Your First Month of ABA Therapy in Maryland: What Parents Can Expect

Starting ABA Therapy: What Maryland Parents Need to Know

You’ve made the decision. Your child is starting ABA therapy. You know it’s the right step forward, but you likely have questions about what the first month will actually look like.

“What happens during sessions? When will I see progress? How can I support my child’s learning?”

These are questions every parent asks. The good news? The first month of ABA therapy is carefully designed to ease both you and your child into this journey with a structured, evidence-based approach.

This guide walks you through what actually happens in your first 30 days of ABA therapy in Maryland, week by week, so you know exactly what to expect and how to support your child’s development.

Before You Begin: Understanding ABA Therapy in Maryland

Your Child’s ABA Therapy Team

Your child will work with two key professionals throughout their ABA therapy journey:

Board Certified Behavior Analyst (BCBA): The clinical supervisor who designs your child’s individualized treatment plan, sets measurable goals, analyzes progress data, and oversees the overall therapy approach. Your BCBA is your primary contact for questions about your child’s plan and progress.

Registered Behavior Technician (RBT): The therapist who works directly with your child during sessions, implementing the strategies designed by the BCBA. Your RBT builds the relationship with your child and collects data during every session.

At The Learning Tree ABA, we match each child with a BCBA and RBT based on your family’s needs, schedule, and your child’s individual profile.

ABA Therapy Settings in Maryland

Depending on your family’s needs and your child’s goals, ABA therapy can take place in several settings:

Many families benefit from a combination of settings. Your BCBA will recommend what works best for your child’s specific goals.

ABA Therapy Hours and Insurance Coverage

ABA therapy recommendations vary based on your child’s individual needs, age, and treatment goals. Therapy hours typically range from 10-40 hours per week, as prescribed by your BCBA.

The Learning Tree ABA accepts Medicaid and most major insurance plans throughout Maryland, including Aetna, CareFirst, United Healthcare, Cigna, and BlueCross BlueShield. Our team handles all insurance verification and authorization paperwork.

Week 1: Rapport Building in ABA Therapy

The Pairing Process

The first week of ABA therapy focuses on rapport building, often called “pairing” in ABA terminology. During this phase, your child’s RBT works to establish a positive, trusting relationship before introducing structured teaching.

During pairing sessions, the therapist will:

  • Engage in child-led play activities
  • Identify your child’s preferred items, activities, and interests
  • Observe your child’s communication patterns and responses
  • Create positive associations with the therapy environment
  • Build trust through enjoyable interactions

What Parents May Observe

Initial sessions may appear unstructured, with the therapist primarily following your child’s lead. This is intentional and evidence-based. Research shows that establishing rapport is essential for effective ABA therapy outcomes.

Children respond differently to new situations. Some engage immediately, while others need additional time to feel comfortable. Both responses are normal and expected.

Supporting Your Child During Week One

Maintain a positive attitude: Frame therapy sessions positively when talking with your child

Share preferences: Provide your therapist with detailed information about your child’s favorite toys, activities, foods, and interests

Prepare the environment: If receiving in-home therapy, create a comfortable space with minimal distractions

Establish consistency: Maintain the scheduled therapy times as much as possible

Week 2: Assessment and Treatment Planning

The ABA Assessment Process

During week 2, your BCBA conducts a comprehensive assessment to develop your child’s individualized treatment plan. This assessment includes:

Direct observation: Systematic observation of your child’s current skills, communication methods, and behavioral patterns

Skills assessment: Evaluation across multiple domains including communication, social interaction, play skills, self-care, and following directions

Parent interview: In-depth discussion about your child’s development, daily routines, strengths, challenges, and family priorities

Baseline data collection: Measurement of current skill levels to track progress over time

Treatment Plan Development

Based on assessment results, your BCBA will develop a treatment plan that includes:

  • Specific, measurable goals tailored to your child’s needs
  • Teaching strategies and intervention methods
  • Data collection procedures
  • Recommended therapy schedule and duration
  • Parent training objectives

Your Role in Treatment Planning

You’ll meet with your BCBA to review assessment findings and discuss the proposed treatment plan. This is an important collaborative meeting where you can:

  • Ask questions about assessment results
  • Share your priorities and concerns
  • Discuss which goals are most important to your family
  • Understand the recommended approach and timeline

Your input is essential. Effective ABA therapy requires partnership between families and clinical teams.

