Should my child do ABA therapy or speech therapy?

Many children with autism benefit from both ABA and speech therapy. ABA addresses overall communication in the context of behavior and learning, while speech therapy focuses specifically on speech and language disorders. They complement each other well, and your child's team can coordinate goals.

What's the main difference between ABA and speech therapy?

ABA therapy uses behavior science to teach a wide range of skills including communication, while speech therapy specifically addresses speech, language, and oral motor skills. ABA focuses on functional communication in real-world contexts, while speech therapy may address articulation, phonology, and language structure.

Can ABA therapists work on speech goals?

Yes, ABA therapy often includes communication goals using approaches like Verbal Behavior (VB). However, ABA therapists aren't speech-language pathologists and can't address all speech issues. They focus on functional communication rather than speech mechanics like articulation.

Does insurance cover both ABA and speech therapy?

Yes, most insurance plans cover both therapies as they address different clinical needs. ABA is typically covered under autism/behavioral health benefits, while speech therapy is covered under medical or rehabilitation benefits. Both may require prior authorization.

ABA Therapy vs Speech Therapy: Understanding the Differences

ABA Therapy vs Speech Therapy: A Comprehensive Comparison

Parents of children with autism often wonder about the differences between ABA therapy and speech therapy. Both can help with communication, but they take different approaches and address different aspects of your child's development. Understanding these differences helps you make informed decisions about your child's care.

Quick Comparison

Aspect	ABA Therapy	Speech Therapy
Provider	BCBA (Board Certified Behavior Analyst) and RBT (Registered Behavior Technician)	SLP (Speech-Language Pathologist)
Focus	Behavior and learning across all domains; communication is one component	Speech, language, communication disorders, and oral motor skills
Hours	Typically 10-40 hours/week	Typically 1-3 hours/week
Setting	Home, center, school, community	Clinic, school, occasionally home
Approach	Behavioral principles, data-driven, functional communication	Language science, developmental models, speech mechanics

What ABA Therapy Addresses

ABA therapy takes a comprehensive approach to development:

Communication in ABA

Functional communication (requesting, rejecting, commenting)
Manding (making requests)
Tacting (labeling things in the environment)
Intraverbals (conversational responses)
Communication across different settings and people
Alternative communication systems (PECS, AAC devices)

Other ABA Areas

Social skills and play
Daily living skills (self-care, safety)
Behavior management
Academic readiness
Motor imitation
Attending skills

What Speech Therapy Addresses

Speech therapy focuses specifically on communication disorders:

Core Speech Therapy Areas

Articulation: Producing speech sounds correctly
Phonology: Sound patterns in language
Expressive language: Using words, sentences, grammar
Receptive language: Understanding language
Pragmatics: Social use of language
Fluency: Speech flow (stuttering)
Voice: Pitch, volume, quality
Oral motor: Mouth muscle coordination for speech
Feeding/swallowing: If SLP has this specialty

How They Complement Each Other

ABA and speech therapy can work together effectively:

ABA Strengths

More intensive hours for practice
Teaches communication in natural contexts
Addresses motivation for communication
Generalizes skills across settings
Targets behaviors that interfere with communication
Coordinates with parents for home practice

Speech Therapy Strengths

Expertise in speech sound production
Knowledge of typical language development
Assessment of language disorders
Oral motor evaluation and treatment
AAC device evaluation and programming
Treatment of specific speech disorders

Collaboration Goals

SLP assesses and identifies speech/language needs
ABA team practices communication throughout the day
Both teams coordinate on communication goals
SLP provides consultation to ABA team on specific issues
ABA addresses behaviors that interfere with speech therapy
Both share strategies with parents

When You Need Both

Consider both ABA and speech therapy when your child has:

Autism diagnosis with communication delays
Articulation problems (hard to understand)
Need for intensive communication practice
Behavioral barriers to communication
Need for AAC device support
Complex language disorders

When ABA Alone May Be Sufficient

Communication delays are primarily motivation/behavioral
Speech sounds are age-appropriate
Language structure is developing well
No specific speech disorder present
Insurance or access limits other services

When Speech Therapy Alone May Be Sufficient

No autism diagnosis or behavioral needs
Specific speech sound disorder only
Language disorder without autism features
Stuttering or voice disorder
Oral motor or feeding concerns

Questions to Consider

What are your child's specific communication challenges?
Is your child's speech difficult to understand?
Does your child need intensive practice opportunities?
Are there behavioral factors affecting communication?
What does your insurance cover?
What providers are available in your area?

Coordinating Care

If your child receives both therapies:

Request providers communicate regularly
Share goals between teams
Ask about coordinated treatment planning
Avoid conflicting approaches or vocabulary
Ensure parents receive consistent guidance
Consider scheduling around each other for child's energy

Making the Decision

To determine the right combination for your child:

Get comprehensive evaluations from both disciplines
Discuss recommendations with each provider
Consider your child's overall needs
Check insurance coverage for both
Assess scheduling and family capacity
Start with what's most needed and add services as appropriate