ABA Family Priorities and Daily Routines Worksheet

Use this worksheet to prepare for a conversation with the responsible clinician. A family priority is important input, but it is not automatically a clinical target. A routine that is difficult on one day is not a diagnosis, a behavior function, or proof that a particular intervention is needed.

Important boundary: This is a family-owned planning worksheet. The sheet is not an assessment, diagnosis, treatment plan, behavior plan, consent or assent record, school plan, medical recommendation, hour recommendation, payer submission, clinical data sheet, or promise of outcome. The responsible professionals must assess, explain, recommend, document, and obtain any required authorization or agreement through their actual processes.

Families and Caregivers / Supporting Progress at Home and Family Wellbeing.

Begin with the people and purpose

Complete only the fields that help the family prepare. Leave a field blank when the answer is unknown or private.

• Child's preferred name: ______________________________________________.
• Child's age or life stage, if useful: ______________________________________________.
• Family member or authorized representative completing this sheet: ______________________________________________.
• People whose perspectives the family wants included: ______________________________________________.
• Preferred language and communication method: ______________________________________________.
• Interpreter, accessible format, relay, AAC, sensory, or meeting support requested: ______________________________________________.
• Planning conversation and date: ______________________________________________.
• Current plan, assessment, or document version, if one exists: ______________________________________________.
• What the family hopes this conversation will clarify: ______________________________________________.

The AHRQ SHARE Approach is a general clinician-led shared-decision-making model. It focuses on meaningful dialogue about options, benefits, harms, risks, and what matters to the patient. This general model is not an ABA goal-writing rule, but its emphasis on dialogue supports bringing priorities and questions into a clinical conversation.

Describe routines before proposing solutions

Write what usually happens, what helps, and what is hard. Avoid deciding why something happens unless a qualified professional has assessed that question.

Routine or settingWho is usually presentWhat the child seems to enjoy or valueDirect family observationCommunication or access support usedWhat feels hard or unsafeWhat the family wants to understand______________________________________________________________________.______________________________________________________________________.______________________________________________________________________.______________________________________________________________________.

Use direct descriptions when possible. “Points to the pantry, signs ‘eat,’ and waits near the counter” is different from “acts out for food.” “Leaves the bathroom when the fan starts” preserves a possible context without claiming a cause.

The AHRQ care-coordination overview describes assessing needs and goals, sharing information, agreeing on responsibility, monitoring, and follow-up as coordination activities. That overview is not an ABA standard, and this worksheet does not make the family the coordinator for every service.

Name priorities without turning them into goals

Families may care about communication, safety, comfort, autonomy, relationships, participation, sleep, meals, school, community access, play, self-care, privacy, or reduced household burden. A priority can be broad. The clinical team still has to determine whether ABA is an appropriate service, what assessment is needed, and how any proposed goal would be defined and measured.

Family priorityWhy it matters in everyday lifeChild's preference or communicationCurrent strength to build fromWhat would feel meaningfully differentWho else may need to participateQuestions before any goal is chosen______________________________________________________________________.______________________________________________________________________.______________________________________________________________________.

The BACB Ethics Codes page identifies the current ethics requirements that apply to covered certificants and applicants. The BACB consumer resources explain common certification roles and consumer resources. Neither source turns a family's worksheet into a clinical assessment or determines what a particular provider, licensee, school, or payer must approve.

Preserve strengths, preferences, and communication

Do not make the difficult moment the whole description of the child. Record interests, reliable skills, trusted relationships, ways of communicating, sensory preferences, and conditions that support participation.

AreaWhat the family noticesChild's own words, AAC selection, sign, gesture, movement, or other communicationSupport that helps access or participationContext where it is differentQuestion for the teamInterests and enjoyment__________________________________________________.Communication__________________________________________________.Relationships__________________________________________________.Choice, refusal, or asking for a break__________________________________________________.Sensory or environmental access__________________________________________________.Independence and help__________________________________________________.

The ASHA AAC portal describes aided and unaided forms of communication. That portal does not prescribe an ABA program. The DOJ's effective communication guidance explains duties for covered entities and emphasizes that the communication method and the nature, length, complexity, and context of an exchange matter. The applicable duty depends on the organization and facts.