Week 3: Structured Teaching Begins

Introduction of Teaching Activities

With rapport established and the treatment plan in place, structured teaching begins in week 3. ABA therapy sessions now include:

Discrete Trial Training (DTT): Brief, focused teaching opportunities with clear instructions, prompting, and reinforcement

Natural Environment Teaching (NET): Learning embedded in natural activities and routines, which is a core approach at The Learning Tree ABA

Positive reinforcement: Immediate access to preferred items or activities following desired responses

Continuous data collection: Documentation of your child’s responses to inform treatment adjustments

Initial Goal Introduction

Your child will begin working on “starter targets”—initial goals selected from the treatment plan. These goals are:

  • Achievable to build confidence and momentum
  • Foundational for more complex skills
  • Individualized to your child’s needs and developmental level

Observable Changes in Week Three

During this phase, you may notice:

  • More structured components within play-based sessions
  • Deliberate teaching moments embedded in preferred activities
  • Consistent reinforcement when your child demonstrates target skills
  • Gradual increases in session structure

Week 4: Parent Training and Home Integration

Parent Training in ABA Therapy

By week 4, parent training becomes an active component of your child’s program. Parent training sessions teach you the strategies your therapy team uses, enabling you to support your child’s learning throughout the day.

Parent training typically includes:

Strategy demonstration: Observation of how therapists implement specific techniques with your child

Guided practice: Opportunities to practice ABA strategies with coaching from your BCBA

Home application: Discussion of how to incorporate strategies into daily routines

Problem-solving: Collaborative solutions for challenges you’re experiencing at home

The Importance of Parent Involvement

Research consistently demonstrates that parent involvement significantly improves outcomes in ABA therapy. When parents learn and implement ABA strategies at home, children:

  • Generalize skills more quickly across settings
  • Receive more consistent learning opportunities throughout the day
  • Show accelerated progress toward treatment goals
  • Maintain skills more effectively over time

Communication With Your Therapy Team

Maintain open communication with your BCBA and RBT throughout week 4 and beyond:

  • Share observations about your child’s behavior at home
  • Ask questions about techniques or strategies
  • Report what’s working well and what’s challenging
  • Request additional support when needed

Creating a Supportive Home Environment for ABA Therapy

Throughout your first month, consider these evidence-based environmental modifications to support your child’s learning:

Designated therapy space: A consistent area for sessions with appropriate materials and minimal distractions

Visual supports: Visual schedules, choice boards, and other visual aids to support communication and understanding

Organized materials: Accessible storage for therapy materials and preferred items used as reinforcers

Consistent routines: Predictable daily schedules that provide structure and reduce anxiety

Minimized distractions: Reduced background noise and visual clutter during therapy sessions when possible

These modifications don’t require significant expense or major changes—small, thoughtful adjustments can meaningfully support your child’s progress.

Understanding Progress in the First Month of ABA Therapy

Realistic Expectations for Month One

The first month of ABA therapy focuses on foundation-building rather than dramatic skill acquisition. Progress during this period typically includes:

Behavioral foundations:

  • Increased tolerance for structured activities
  • Improved attention to tasks and activities
  • Better cooperation with simple requests
  • Reduced resistance to certain activities

Communication development:

  • More frequent communication attempts
  • Increased use of gestures or vocalizations to request items
  • Improved response when name is called
  • Beginning approximations of target words (for verbal goals)

Social engagement:

