social skills, aggression, self-injury)?
- Does your child have any medical conditions or take medications?
- What are your family’s biggest priorities for therapy?
This conversation is crucial. It tells the BCBA exactly what to focus on during the assessment and gives them baseline information to measure progress.
You’ll also receive paperwork: consent forms, privacy agreements (HIPAA), insurance information, and a parental questionnaire. Have these completed before the first session. It saves time and lets the BCBA jump straight into working with your child.
The Initial Assessment: Building Your Child’s Profile
The first in-person session is often called the initial assessment or baseline evaluation. It’s not therapy yet. It’s research.
The BCBA and their team spend 1-3 hours (or sometimes multiple sessions) observing and testing your child. They’re looking for:
Strengths: What can your child do? Can they follow one-step directions? Two-step? Do they make eye contact? Can they use words? Do they enjoy playing with toys?
Challenges: What behaviors occur most? How often? In what situations? Does your child have meltdowns during transitions? Do they avoid certain sensory experiences? Do they engage in self-stimulating behaviors (stimming)?
Communication level: Can your child speak in full sentences? Use single words? Understand speech? Do they communicate non-verbally (pointing, gestures)?
Sensory preferences: Does your child prefer visual input? Sound? Touch? Movement? Are they sensitive to certain textures, tastes, or loud noises?
Learning style: Does your child learn better through play? Through structured tasks? What motivates them?
The BCBA might use standardized assessment tools like the VB-MAPP (Verbal Behavior Milestones Assessment and Placement) or the ABLLS-R (Assessment of Basic Language and Learning Skills, Revised). These tools measure skills across communication, social, academic, and self-help domains.
Your child might be asked to:
- Follow simple instructions (“Touch your nose”)
- Identify pictures or objects
- Imitate actions
- Play with toys
- Respond to their name
- Sit at a table for a short task
If your child refuses or becomes upset, that’s okay. The BCBA notes this reaction. It’s part of the picture.
What Your Role Is During the First Session
Parents are welcome, and often encouraged, to stay during the first session. Here’s what to do:
If your child is comfortable with your presence: Sit nearby but let the BCBA lead. Don’t redirect your child or answer for them. The BCBA needs to see your child’s independent skills and challenges. Your job is to observe and answer questions when the BCBA asks.
If your child is anxious: Some kids do better with a parent in sight but not directly involved. You can sit across the room. Your presence is reassuring, but you’re not participating.
If your child wants you involved: The BCBA might ask you to demonstrate how your child responds at home or ask you to do a task with them. This helps the BCBA understand the parent-child dynamic.
Ask questions: Don’t sit silently. Ask what the BCBA is testing. Ask why. This is your child. You should understand what’s happening.
After the Assessment: What Comes Next
Once the initial assessment is complete (usually within 1-2 weeks), the BCBA writes a formal report. This document includes:
- Your child’s current skill levels across domains
- Challenging behaviors and their triggers
- Strengths and abilities
- A diagnosis or functional summary
- Treatment recommendations (how many hours per week, therapy type, specific goals)
In New Jersey, funding comes from the Division of Developmental Disabilities (DDD) or NJ FamilyCare (Medicaid). In Arizona, funding typically comes from Arizona Department of Developmental Disabilities (DDD) or AHCCCS (Arizona’s Medicaid).
The assessment report is essential for getting insurance approval. Children’s Specialized ABA helps submit this to your insurance or state program. Most approvals take 1-4 weeks.
The Real Therapy Begins: Your First Treatment Session
Once insurance approves, your child starts actual ABA therapy. This is different from the assessment.
The BCBA creates a Behavior Intervention Plan (BIP) based on assessment findings. This plan includes:
- Target behaviors to increase (communication, social skills, task completion)
- Target behaviors to decrease (aggression, self-injury, avoidance)
- Strategies the therapist will use (reinforcement, prompting, extinction)
- Specific goals for the first 3-6 months
Your child works with a Registered Behavior Technician (RBT) or ABA Therapist. If your child receives in-home ABA therapy (the most common model in NJ and AZ), the therapist comes to your house 10-40 hours per week, depending on your child’s needs and insurance approval.
