You got the diagnosis. You did the research. You called around, sat on waitlists, and fought with insurance. And now someone is telling you your child’s first ABA session is scheduled for next Tuesday.

So what actually happens?

If you’re feeling nervous, that’s normal. Most parents walk into the first session with a mix of hope and dread. You want this to help. You also have no idea what “this” looks like in practice. Here’s the honest version of what to expect—both what happens clinically and what you and your child might actually feel.

Before the Session Even Starts

Before your child’s first session, there’s usually an intake process. This varies by provider, but at Treetop, it typically includes a phone call or meeting with a Board Certified Behavior Analyst (a BCBA, the person who designs your child’s therapy plan). They’ll ask about your child’s daily routines, what they love, what’s hard, how they communicate, and what goals matter to you. This isn’t a test. There are no wrong answers—they’re trying to understand your kid as a whole person, not just a set of behaviors.

How to Prepare Your Child

• Keep it simple and honest. Tell your child they’re going to meet some new people who are going to play and work with them.
• If your child responds well to visual schedules or social stories, prepare one in advance—ask if the center can share photos ahead of time.
• Bring items that comfort or motivate your child: a favorite toy, snack, or fidget. These aren’t just for comfort—they’re useful assessment data too, since the BCBA needs to know what your child finds reinforcing.
• Bring any previous evaluations, IEP documents, or medical records relevant to your child’s development, and arrive a few minutes early so your child has time to transition into the new environment.
• Don’t over-prepare or coach your child on how to behave. The BCBA needs to see your child as they naturally are—authentic behavior during the assessment leads to a more accurate program.

What the First Session Actually Looks Like

Here’s what surprises most parents: the first session can look a lot like play. Once regular therapy begins, your child’s therapist (a Registered Behavior Technician, or RBT) may spend much of the first session just getting to know your kid, following their lead. If your kid loves trains, they’ll play trains. The goal isn’t to start drilling skills or correcting behavior—it’s to build a relationship. Your child needs time to feel comfortable with this person before more structured work begins. It can feel surprisingly low-key, and that’s by design.

Before regular therapy begins, however, your child will typically complete an intake assessment or initial evaluation led by a BCBA. Depending on your child’s age and profile, the assessment may last 2 to 3 hours—sometimes split across two visits if a child has limited tolerance for new environments. It includes several distinct pieces:

• Skill assessments: the BCBA presents tasks across language, social, motor, and self-care domains, often using standardized tools like the VB-MAPP or ABLLS-R, to see what your child can do independently, with help, and not yet.
• Preference assessment: identifying what your child finds genuinely rewarding. Understanding what motivates your child helps the therapy team identify effective reinforcers and make learning more engaging.
• Behavior observation: if your child has behaviors that interfere with daily life, the BCBA watches for patterns, triggers, and what happens afterward—these observations can help inform further assessment of why the behavior occurs.
• Parent interview: your input is clinical data, not small talk. Be as specific as possible about medical history, sleep, eating, daily routines, school experiences, and what you most want to change or build.

ABA treatment should be individualized based on your child’s needs, strengths, preferences, and assessment findings. The information gathered during the assessment helps the BCBA determine which goals to prioritize and how your child’s treatment plan should be structured. No two children should get exactly the same plan because no two children are alike.

What Your Child Might Do

Every kid is different. Some children warm up quickly and start playing with the therapist within minutes. Others take longer. Both are completely fine. Your child might

• Play happily and barely notice anything is different
• Be shy or hesitant at first, then gradually engage
• Explore boundaries as they figure out what to expect from this new person
• Have a tough time and cry or refuse to participate
• Surprise you by doing things they don’t usually do at home

None of these responses mean the session went well or poorly. The therapist is trained to meet your child where they are. If your child has a hard first session, that doesn’t mean ABA isn’t going to work—they may simply need more time and support to adjust to a new person, place, or routine.

What You Might Feel (and Why That’s OK)

Let’s talk about you for a second.

