ABA vs. speech therapy: does my child need both?
Clinically reviewed by Ruth Gluck, MSEd, BCBA
ABA therapy and speech therapy aren't competitors — they do different jobs. Speech therapy specializes in how a child communicates. ABA teaches skills across all of daily life, communication included, and works on the behaviors that get in learning's way. Many children with autism do both, and the two work best coordinated.
What does speech therapy do?
A speech-language pathologist (SLP) is a specialist in communication — all of it. Speech sounds, first words, building sentences, understanding language, conversation skills, and feeding or swallowing issues too. If your child's communication uses pictures, signs, or a talker device, the SLP is usually the expert who sets that up.
Sessions are typically short and focused — often 30 to 60 minutes, once or twice a week — and go deep on communication in a way no other therapy does. For a child whose main challenge is speech and language itself, an SLP is the specialist you want.
What does ABA therapy do?
ABA therapy is broader and more woven into daily life. A BCBA designs a plan across whatever your child needs most — asking for things instead of melting down, dressing, playing with other kids, handling changes in routine, staying safe — and a therapist works that plan one-on-one for multiple hours a week, usually in your home or daycare.
Communication goals live inside ABA too, but the angle is different: ABA focuses on making communication work — teaching your child that words, signs, or pictures get real results, and practicing them across the whole messy day, not just in a session room.
How do they overlap — and differ?
The overlap is communication, and that's by design, not a turf war. A helpful way to hold it: the SLP is the specialist in how your child communicates — sounds, words, sentences, devices. ABA is the generalist in making skills stick — motivation, practice, and using skills everywhere they're needed.
The differences are dosage and scope. Speech therapy is a scalpel: an hour or two a week, aimed precisely at communication. ABA is scaffolding: more hours, spread across daily routines, catching skills and behavior at the same time. A child who learns a new word with their SLP on Tuesday can practice it fifty times inside ABA sessions by Friday.
Do many children do both?
Yes — for many children with autism, both at once is the standard recommendation, not the deluxe package. The evaluation report that diagnosed your child probably recommends some mix of ABA, speech, and sometimes occupational therapy on the same page.
When both are running, coordination matters more than anything. Good providers share goals: the BCBA folds the SLP's communication targets into daily ABA practice, and the SLP hears what's working at home. Ask any ABA provider you're considering how they coordinate with speech therapists — a good answer is specific, and 'we're happy to connect with them' should be the floor.
How do you decide where to start?
Start from the evaluator's recommendations — that report was written for exactly this decision. From there, practical wisdom: if waitlists differ, get on all of them now and start whichever opens first; one therapy running beats two therapies pending. Insurance details differ by plan too, which is why we check benefits for free before any family commits to anything.
And if you're still sorting out what your child needs, ask us — honestly, even if the answer is 'start with speech first.' Our intake team talks through exactly this question with Kansas and Colorado families every week, no strings attached.