Finding therapy & early intervention

Early Intervention — if your child is under 3

Early Intervention (EI) is a federally mandated program under IDEA Part C. Every state runs its own version, but the core guarantee is the same: free evaluations and services for children under 3 who have a developmental delay or condition likely to cause one. Autism qualifies.

The catch: services end at age 3. After that, responsibility shifts to the school district. Apply the day of diagnosis — evaluation alone can take weeks, and services don't start until after the Individualized Family Service Plan (IFSP) is written. The IFSP is the EI equivalent of an IEP — it documents your child's current abilities, the services they'll receive, and the outcomes the team is working toward.

Transition planning from EI to the school district should begin when your child is 2.5 years old. Ask your EI coordinator about this transition well before your child's third birthday — it doesn't happen automatically and requires its own evaluation.

Find your state's EI program on your state hub page. Most can be reached with a single phone call; you don't need a doctor's referral.

ABA therapy

Applied Behavior Analysis (ABA) is the most extensively researched autism therapy and the one most commonly covered by insurance. It focuses on building communication, daily living, and social skills while reducing behaviors that interfere with learning.

Waitlists at reputable providers routinely run 6–18 months. Add your child's name to a waitlist now — you can always decline when a spot opens. Most states now mandate ABA coverage; call your insurer and ask specifically for your autism benefit summary before assuming it isn't covered.

ABA comes in two forms: intensive (20–40 hours per week, typically for younger children or those with significant support needs) and focused (10–15 hours per week, targeting specific skill areas). Which is appropriate depends on your child's evaluation.

Look for providers whose therapists hold a BCBA credential — Board Certified Behavior Analyst. A BCBA requires a graduate degree and supervised clinical hours. You can verify any BCBA's credentials on the BACB public registry at bacb.com.

OT, speech therapy & PT

Occupational therapy (OT) addresses sensory processing, fine motor skills, self-care routines, and emotional regulation. Many autistic children benefit from OT alongside or instead of ABA. At a first OT evaluation, the therapist will typically assess your child's sensory profile, fine motor coordination, and ability to manage daily living tasks like dressing and eating.

Speech-language therapy covers more than talking — it includes pragmatic language (social communication), AAC (augmentative and alternative communication) for non-speaking or minimally speaking children, and feeding difficulties that often accompany autism. AAC includes speech-generating devices, picture exchange systems, and apps; it does not replace speech and does not reduce motivation to speak.

Physical therapy (PT) is less common but relevant for children with low muscle tone, motor delays, or coordination differences.

Your pediatrician can write referrals for all three. School districts are also required to provide these therapies through the IEP if they are educationally necessary — at no cost to your family. Note the tradeoff: school-based therapy is free but focused on educational goals; private therapy targets broader functional goals and may be more intensive.

Finding a provider

Start your search with credentialing databases rather than general directories — they let you verify qualifications before you call:

• ABA / BCBA: BACB provider directory — search by zip code and verify credentials in one step.
• Speech-language pathologists: ASHA ProFind — American Speech-Language-Hearing Association's certified provider search.
• Occupational therapists: AOTA OT Finder — American Occupational Therapy Association's directory.
• Early Intervention: Your state's EI program directory is linked from your state hub page.
• University autism centers: Many run lower-cost therapy clinics staffed by supervised graduate students. Search "[your city] university autism clinic."

Being on multiple waitlists simultaneously is standard practice — providers expect it. Join every waitlist you're interested in and inform them when you've found a provider.

Insurance and prior authorization

Prior authorization means your insurer must approve therapy before they'll pay for it. Most insurers require prior auth for ABA and sometimes for OT and speech as well. What to gather before calling: the diagnosis report, the provider's treatment plan and recommended hours, and the provider's NPI (National Provider Identifier) number.

When coverage is denied, take these steps: request the denial in writing and review the specific denial reason — insurers are required to give you one. File a written appeal within 30 days (most state laws mandate this window). Your provider can supply a letter of medical necessity to support the appeal.

If the appeal is denied, contact your state's insurance commissioner — most states have a formal external review process. Most states mandate ABA coverage; a denial does not always mean "not covered." The Autism Speaks insurance coverage by state guide lists your state's mandate.

What to ask a provider before you start

For any therapy provider, ask:

• Are you in-network with my insurance?
• What is your current waitlist length?
• How do you involve parents and caregivers in sessions?
• What does a typical week of therapy look like?
• How do you measure and share progress?
• How do you communicate progress to parents between sessions?
• For ABA specifically: What is your BCBA-to-technician supervision ratio?
• For speech specifically: Are you familiar with AAC and willing to support it if my child needs it?

A provider who resists parent involvement or can't explain their approach in plain language is a yellow flag. You should understand what your child's therapist is working on and why.