ABA Service Intensity Recommendation Questions Worksheet for Families

Use one copy for one dated recommendation and one defined service period. Attach or link the complete source. Write “not stated” when the document is silent and “needs clarification” when the unit, time period, setting, or service category is unclear. Do not reconstruct missing details from memory.

Families looking for an ABA service intensity worksheet for parents can use these fields to prepare questions, but the signed source and the responsible clinician remain authoritative for the recommendation.

Families and Caregivers / Progress, Quality, Rights and Ethical Care.

What this worksheet can and cannot do

The worksheet can preserve exact wording, organize questions, and record attributed explanations. It can also show which decisions are still open. That is useful when a treatment plan, authorization notice, family calendar, and provider schedule use similar numbers for different jobs.

Important boundary: This worksheet cannot recommend an ABA service intensity or setting. It cannot decide medical necessity, clinical appropriateness, consent, assent, coverage, authorization, staffing, family feasibility, school obligations, or what a payer should approve. It cannot convert an unclear unit, revise a treatment plan, or direct a family to accept, increase, reduce, or stop care. Those decisions stay with the people and organizations responsible for them.

The BACB Ethics Code for Behavior Analysts addresses professional responsibility, client and stakeholder involvement, informed consent, service agreements, records, and continuity within its scope. This family worksheet does not determine whether a certificant complied with the code.

Anchor the record to one complete source

A number without its source is easy to misread. “Twenty hours” might refer to a weekly recommendation, a monthly authorization, one service category, all direct and caregiver services together, or a proposed schedule that the provider cannot yet staff. Keep the label literal.

Source fieldFamily entryLearner and family name or family record label. Copy the source identifier.Document title. Use the exact title.Author, credentials, organization, and contact route. Preserve every attribution.Date signed or issued.Version, amendment, or page range.Recommendation period.Exact service-intensity wording.Attached or secure source location.Correction or clarification requested.

Keep an amendment as a new dated source rather than silently replacing the earlier language. If an evaluation, treatment plan, service request, authorization, and schedule disagree, list each separately. The difference is a question, not proof that one record is wrong.

Separate the recommendation from the later operational decisions

These records may influence one another, but they are not interchangeable.

LayerWhat to copyWho should explain or decide itWhat the worksheet must not assumeClinical recommendation. Start with the clinical source.Service category, intensity, setting, period, stated rationale, and review ruleQualified treating clinician or team identified in the sourceThe recommendation is not automatically authorized, available, accepted, or scheduled.Family and learner decision process. Preserve the conversation.Questions, preferences, access needs, burdens, alternatives, consent process, and assent-related communicationLearner and authorized decision-maker with the responsible teamA signature alone does not prove understanding, agreement, assent, or fit.Payer request or authorization. Copy the complete notice.Requested category and units, decision, effective dates, conditions, and notice sourceProvider and payer under the applicable product and processAuthorization does not equal a clinical recommendation, benefit guarantee, payment promise, or delivered care.Provider capacity and schedule. Use the dated calendar.Available staff, setting, start date, calendar, cancellations, and changesProvider scheduling and clinical ownersAvailable hours are not necessarily recommended hours, and a calendar does not prove delivery.Delivered care. Use the designated service record.Dated service records by category and unitProvider records, with payer or family reconciliation as applicableAttendance alone does not prove benefit, fidelity, billability, or payment.

The CMS person-centered care overview describes care guided by a person's goals, preferences, and values, with communication and collaborative planning. The overview does not set an ABA intensity or compel a specific coverage decision.

Copy every component before discussing the total

“ABA hours” can contain different service categories. Ask whether the recommendation separates direct treatment, protocol modification, caregiver guidance, assessment, reassessment, care coordination, or other work. Preserve the terminology used in the source instead of relabeling it. Keep each category separate.

Recommendation componentExact quantity and unitFrequency or periodSetting or modeProvider roleSource pageNeeds clarification?Direct treatment. Copy direct care separately.Clinical oversight or protocol modification. Preserve the source label.Caregiver guidance or coaching.Assessment or reassessment.Care coordination or other named service.

Do not add categories together unless the source uses compatible units and the same period. A weekly estimate, monthly maximum, and authorization unit are not one total merely because they all describe time.

The CASP ABA Practice Guidelines Version 3.0 public page describes the guidelines as informing planning, implementation, and evaluation of ABA assessment and treatment services for ASD. The full guideline requires a license. This page relies only on the public description and does not reproduce licensed guidance or use it to make a medical-necessity decision.

