Starting ABA therapy can feel like stepping into the unknown. Most Maryland families come to us with the same mixture of hope and uncertainty: they know Applied Behavior Analysis can help their child, but they’re not quite sure what those first weeks will actually look like day to day. The good news is that the first month follows a predictable rhythm, and understanding that rhythm in advance makes the whole experience far less intimidating. At Golden Moon ABA, we walk every family through this stage carefully, because what happens early on sets the tone for everything that follows.
Week One: Intake, Paperwork, and Building Trust
The first week is almost entirely about gathering information and helping your child feel safe with new people. Once intake is complete and insurance authorization comes through, your appointment schedule is set up. A Board Certified Behavior Analyst (BCBA) typically conducts caregiver interviews, observes your child in their natural environment, and begins reviewing any medical or educational documents you’ve shared. Expect questions about sleep, eating, communication style, sensory preferences, favorite toys, and what tends to trigger meltdowns. None of this is judgmental — it’s how the clinical team builds an accurate picture before designing a plan.
Behavior technicians may also pop in during this week to begin what we call pairing. Pairing is exactly what it sounds like: the therapist spends time with your child doing fun, low-pressure activities so the child starts to associate the therapist’s presence with positive experiences. No demands, no drills — just play. The CDC’s “Learn the Signs. Act Early.” program emphasizes how critical relationship-building is during early intervention, and that principle anchors how we structure these initial sessions.
Week Two: The Initial Assessment and Goal-Setting
By the second week, your BCBA conducts a more formal skills assessment using standardized tools such as the VB-MAPP, ABLLS-R, or AFLS, depending on your child’s age and developmental profile. This isn’t a test your child can fail — it simply pinpoints where they currently are across communication, social skills, play, self-care, and academic readiness. From there, the BCBA drafts a treatment plan with specific, measurable goals.
You should expect to sit down for a goal-review meeting toward the end of this week or early in week three. Bring your priorities. If toilet training is keeping your family up at night, say so. If you most want your child to ask for food rather than scream for it, say that too. Treatment plans should reflect what matters most to your family, a principle reinforced by guidance from the Eunice Kennedy Shriver National Institute of Child Health and Human Development on individualized autism intervention.
Week Three: Therapy Begins in Earnest
Once goals are signed off, structured sessions begin. Hours vary widely — some children start at 10 hours a week, others at 30 or more, depending on clinical recommendations and what insurance authorizes. Sessions blend natural-environment teaching (learning through play and routines) with more structured discrete-trial work, depending on the skill being targeted.
This is often the week parents first see flashes of progress. A child who has never requested a snack might hand over a picture card. A child who has always melted down at transitions might tolerate a two-minute warning. These moments are small, but they’re not accidents — they’re the result of careful prompting, immediate reinforcement, and repetition. Decades of research summarized by the National Institutes of Health show that early intensive ABA produces measurable gains in adaptive behavior when delivered with fidelity.
Week Four: Data, Parent Training, and Early Progress
By the fourth week, your team has enough data to start showing you trends. ABA is a data-driven discipline; every session generates numbers on prompts used, skills mastered, and behaviors observed. Your BCBA will walk you through these graphs in plain language. Don’t be intimidated by them — they’re simply a record of what’s working and what needs adjusting.
This is also when parent training typically ramps up. You’ll learn how to use the same reinforcement strategies at home, how to set up the environment to encourage communication, and how to respond to challenging behavior in ways that don’t accidentally reinforce it. The University of Alabama Autism Spectrum Disorders Clinic notes that parent involvement is one of the strongest predictors of generalization — meaning skills your child learns in session actually carry over into real life.
Typical Skill Focus in the First Month
The chart below shows roughly how a BCBA might distribute focus across skill domains during the first month for a young child. Exact allocations vary based on the assessment, but this gives you a realistic sense of where energy goes early on.
How Families Can Prepare
The most useful thing you can do before therapy starts is gather information and be honest about your child’s strengths and struggles. Bring evaluation reports, IEPs, and a list of words or sounds your child uses. Be ready to talk about routines that work and routines that don’t. If your family is navigating Maryland’s broader autism support system, the Maryland Developmental Disabilities Administration can help you understand which state-funded supports complement clinical ABA services.
For families in Montgomery County, the Montgomery County Autism Waiver Service Coordination program is a valuable local resource in Silver Spring, providing case management for children who qualify through the state waiver. Combining clinical ABA with these community supports often produces the strongest outcomes.
Practically, set up a quiet space in your home where sessions can happen with minimal distraction. Keep favorite toys and reinforcers accessible but not freely available — they’ll be far more motivating during therapy. And take care of yourself: ABA is a marathon, not a sprint, and burned-out caregivers can’t be the partners their kids need.
The Bigger Picture
One month into therapy, you won’t see your child transformed. What you’ll see is a foundation — trust with the therapy team, clearer baseline data, the start of a few new skills, and a parent training rhythm. That foundation is everything. Children who finish their first month with strong rapport and a well-built plan tend to make faster progress over the following six to twelve months than children who were rushed into intensive demands before they were ready.
If you’re considering ABA for your child or are about to begin, learn more about our team and our approach on the Golden Moon ABA About Us page. We’re a BCBA-led practice serving families across Silver Spring, Montgomery County, and the wider Maryland region, and we’d be glad to talk through what your first month might look like.
Source: Centers for Disease Control and Prevention, Autism Spectrum Disorder Data and Statistics