08/20/2026
ABA: What are we doing?
I met a family recently that told a story that I have heard time and time again.
The doctor of a young autistic girl recommended ABA for her.
The ABA center that mom contacted said she "needed" 30 hours a week. The family accepted and Medicaid was going to be billed.
The child received ABA services 7 days a week. 4 hours a day on weekdays, and 5 hours a day on Saturday and Sunday.
The services were provided by an RBT, a behavior "technician". Mom did not know they weren't therapists.
Mom's main concern was safety, including elopement, significant impulsivity and risk taking during gross motor play.
Services have been 7 days a week for a YEAR. That's over $100,000 billed to Medicaid according to current billing guidelines.
The child still elopes, is still impulsive and still engages is risky gross motor play.
More about this child: She loves exploring, and LOVES her mama. She is non-speaking, but speech was not recommended by her doctor. No aggressive behaviors or SIB reported. She engages is risky play but has incredible body awareness, postural stability and balance. She is creative, open to playing with new toys introduced to her and is a fast visual learner. She can dance, too. If Disney music comes on and everything stops for a spontaneous dance party...as it should!
Mom thinks the 30 hours is too much.
Mom has been struggling with the schedule and the fact that there's a stranger in their house 7 days a week.
Mom trusted the ABA center when they said she "needs" 30 hours a week, so she continued.
During the school year, the child will go to school full time and continue with 4 hours of ABA everyday after school. While neurotypical kids are out playing or doing whatever they want after a schoolday, the autistic child has to work a second shift. They still have to perform. The ABA center said she "needed" it, and mom believed them. She trusted them.
This is happening in all 50 states:
Children are being robbed of valuable childhood time because they have a diagnosis of autism.
Children are being asked to work more, and harder, and mask for longer because their brain is different.
Strangers enter a family's home for multiple hours a day, up to 7 days a week, changing the dynamic of the household.
These ABA centers send minimally trained "technicians" to deliver the vast majority of the services. They are not therapists and therefore are not providing therapy. Their supervision requirements are also miminal and can be done virtually. But, these centers convince scared and desparate families that they "need" 30 hours to have any hope for their child's future.
The requirements for a technician are 40 hours of observation, a high school diploma and pass a test. No education about autism, neuro, sensory processing. They have dangerously limited knowledge on behavior, so an escalation, which they may or may not have caused because of their lack of training, is a potential risk.
What are we doing?
That's a serious question.
What are we actually doing?
Technicians who only require a high school diploma are billing for services deemed "medically necessary" in order to get funded to the tune of tens of thousands of dollars pet child.
The fleecing of insurance companies is happening while the autistic community has been screaming for years that ABA is harmful.
What are we doing?
It takes 2,000 hours of training to be a Lexus certified mechanic.
To become a licensed locksmith in my state you need 5,000 hours of training.
To work with an autistic human being, one on one, for dozens of hours a week?
You need 40 hours of training.
What are we doing?
Families deserve informed consent and we have to stop robbing hours of childhood, just because a child has an autism diagnosis.
Make it make sense.
Picture of my puppy offering a high 5 for reading the whole post. 😁🐶🐾
