The week of the diagnosis
This family came to us in February of last year. Their son was three. His pediatrician had said the word “autism” the week before, and his mom had cried in the parking lot for forty minutes before she could drive home.
By the time we got on our first call together, she was past the crying part and into the do-something-about-it part. That phase, in my experience, is the hardest one to be in. Everything feels urgent and nothing feels under control.
We started with the basics. Benefits verification. A care coordinator assigned by the end of the week. An assessment scheduled for the following Tuesday.
Months one through four — the slow start
Most families want to know how fast progress happens. The honest answer is that the first month or two usually feels slow. Our team meets the child where they are, and where they are at the start is often somewhere the family has been struggling for a long time.
For this family, the first three months looked like an RBT in their home four days a week. Mostly play. A little bit of structured work at the table. Some hours where the parents could not tell if anything was changing.
I remember a phone call with his mom in week six. She said, “Are we doing this right? I cannot tell if it is working.” That is the call I remember most.
What was actually happening
What was actually happening was a lot — just not in ways that show up in a parent's day. Our BCBA was building data on what motivated him, what frustrated him, and what he could already do that nobody had noticed. The RBT was establishing safety, building trust, learning his rhythms.
This is the part of ABA that does not look like progress. But it is the part that makes progress possible later.
Month five — the first peek
In month five we started seeing the first peeks of what would later become a flood. He started bringing toys to his RBT instead of running away with them. He started using a picture exchange to ask for snacks. He started waving goodbye when she left.
His parents did not always notice these things in real time. They were tired. They were running their household. They were carrying the weight of two other kids and a grandmother in declining health.
When we sent the monthly progress note, his dad wrote back to us: “I do not see most of this. Help me see it.”
I do not see most of this. Help me see it.
The morning
The morning he said their names back was a Tuesday in April. He had been in ABA for fourteen months. His parents were both in the kitchen.
He came around the corner. He said his mom's name. Then he said his dad's name.
His mother told me later that her first thought was that she had imagined it. Her second thought was to ask him to do it again. She did not ask him to do it again. She just sat down at the kitchen table and cried.
What we tell every family at the start
We tell every family at the start that progress in ABA is not a straight line. It is not a chart that goes up cleanly. It is months of small foundation work that nobody can see, followed by moments that change the entire room. The first time he said their names was one of those moments.
It is the reason we keep caseloads where we do. It is the reason we send written progress reports every month. It is the reason your BCBA reads your child's session notes the same week they happen.
Where they are now
That was a year ago. He is now using three-word phrases. He is asking for what he wants without picture exchange. He still works with the same RBT he started with — and that consistency is part of why he is where he is.
Their family did the work. Our team did the work. He did the work. The morning he said their names was the moment all of that became visible.
If you are in week six and wondering if it is working — call your BCBA. Ask them what they are seeing. The work is happening. The morning is coming.
— Brittany Brown