The first therapy session typically looks like:
- Therapist arrives 5-10 minutes early
- Greets your child in a calm, friendly way
- Explains what you’ll do (“Today we’re going to practice saying ‘more'”)
- Uses play and preferred activities mixed with learning tasks
- Offers praise and rewards (called reinforcement) for correct responses
- Redirects gently if your child refuses or becomes upset
The therapist takes data on every single response: Did your child follow the instruction? Independently or with prompting? How long did it take? Did they refuse?
This data is crucial. It shows whether your child is making progress toward their goals.
What Your Home Looks Like During In-Home Therapy
If you’re enrolled in in-home ABA, expect:
- A therapist in your home 10-20+ hours per week
- Your living room, kitchen, or a designated therapy space set up with toys and teaching materials
- Consistency: Same therapist as much as possible (builds rapport)
- Parent involvement: The therapist should teach YOU strategies to use during non-therapy hours
- Communication: Weekly or monthly reports on progress and how to practice at home
Many families find in-home therapy less disruptive than clinic-based. Your child is in their natural environment. Therapists can target real-life situations: transitions, mealtime challenges, sibling conflicts.
First Session Feelings Are Normal
Your child might:
- Be shy or withdrawn with a new person
- Refuse to cooperate
- Have a meltdown
- Surprise you by being perfect
- Do something completely unexpected
All of this is normal. ABA therapists have seen it all. They don’t judge. They adapt.
You might feel:
- Relief that someone’s starting to help
- Guilt (“I should’ve started sooner”)
- Overwhelm (“This is a lot of data and information”)
- Hope (“Maybe my child will make real progress”)
- Frustration (“Why is my insurance slow?”)
These feelings are valid. Therapy for your child is an emotional journey. It’s okay to feel all of it.
Children’s Specialized ABA in New Jersey and Arizona
At Children’s Specialized ABA, we’ve conducted thousands of first sessions. We work with families in New Jersey and Arizona. Our team includes BCBAs, RBTs, and therapists trained in evidence-based ABA practices.
We understand that starting therapy is scary. Our job is to make the first session clear, supportive, and focused on your child’s unique strengths and needs.
We’re also a partner of RWJBarnabas Health, New Jersey’s largest health system. This means your child’s care can be coordinated with medical providers, developmental pediatricians, and other specialists.
Your Next Steps
Ready to get started?
- Request an initial consultation: Contact Children’s Specialized ABA. We’ll discuss your child’s diagnosis, your goals, and answer your questions.
- Schedule your intake meeting: A BCBA will gather your child’s history and recommend next steps.
- Attend the initial assessment: Bring your child, stay involved, and ask questions.
- Get insurance approval: We’ll submit the assessment report and coordinate with your insurance or state program.
- Start therapy: Your child’s therapist will arrive ready to build skills and support your family.
Frequently Asked Questions
Q: How long is the first session?
A: Initial assessments typically take 1-3 hours. It depends on your child’s age, cooperation level, and the type of assessment used.
Q: Will my child be away from me during the assessment?
A: Not usually. You’re welcome to stay. Some parents sit nearby; others step out briefly. We work with you based on your child’s comfort level.
Q: What if my child refuses or becomes upset?
A: That’s normal. We have strategies to help. The assessment is still valuable, we learn what challenges your child faces and how they respond under stress.
Q: When will we see progress?
A: Some families notice changes in weeks. Others take months. It depends on your child’s baseline skills, the intensity of therapy, and consistency at home. We track data every session.
Q: How much does ABA therapy cost?
A: Cost varies by insurance and location. In New Jersey, NJ FamilyCare and DDD often cover most or all costs. In Arizona, AHCCCS typically covers ABA. Private insurance varies. We help navigate this with you.
Q: Will my child’s therapist be the same person?
A: We work hard to maintain consistency. The same therapist builds rapport and understands your child’s style. Sometimes staffing changes happen, we manage transitions carefully.
Q: Can we do virtual/telehealth ABA?
A: For assessment and parent coaching, yes. For direct therapy, mostly no. ABA requires hands-on interaction, physical prompting sometimes, and in-home environmental work.
Q: What if we don’t like the therapist?
A: Tell us. We can arrange a new therapist. The therapeutic relationship matters.
The first ABA session isn’t about perfection. It’s about starting. Starting to understand your child’s skills, starting to build strategies, and starting a partnership with professionals who believe in your child’s potential.
Questions about getting started with ABA therapy? Contact Children’s Specialized ABA today. We’re here to support your family every step of the way.