  • Increased eye contact during interactions
  • More consistent engagement in play activities
  • Improved response to social bids from others
  • Beginning awareness of peers (in group settings)

Routine participation:

  • Smoother transitions between activities
  • Better participation in daily routines
  • Decreased frequency or intensity of challenging behaviors
  • Improved response to visual supports

Individual Variability in Progress

Every child responds to ABA therapy differently. Factors affecting the rate of progress include:

  • Age and developmental level
  • Intensity of therapy services
  • Consistency across settings
  • Individual learning style
  • Complexity of goals
  • Parent involvement and home practice

Neither rapid progress nor gradual progress indicates therapy effectiveness during the first month. The foundation being built during this time is essential for long-term success.

Common Questions About the First Month of ABA Therapy

“What does a typical ABA therapy session look like?”

ABA therapy sessions are structured but flexible, typically including:

  • Review of previous session data
  • Warm-up with preferred activities
  • Structured teaching activities (DTT and NET)
  • Play-based learning opportunities
  • Natural environment practice
  • Session documentation and data entry

Sessions balance structure with your child’s interests and energy level.

“How much involvement is expected from parents?”

Parent involvement is crucial for ABA therapy success. Expectations typically include:

  • Attending scheduled parent training sessions
  • Implementing strategies at home
  • Communicating regularly with your therapy team
  • Observing sessions when possible
  • Providing feedback about progress and challenges

The Learning Tree ABA provides comprehensive parent training to ensure you feel confident and capable in supporting your child’s development.

“When will I see significant changes?”

Most families begin observing measurable progress in specific skill areas within 3-6 months of consistent ABA therapy. However, some changes may be visible sooner:

  • Improved cooperation and engagement often appear within weeks
  • Skill acquisition timelines vary by goal complexity
  • Generalization of skills across settings develops over months
  • Long-term progress requires consistent, intensive intervention

Your BCBA will provide regular progress updates and adjust treatment plans based on data.

“What if my child resists therapy sessions?”

Some resistance, particularly initially, is common and expected. Your therapist is trained to:

  • Use positive reinforcement to increase cooperation
  • Adjust activities based on your child’s responses
  • Gradually increase task demands as tolerance improves
  • Maintain a positive, supportive approach

If resistance persists or intensifies, your BCBA will analyze the function of the behavior and modify the treatment approach accordingly.

Supporting Your Family Throughout ABA Therapy

Sibling Considerations

If your child has siblings, they may have questions or feelings about ABA therapy. Consider:

  • Age-appropriate explanations of therapy
  • Opportunities for siblings to observe sessions
  • Individual attention for siblings
  • Family activities that include everyone

Learn more in our guide about supporting siblings of children with autism.

Managing Your Own Expectations

Starting ABA therapy represents a significant commitment for families. Remember:

  • Progress takes time and consistency
  • Small steps lead to meaningful change
  • You don’t need to be perfect—just consistent
  • Your therapy team is there to support you
  • Asking questions is encouraged and expected

Self-Care for Parents

Supporting a child through ABA therapy while managing all your other responsibilities can be demanding. Prioritize:

  • Connecting with other parents who understand your experience
  • Asking for help from family and friends when needed
  • Celebrating small victories
  • Taking breaks when necessary
  • Maintaining your own physical and emotional health

What Happens After Month One?

Months 2-3: Skill Development Acceleration

After the first month’s foundation-building, you’ll typically observe:

  • More noticeable progress in target skill areas
  • Mastery of initial goals and introduction of new objectives
  • Better generalization of skills across settings and people
  • Increased parent confidence in implementing strategies
  • Regular progress reviews and treatment plan updates

Months 4-6: Measurable Progress

By the end of six months, many families report:

  • Significant improvements in multiple skill domains
  • Better daily functioning and routine participation
  • Reduced frequency of challenging behaviors
  • Increased independence in targeted areas
  • Meaningful quality-of-life improvements for the whole family

Long-Term ABA Therapy Outcomes

Research demonstrates that comprehensive, high-quality ABA therapy leads to:

  • Substantial improvements in communication skills
  • Enhanced social interaction abilities
  • Increased independence in daily living skills
  • Better school readiness and academic performance
  • Improved quality of life for children and families

Treatment duration varies based on individual needs, goals, and progress. Your BCBA will regularly assess whether your child is meeting goals and recommend adjustments to therapy intensity as appropriate.