Record practical fit and limits honestly

A clinically reasonable idea can still be difficult to carry out in a specific household. Work, school, transportation, sleep, health, housing, caregiving, siblings, privacy, culture, language, food access, technology, and cost can affect fit. Recording a constraint is not refusing care.

Practical questionFamily's current situationWhat is workable nowWhat is not workable nowSupport or clarification requestedPerson who will follow upReview dateTime and schedule____________________________________________________________.Materials or technology____________________________________________________________.Language or communication access____________________________________________________________.Transportation or service setting____________________________________________________________.Privacy, siblings, or household needs____________________________________________________________.Health, sleep, meals, or other care____________________________________________________________.

The BHCOE standards describe expectations for organizations seeking BHCOE accreditation, including areas related to clinical practice, rights, consent, documentation, coordination, and outcomes. They apply within that accreditation context and do not prove that any organization is accredited or that one worksheet satisfies a standard.

Prepare questions for collaborative planning

An ABA family priorities worksheet is most useful when each open question has an owner and a date. Ask the responsible clinician to distinguish family input, clinical findings, recommendations, options, decisions, and items that require another professional or organization.

QuestionWhy the family is askingSource or example to bringWho should answerAnswer or options explainedDecision still openOwner and follow-up date______________________________________________________________________.______________________________________________________________________.______________________________________________________________________.

Questions might include:

• How will the child participate in choosing, refusing, pausing, or changing a goal?
• Which family priority appears appropriate for ABA, and which belongs with another professional or ordinary family support?
• What assessment supports a proposed goal?
• What meaningful everyday result would the team look for, and how would burden or adverse effects be noticed?
• How would the plan preserve the child's communication system and existing strengths?
• Which part is a recommendation, which part is a family decision, and which part depends on payer or school action?
• When will the team revisit fit if the routine, health, schedule, or family priority changes?

Keep the decision trail separate

Do not silently replace the family's original words after a meeting. Add a dated response so the difference between input and decision remains visible.

DateFamily input or questionClinician assessment or explanationOption or recommendationFamily responseDecision and document sourceUnresolved item and owner______________________________________________________________________.______________________________________________________________________.______________________________________________________________________.

If the child, family, clinician, school, physician, speech-language pathologist, occupational therapist, payer, or another party disagrees, record each position with its source. This sheet cannot decide whose position controls. Consent, assent, authorization, school procedures, professional scope, and legal authority have their own requirements.

Fictional example: Niko's morning routine

Niko is fictional, 10, and communicates with speech, gestures, and a tablet. His father, Dev, completes the worksheet before a treatment-plan conversation.

• Dev writes that Niko enjoys choosing music and packing his snack. He independently finds his shoes, but the family often misses the bus after the bathroom fan turns on.
• Niko uses his tablet to say “fan off” and “wait.” Dev records those exact selections. He does not write that Niko is avoiding school or that the fan causes every delay.
• The family priority is a calmer, more predictable morning in which Niko can ask for a pause and still participate in the steps that matter to him.
• Dev records that a long daily practice block is not workable. A brief routine during ordinary preparation may fit, but the family wants the clinician to assess the situation before recommending anything.
• At the meeting, the clinician agrees to review direct observations and communication access. The team has not selected a goal, procedure, measurement system, or hour recommendation yet.

The example preserves strengths, communication, routine context, family fit, and open decisions. Nothing in it establishes function, medical necessity, assent, treatment effectiveness, or the right clinical plan.

What this worksheet cannot establish

No universal federal, BACB, BHCOE, school, payer, or state rule requires this exact worksheet or makes every family priority an ABA goal. Providers may use different assessment, planning, consent, communication, and documentation processes.

This worksheet cannot diagnose a condition, identify behavior function, choose or change treatment, define mastery, establish generalization, recommend hours, measure fidelity, prove assent or consent, establish medical necessity, obtain authorization, override a school plan, or assign legal responsibility. It cannot show what happens outside the routines the family describes.

It can help a family preserve what matters, what the child communicates, what is already working, what does not fit, what the family directly observed, and what questions need a responsible answer. Date corrections and new priorities instead of erasing the earlier context.