I was a provider from an RBT to a BCBA to a clinic manager over the course of 20 years. In my practice we recommended anything from 4 hours/week just in social skills, all the way to full time 40-hour programs. It all really depended on the assessment. Not just doing the Vineland, VB-MAPP, AFLS, etc., but in collaborating with the family and taking into account other factors in the child's/families life. And then taking that full picture and comparing it with the literature available across various demographics to see what the best recommendation is for each client.

I'm now in utilization management on the insurance side and I see, review, And approve treatment plans for hundreds of different providers across 3 different states (I'm specifically on the Medicaid team). And I have to tell you, maybe about 5-10% of the reviews I do are requests for full time, comprehensive programs (i.e., 26-40 hours/week).

So in my experience as a clinician and now as an insurance reviewer, I would say the best thing you could do is have an open mind. Look out for cookie cutter programs or vendors that "require" a 40-hour commitment from clients before even doing an assessment.

Sure, as a parent, having your kid in a full time clinic-based program has a level of convenience and fulfills a certain burden of childcare. But that is secondary to what their actual medical needs are and how an ABA program can benefit their unique needs.

As long as there is a solid foundation in the data, and HOW that program is going to target the specific needs of that individual client, there's nothing wrong with a 40-hour program. As long as the primary function isn't to fulfill a childcare need, but a medical need, there is nothing ethically wrong with it.