Ask how the recommendation connects to the current plan

A family can ask for the clinician's stated reasoning without trying to perform the clinician's analysis. Use plain questions and record the answer with its speaker and date.

Family questionExact source or gapPerson asked and dateAttributed explanationDocument or decision promisedFollow-up dateWhich current assessment findings and goals does this recommendation address? Note the answer.Why are these service categories and settings included? Capture the explanation.What does the stated quantity mean in ordinary calendar terms? Write the clarification.Which benefits, burdens, risks, or alternatives were discussed? List what was covered.How will the learner's experience and communication be considered? Preserve the response.What evidence or event will trigger review? Identify the trigger.How would a school, health, family, or access change be brought back for review? Name the route.

The AHRQ SHARE Approach provides a general structure for discussing options, benefits, harms, risks, and what matters to the person. It is not an ABA intensity standard and does not replace the provider's informed-consent process.

Record learner and family context without converting it into a prescription

The recommendation belongs beside the learner's communication, health, sleep, school, other care, relationships, culture, transportation, rest, interests, and family capacity. The recommendation does not override them. A worksheet can make those topics visible, but it cannot calculate the “right” schedule from them.

Context to discussLearner or family informationHow it was communicatedQuestion for the teamOwner and next actionLearner goals, preferences, interests, and signs of assent or dissent.Communication and accessibility needs.Health, sleep, feeding, medication, pain, or fatigue information.School and other services.Family routines, work, caregiving, transportation, rest, and financial constraints.Cultural, language, privacy, and relationship considerations.

Record direct learner communication in the form used, such as speech, sign, gesture, AAC, writing, behavior in context, or another accessible method. Do not turn a single response into a conclusion about assent, capacity, preference, or clinical fit. Ask the responsible team how ongoing participation and withdrawal signals will be recognized.

Test whether the proposed calendar is understandable

A clinical recommendation and a workable calendar answer different questions. Before services begin, the family can ask the provider to map the proposal without treating the draft calendar as a final decision.

Calendar questionCurrent answerSource or speakerUnresolved dependencyFollow-up owner and dateWhich days, times, settings, and service categories are proposed? Copy the proposal.Which parts have staff and a confirmed start date? Mark what is confirmed.Which parts depend on authorization, hiring, records, transportation, or another decision? Name each dependency.How are school, meals, sleep, other care, family time, and preferred activities protected? Note the safeguards.How can the learner or family report burden, access barriers, distress, or a change in circumstances? Keep the contact route.Who reviews a proposed increase, reduction, setting change, or pause? Identify the reviewer.

Do not label a calendar “feasible” simply because every recommended hour fits on paper. Staffing, travel, transitions, learner experience, family capacity, and access can change. A concern should return to the proper clinical, scheduling, payer, school, or family decision route.

Close each question without erasing the history

Keep the original question after an answer arrives. A clarification may resolve wording without changing the recommendation. A corrected document may replace an error without proving that the recommendation is appropriate. A new clinical decision should appear in its own signed or otherwise responsible source.

Open itemStatusResponsible ownerAnswer or action with dateNew source issued?Next reviewMeaning of the quantity and unit.Service categories included.Stated rationale and linked goals.Learner and family questions.Authorization or coverage dependency.Capacity and schedule dependency.Review trigger and date.

Urgent medical or safety concerns need the appropriate immediate clinical or emergency route. An unresolved documentation question should not delay urgent help.

Fictional example: questions about a mixed service recommendation

All names, organizations, records, dates, and quantities below are fictional.

FieldFictional entrySource.Harbor ABA Services treatment plan, version 4, signed August 18 by Riley Chen, BCBA.Exact recommendation.Twelve hours per week of direct treatment, two hours per month of caregiver guidance, and clinical oversight “as clinically indicated,” for a 12-week review period.Clarification needed.“As clinically indicated” does not state an expected quantity. The plan also lists home and community settings without allocating time between them.Stated rationale.Riley says the recommendation addresses two communication goals and one community-participation goal. The family records the explanation as Riley's statement; the worksheet does not certify it.Learner and family input.Jordan uses AAC to select “home after school” and “Saturday park.” The family asks how Jordan's communication will inform setting and schedule discussions.Separate decisions.Coverage review is pending. The provider reports eight currently staffable direct-treatment hours. No final calendar has been accepted.Next action.Riley will issue a clarification about oversight and settings by August 25. The family will keep the signed recommendation unchanged and compare later records separately.

This example does not establish that 12 hours is suitable, authorized, available, wanted, or effective for any person. The worksheet does not interpret Jordan's AAC selection as consent or assent, direct a schedule, or predict a payer decision.