Watching someone else work with your child can bring up a lot of feelings. Relief that help is finally here. Guilt that your child needs help at all. Anxiety about whether you’re making the right choice. Sadness, hope, and exhaustion all at once.

Some parents feel uncomfortable watching from the other room. Others feel emotional seeing their child connect with the therapist. A few feel frustrated that the first regular therapy session seems “too easy” or wonder when the real therapy starts. All of that is valid. You’ve been carrying a lot to get to this point.

If you have questions during or after the session, ask them. A good provider wants you involved. At Treetop, parent communication is a core part of how we work—you’re not a bystander in your child’s therapy; you’re a partner.

What Happens After the First Session

After the assessment, the BCBA uses what they learned to develop your child’s individualized treatment plan. That plan typically includes long-term goals, short-term objectives, behavior intervention strategies when needed, and a recommended therapy schedule based on your child’s specific needs.

You’ll have a meeting to review that plan before regular therapy begins. This is your chance to ask questions, push back on anything that doesn’t align with your priorities, and understand why each recommendation was made. Most Treetop families start regular sessions within two weeks of completing the assessment.

You should walk out of that meeting knowing what the short- and long-term goals are, why each was chosen, how progress will be measured, and what role you’ll play at home. If any of that is unclear, ask until it is.

Frequently Asked Questions

Should I stay during my child’s first ABA session?

Parents are often involved in at least part of the initial assessment so the BCBA can learn about your child and observe parent-child interactions. Depending on your child and the assessment process, the BCBA may also have you wait nearby for portions of the visit.

What if my child refuses to cooperate during the first session?

That’s useful clinical information, not a failed assessment. BCBAs are trained to work with children who are hesitant, dysregulated, or overwhelmed by new environments. The assessment may take longer or require another visit so the BCBA can develop an accurate picture of your child’s skills and needs.

Can siblings come to the first session?

It depends on the center—call ahead and ask. Some centers have waiting areas where siblings can be supervised; others prefer you come without additional children so the BCBA can focus fully on your child’s assessment.

Will my child get a diagnosis at the first ABA session?

No. The initial ABA assessment evaluates your child’s skills and needs so the BCBA can develop an individualized treatment plan; it is not an autism diagnostic evaluation. If your child doesn’t yet have a diagnosis, our autism screening page covers next steps.

How is the first ABA session different from an autism evaluation?

An autism evaluation determines whether your child meets diagnostic criteria for autism. The initial ABA assessment focuses on understanding your child’s specific skills and needs so the BCBA can build a personalized treatment plan—they’re separate processes with different purposes.

How often will we meet with the BCBA after therapy starts?

Typically monthly at minimum, more often at first. The BCBA reviews data, adjusts goals, and checks in with parents regularly. Parent training sessions are usually built into the schedule so you learn to carry strategies into daily life at home.

What if I disagree with the treatment goals the BCBA sets?

Speak up before signing the treatment plan. Your priorities as a parent are clinically relevant. A good BCBA will incorporate family goals into the program—if a goal doesn’t make sense to you, ask for the clinical rationale. You have the right to understand and agree with every target before therapy begins.

You Don’t Have to Have It All Figured Out

If you’ve been going back and forth about starting ABA therapy, the hardest part is usually just booking that first session. Once you’re in the room, it tends to feel a lot less scary than you imagined—and Treetop’s team walks with you from that first call through the first day of regular services. Every family gets a dedicated care coordinator who tracks authorizations, answers questions, and connects you to your BCBA. That’s what we’re here for.

79% of Treetop families pay $0 out-of-pocket, and we accept most major insurance plans and Medicaid across every state we serve. If you have coverage questions before booking, our team can verify your benefits before the assessment even happens. We offer center-based and in-home ABA therapy, depending on location and your child’s needs. Your care team can help determine which available setting is the best fit for your child and family.

Ready to take the next step? Contact Treetop or find a center near you to get started. You can also read our complete guide to what ABA therapy involves if you want to learn more first.

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