The Learning Tree ABA Approach

At The Learning Tree ABA, we’re committed to providing evidence-based, compassionate ABA therapy that respects each child’s individuality and supports each family’s unique needs.

What Sets Us Apart

Individualized treatment: Every therapy plan is tailored to your child’s specific strengths, challenges, and goals

Natural Environment Teaching: We emphasize learning in natural contexts through play and daily routines

Family partnership: We treat parents as essential team members and provide comprehensive training and support

Flexible service delivery: We offer in-home, center-based, and school-based options

Experienced team: Our BCBAs and RBTs bring expertise, compassion, and dedication to every family we serve

Insurance support: We handle all insurance verification, authorization, and billing processes

Serving Maryland Families

The Learning Tree ABA proudly serves families throughout Maryland, including:

Getting Started With ABA Therapy in Maryland

If you’re preparing to begin ABA therapy or considering whether it’s appropriate for your child, The Learning Tree ABA is here to answer your questions and support your family.

The first month is just the beginning of your child’s ABA therapy journey. With the right support, consistent implementation, and collaborative partnership between your family and therapy team, meaningful progress is possible.

Contact The Learning Tree ABA today to learn more about our services, schedule a consultation, or begin the intake process. Call us at 410.205.9493 or schedule a free consultation.

Frequently Asked Questions: First Month of ABA Therapy in Maryland

How long are ABA therapy sessions in Maryland?

ABA therapy session length varies based on your child’s individualized treatment plan, age, and needs. Sessions typically range from 2-4 hours, though some children receive shorter or longer sessions depending on their specific goals and tolerance for structured activities. Your BCBA will determine the appropriate session duration based on your child’s assessment results and treatment objectives. At The Learning Tree ABA, we work with families to create schedules that balance therapeutic intensity with family needs and your child’s developmental level.

Does Maryland Medicaid cover ABA therapy for children with autism?

Yes, Maryland Medicaid covers ABA therapy for eligible children diagnosed with autism spectrum disorder. Maryland’s Medicaid program includes comprehensive coverage for medically necessary ABA services with no annual hour caps. Additionally, Maryland offers an Autism Waiver that provides supplemental services for children with autism who qualify. The Learning Tree ABA accepts all Maryland Medicaid plans and handles the authorization process, making it easier for families to access needed services without navigating complex insurance requirements.

What qualifications should I look for in an ABA therapy provider in Maryland?

When selecting an ABA therapy provider in Maryland, look for programs that employ Board Certified Behavior Analysts (BCBAs) who hold current certification from the Behavior Analyst Certification Board (BACB). Registered Behavior Technicians (RBTs) should also maintain current RBT credentials. Quality providers should offer individualized treatment planning, evidence-based interventions, comprehensive parent training, regular progress monitoring, and clear communication. The Learning Tree ABA’s clinical team includes experienced BCBAs and trained RBTs who follow ethical guidelines and evidence-based practices in all therapy services.

Can ABA therapy help with challenging behaviors like tantrums and aggression?

ABA therapy is evidence-based for addressing challenging behaviors in children with autism. During the assessment phase, your BCBA will conduct a functional behavior assessment to understand the purpose or function of challenging behaviors. Treatment plans then include strategies to teach replacement behaviors—appropriate ways for your child to communicate needs or access desired items—while reducing challenging behaviors through positive reinforcement of appropriate alternatives. Most families observe decreases in challenging behavior frequency and intensity as children develop better communication and coping skills. Learn more about understanding behavior as communication.

