How to Prepare Your Child for Their First Day of Therapy

Starting ABA services can be nerve-wracking for many families. It’s important for a child’s trajectory that their therapy providers and family are on the same page, have strong communication, and know what to expect from one another. Here are some things to keep in mind and ideas on ways you can prepare your family for this change. 

Understanding What to Expect

Overview of ABA Therapy

ABA therapy can sound intensive when you first learn about it. Research supports that most children benefit from “comprehensive” ABA. This ultimately means your child may be receiving therapeutic services 25-40 hours per week. However, keep in mind that your child will be somewhere throughout the week, whether that is at home, at daycare, or at school. Comparatively, ABA therapy is the only place your child is likely to get 1:1 attention, support, and an intentional focus on expanding their skillset. 

When you observe your child receiving ABA therapy, it shouldn’t be so structured that it feels like a full-time job for them. Yes, there may be components where your child completes tasks at a desk or works on some activities that are less preferred, like cleaning up after mealtime or brushing their teeth. However, a majority of your child’s time in early intervention should look like intentional play. During these play activities, therapists should embed learning opportunities and make these interactions fun. This approach keeps your child from getting burnt out. 

Day-to-day, you, as a family member, will likely interact most with your child’s Registered Behavior Technician (RBT). These are the professionals who will provide direct services to your child. The Board Certified Behavior Analyst (BCBA) will mostly interact with you during family guidance (parent training) meetings each month or at drop-off and pick-up on occasion.

The First Day Agenda

On your child’s first day, you will generally meet with the BCBA and RBT at drop-off. At this point, the BCBA will support your child’s transition into the center. If you are more comfortable coming into the center with them for a few minutes, that should be welcomed by the ABA clinic. Although a fast transition is oftentimes easier for children, we understand that you may want updates on how your child is doing. If you would like to receive pictures or videos, please make sure your child’s BCBA knows this as well. 

During the first few weeks of services, your child’s therapy team will focus on building rapport with them. This looks like playing with preferred items and trying a few new skills, but no back-to-back or intensive demands until they have built a strong foundation and rapport with the people and the building. This prevents the center from becoming an aversive place that is associated with work.

Preparing Your Child

Talk About It in Advance

This may be developmentally appropriate for some children. For some kids, it might be an option to communicate that they are going to a fun place where there will be new toys and new friends. It may be helpful to show them pictures of the center, rooms in the center, or some faces they may see on their first day. 

Create Predictability

Transitions can be hard for any child on the autism spectrum. Dreading a transition does not necessarily mean that the child does not want to go to the place they are transitioning to. More often than not, transitions are difficult because they aren’t always predictable. Driving on a certain route is not always guaranteed due to construction. The place we are going may be closed for a variety of reasons. And when the destination is new, this can cause some anxiety for both ourselves and our children. Another way to help make the destination predictable may be to visit the center with your child a few times, even if that just means pulling into the parking lot. Our owners and BCBAs should be able to facilitate a few meet and greets before your start date if needed. Please reach out if that is something you are interested in. 

It may also be supportive to read social stories with your child about transitions, going to new places, etc. Then practicing these transitions helps cement the lesson from these stories. 

Practice Skills That Will Help

Several skills are required to successfully transition to a new place. This includes separating from caregivers, packing and unpacking bags to bring, and transitioning from preferred locations/activities to potentially non-preferred locations/activities. 

Setting the Environment Up for Success

Pack the Essentials

It may be helpful for your child to bring their favorite items or toys to the center. Keep in mind that bringing those items could result in them getting lost or damaged, but even if it just means your child being able to bring them in the car with them or to walk into the center with these items and then put them in their backpack, this may be helpful. Additionally, some children have a hard time with other novel items like new clothes or water bottles, so make sure you pack extra clothes, water bottles, diapers, etc., just in case.

Establish a Consistent Routine

As with any change, routine can be helpful. Routines help create predictability and a sense of control. It could be helpful to prepare prior to starting any new venture to ensure routines are in place for nighttime and increasing sleep, ensuring meals are prepared and packed, and setting out clothes to prevent a scramble in the morning.

It could also be helpful when saying goodbye to your child once you arrive at Essential to use the same goodbye routine (e.g., song, kids, hug). This may signal to your child that it’s time to go inside the center, and you’ll see them later. We know it’s hard, but you’ve got this! 

Caregiver Preparation

Manage Expectations

The first few days are about building trust and adjusting, so you will likely not see goals met for at least a few weeks or months into services. ABA is behavior change over time. This ensures behaviors that change to maintain in the long run. Additionally, behavior may change temporarily as your child adapts. It would not be out of the question to see some changes in behavior in a negative way right at the start of services, as can happen with any changes in the schedule or environment. Communicate these to your treatment team to ensure you are getting the support you need as well. 

Communicate with the Therapy Team

Remember that you and the BCBA are on the same team. You are the expert on your child. Although the BCBA may be an expert at ABA and autism in general, you know your child better than anyone. It is important that you share your experience with the team to make sure your child is getting comprehensive care. Fill out your intake forms thoroughly, complete the assessments to the best of your ability, etc. Ensure the team has the best information possible about your child. Ask questions and stay informed about goals and progress. This may look like coming to your monthly minimum family guidance meetings or emailing weekly to ensure you are in the loop.

Emotionally Prepare for Separation

It is totally normal to feel nervous — trust the process and the professionals. Feel free to reach out to the clinic to better understand what to expect and how to prepare. Just remember that you are getting your child the support they need to succeed.

After the First Day

Decompress and Connect

Provide downtime after therapy. Although therapy should be fun, it can also be exhausting for your family. Plan a calm, relaxing night for your family during that first week. We also recommend you celebrate small wins - not just your child's, but your own. You have started the hard work, and your child has a team behind them, now. 

Stay Consistent

Attend family guidance meetings to ensure you know what to reinforce at home. You are one of the most important components of the therapy team, so please never hesitate to reach out or set up a meeting with the BCBA. Ensure communication on absence from services, as these can cause setbacks for your child. Ensure you know how to intervene using ABA principles outside of services!

Conclusion

Remember that starting ABA is a big milestone — it’s okay to feel a mix of emotions. With preparation and teamwork, the first day can be a strong foundation for progress.