Waiting for an Autism Evaluation? You Can Start ABA Therapy Now

Understanding the Wait: Why Evaluation Waitlists Are Long

Across the United States, demand for autism evaluations has grown significantly, leading to months-long waitlists in many areas. Pediatric developmental specialists, child psychologists, and neurology clinics often have limited openings, especially for comprehensive diagnostic assessments. While this delay can be frustrating, it's important to know that you don't have to hit "pause" on your child's progress. Many families use this time to start therapeutic services, including applied behavior analysis (ABA), before a formal diagnosis is made.

What causes the backlog?

• Increased awareness: More parents and educators are recognizing early signs of autism, leading to more referrals.
• Shortage of specialists: There are far fewer qualified diagnosticians than needed to keep up with referrals.
• Complex assessment procedures: Standard autism evaluations require multiple sessions, observation, and caregiver interviews, all of which take time to schedule and complete.

The good news: you can take action now. Starting ABA therapy does not always require a completed evaluation report.

🔗 Related reading: Home vs Center Based ABA for 3-Year-Olds: Which Is Best? · Local ABA Therapy

Can You Start ABA Without a Complete Diagnosis?

Yes, in many cases. ABA providers often accept children who have a medical recommendation, such as a prescription from a pediatrician or developmental pediatrician, noting developmental delays or suspected autism. This is sometimes called a "medical necessity" letter or a referral for ABA services.

What documentation do you need?

• A diagnosis of a developmental delay (e.g., speech delay, social-communication delay)
• A note from your child's primary care provider recommending behavioral intervention
• Results from a developmental screening (like the M-CHAT) that indicate risk

Each ABA provider and insurance plan has its own requirements. Some will accept a temporary diagnosis of "suspected autism" and begin an initial assessment. Others may require a more specific diagnostic code. The best step is to contact providers and ask if they offer pre-diagnosis services.

The Role of Insurance and Medicaid in Pre-Diagnosis Coverage

Most private insurance plans and state Medicaid programs cover ABA therapy for children with a diagnosis of autism. However, coverage for services before a formal diagnosis varies.

Private insurance

Many plans will cover an initial behavioral health assessment and a limited number of ABA sessions to evaluate your child's needs, even before a full autism diagnosis is confirmed. This is often billed under a code for "developmental delay" or "other behavioral disorder." Check your plan's summary of benefits or call the customer service number listed on your insurance card. Ask specifically: "Do you cover ABA therapy for children with developmental delays or suspected autism?"

Medicaid and state programs

State Medicaid programs (like EPSDT or a state's Early Intervention system) often provide coverage for children under age 3 or 3-5 who show developmental delays. If your child is already enrolled in Medicaid, you may be able to access ABA through a provider in your state's network. Some states have waiver programs that require a formal autism diagnosis, but many still fund early intervention services without one. Contact your state's Medicaid office or early intervention coordinator for details.

Important: If you don't currently have insurance but are eligible for Medicaid, apply as soon as possible. Many states also have programs for uninsured children.

🔗 Related reading: SC Medicaid Autism Waivers: A Complete Guide for Families · Nearby ABA Therapy

How to Find a BCBA-Led Provider While You Wait

The key is to be proactive. Instead of waiting for the evaluation appointment, begin searching for ABA providers that can start promptly.

Steps to get matched

• Use a free matching service: Companies like Get Started with ABA connect families with vetted, BCBA-led providers in their area. You provide basic information about your child's needs and insurance, and they match you with clinics that have availability. This saves you hours of calling around.
• Check provider websites: Look for statements like "accepting new clients" or "insurance accepted." Many clinics list their intake criteria.
• Ask your pediatrician: Your child's doctor often knows which local ABA providers offer pre-diagnosis assessments.
• Contact your state's autism association: Many have provider directories and can suggest clinics with shorter wait times.

What to ask potential providers

• Do you accept my insurance or Medicaid?
• Can you start an ABA assessment before a formal autism diagnosis?
• What documentation do you need from my child's doctor?
• What is your current wait time for an intake?
• Do you offer in-home, center-based, or school-based therapy?

What to Expect from an Interim ABA Assessment

Once you connect with an ABA provider, the process typically begins with an assessment by a board-certified behavior analyst (BCBA). This is not a substitute for a medical diagnostic evaluation, but it helps the BCBA understand your child's strengths and areas for growth.

Components of a behavioral assessment

• Interview with caregivers: The BCBA will ask about your child's daily routines, communication, social interactions, and any challenging behaviors.
• Direct observation: The BCBA will watch your child in natural settings (home, school, or clinic) to see how they play, learn, and communicate.
• Standardized tools: Many BCBAs use assessment instruments like the VB-MAPP (Verbal Behavior Milestones Assessment and Placement Program) or the ABLLS-R (Assessment of Basic Language and Learning Skills).

Based on the assessment, the BCBA will create a personalized treatment plan with goals targeting communication, social skills, daily living skills, and behavior reduction. This plan can be implemented immediately, even while you wait for the formal autism evaluation.

Practical Steps to Prepare for a Formal Autism Evaluation

While you're starting ABA, continue the diagnostic process. The ABA provider's assessment data can even help the diagnostician make a more informed decision.

What you can do now

• Keep a log: Write down specific behaviors, communication milestones, and social challenges you observe. Note any regression or loss of skills.
• Record video clips: Short videos of your child playing, interacting with others, or engaging in repetitive behaviors can be very helpful for the evaluation team.
• Gather records: Collect any previous developmental screenings, daycare or school reports, and notes from your pediatrician.
• Prepare a list of questions: Write down everything you want the diagnostician to address, such as concerns about feeding, sleep, or sensory issues.

If the waitlist is very long (months), ask your pediatrician about other options: some states have tele-evaluation services, or you might be able to travel to a nearby city with shorter wait times.

Common Mistakes Families Make During the Waiting Period

Knowing what pitfalls to avoid can help you make the most of this time.

• Waiting to start any therapy: The biggest mistake is doing nothing. Even if ABA isn't yet available, consider speech therapy, occupational therapy, or a parent training program. These can be started with a delay diagnosis as well.
• Not checking insurance benefits early: Many families assume a service isn't covered, only to find out later that it is. Call your insurance company as soon as you have a referral.
• Forgetting about Medicaid waivers: If your child gets on a Medicaid waiver waitlist now, they may have coverage when the evaluation is complete.
• Overlooking free consultation: Many ABA providers offer a free 15-30 minute phone consultation. Use this to gauge if they're a good fit.
• Assuming one diagnosis is required for everything: Some services require a specific autism diagnosis, but many do not. Always ask before ruling something out.

How Get Started with ABA Can Help You Move Forward

The wait for an autism evaluation can feel disheartening, but you don't have to navigate it alone. Get Started with ABA is a completely free service that matches families like yours with vetted, BCBA-led ABA providers in your area. They take into account your insurance, location preferences, and any specific needs your child has. The goal is to get your child into therapy as soon as possible - even before the diagnostic report arrives.

Here's how it works:

• You fill out a short form with basic information about your child and your insurance.
• Our team reviews your needs and identifies providers that offer pre-diagnosis assessments.
• You receive a personalized list of matches, usually within a few days.
• You choose the provider that fits best and schedule your intake appointment.

There is no obligation, and you never pay a fee. We believe every child deserves early intervention, no matter where they are on the diagnostic journey. If you're ready to stop waiting and start making progress, let us help you find a BCBA-led provider today.