How is progress measured in ABA therapy?

Progress in ABA therapy is measured through systematic data collection during every session. Your child’s RBT records responses to teaching trials, instances of target behaviors, skill demonstration, and other relevant data points. Your BCBA analyzes this data regularly to assess progress toward goals, determine if interventions are effective, and make treatment adjustments as needed. Families receive regular progress reports showing your child’s performance on each goal over time. This data-driven approach ensures therapy remains effective and responsive to your child’s changing needs.

What is Natural Environment Teaching in ABA therapy?

Natural Environment Teaching (NET) is an ABA approach that embeds learning opportunities into naturally occurring activities and routines rather than only using structured table work. NET uses your child’s interests and motivation to create teaching moments during play, daily routines, and preferred activities. This approach helps children generalize skills more effectively because learning happens in the contexts where skills will actually be used. At The Learning Tree ABA, we emphasize NET to make therapy feel natural and enjoyable while building meaningful, functional skills that transfer to real-world situations.

How soon will my child start talking with ABA therapy?

Communication development timelines vary significantly among children with autism. Some children develop verbal language quickly with ABA therapy, while others may use alternative communication methods like gestures, picture exchange, or augmentative communication devices. Your child’s BCBA will assess current communication skills and set appropriate goals based on your child’s individual profile. For some children, early communication goals focus on non-verbal skills like pointing, gesturing, or using visual supports. For others, goals may target verbal approximations, word use, or sentence building. Progress depends on many factors including age, baseline skills, therapy intensity, and individual learning patterns. Learn more about speech and communication development.

Can I observe my child’s ABA therapy sessions?

Yes, parent observation is generally encouraged in ABA therapy, though the approach may vary depending on your child’s individual needs. Some children perform better with parents observing, while others may be more focused when parents are not directly visible. Your BCBA will help determine what works best for your child. Observation opportunities allow you to see strategies in action, understand how to implement techniques at home, and ask questions about specific approaches. Parent observation and involvement are key components of effective parent training, which is essential for generalizing skills across settings.

What should I do if I don’t agree with my child’s treatment goals?

Open communication with your BCBA is essential. Treatment goals should reflect your family’s priorities and values, not just clinical recommendations. If you have concerns about proposed goals, schedule a meeting with your BCBA to discuss your perspective. Together, you can adjust the treatment plan to better align with what matters most to your family while still addressing your child’s developmental needs. Effective ABA therapy requires true partnership between families and clinical teams. Your input is valued and necessary for creating meaningful, family-centered treatment plans.

How do I prepare my child for their first ABA therapy session?

To prepare your child for their first ABA therapy session, maintain a positive attitude when discussing therapy, referring to it as “playtime” or using other positive language. If doing in-home therapy, prepare a comfortable space with some of your child’s favorite toys accessible. For center-based therapy, consider visiting the center beforehand to familiarize your child with the location. Bring comfort items like favorite toys or snacks. Use visual supports like a simple schedule if your child responds well to visual information. Remember that initial hesitation is normal—your therapy team is experienced in helping children feel comfortable and building positive associations with therapy sessions.

Does The Learning Tree ABA offer services throughout Maryland?

Yes, The Learning Tree ABA provides ABA therapy services throughout Maryland, including Baltimore County, Montgomery County, Howard County, Prince George’s County, Carroll County, Anne Arundel County, Harford County, Baltimore City, and additional Maryland counties. We offer in-home therapy, services at our Hunt Valley center, and school-based support. If you’re unsure whether we serve your area, please contact us to inquire about availability in your location.

The Learning Tree ABA provides comprehensive, evidence-based ABA therapy for children with autism throughout Maryland. Our experienced BCBAs and dedicated RBTs partner with families to create individualized treatment plans that support meaningful progress. Contact us today at 410.205.9493 or schedule a free consultation to learn how we can support your child’s development.

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