Our daughter (4) was just approved to start ABA. The provider is recommending 30 hours a week, which honestly sounds like a full-time job for a four-year-old. Insurance approved 25.
Is 30 hours normal? I'm worried about her being exhausted and missing time at the preschool she loves. How do I know what number is actually right for her and not just what the clinic wants to bill?
BCBA here. Great question, and the fact that you're asking it is a good sign.
There are two broad models. "Comprehensive" ABA targets many developmental areas at once and typically runs 26-40 hours per week. "Focused" ABA targets a small number of specific goals and runs about 10-25. So 30 hours isn't inherently wrong for a 4-year-old - early intensive intervention is a legitimate, well-studied approach - but the number should fall out of her assessment and goals, not out of a billing template.
Questions I'd want your provider to answer clearly:
1) Which specific goals require this intensity, and what does the assessment show?
2) How will hours taper as she meets goals? (There should be a plan for LESS over time.)
3) How does the preschool she loves fit in? Time with typically developing peers is valuable - a good plan works around it or even embeds support there, rather than replacing it.
4) How will you protect her from burnout, and how do you respond when she doesn't want to participate? (You want to hear something about assent and making sessions fun - not "we work through it.")
Red flag to watch for: if every child at the clinic somehow needs the same number of hours, the number is about the clinic, not the children.
And practically: you can accept fewer hours than recommended. Starting at 20-25 with a plan to reassess in 90 days is a completely reasonable position, and any provider worth staying with will engage with it rather than pressure you.
Parent perspective: we started at 30 hours and our son was a puddle by dinner every night. We dialed back to 20 blended around preschool mornings and the difference was immediate - better sessions, better moods, still great progress. The right number turned out to be the one our kid could actually sustain. Don't be afraid to say that out loud in the planning meeting.
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