“Should my child do speech therapy or ABA therapy?”

I hear this question from parents in New York, in Shanghai, in Hong Kong, and in almost every consultation that starts with a newly diagnosed child. It is a reasonable question. It is also the wrong shape. Speech and ABA therapy are not two options to choose between. They are two halves of one plan: one discipline knows language deeply, the other knows how learning happens. A child who gets both, working as a single team, gets something neither can offer alone.

I am a speech-language pathologist and a behavior analyst, so I have sat on both sides of this table. This is how the two fit together, and why the foundations of communication are built on motivation long before they are built on words.

What each discipline brings

A speech-language pathologist (SLP) and a Board Certified Behavior Analyst (BCBA) are trained to look at the same child and notice different things. That is the point.

Speech-language therapy (SLP) Applied behavior analysis (ABA)
Assesses sounds, vocabulary, grammar and social use of language Assesses what motivates the child and what the behavior is communicating
Chooses the right speech and language targets for this child Designs how those targets are taught, prompted and faded
Identifies an AAC system (such as picture exchange or a speech-generating device) when speech is not yet reliable Builds a plan for using that system independently, not only with an adult nearby
Uses play and daily routines to grow spontaneous language, joint attention and peer interaction Uses reinforcement, structured teaching and natural-environment teaching to build and generalize skills
Addresses articulation and feeding concerns Tracks data so the team knows what is working

Read the table again and notice how few rows are in competition. Both professions are trained in what to teach and in how to teach it; what differs is where the depth of that training sits. The speech-language pathologist holds the content expertise in speech, language and communication. The behavior analyst holds the expertise in the science of learning and behavior, and in how behavior interacts with the environment. Put the two in the same room and the plan gets sharper on both sides.

Motivation comes first

When I map out how early communication skills develop, the base of the pyramid is not vocabulary. It is motivation.

Communication exists because someone wants something: a toy, a turn, a break, your attention, the song again. A child who has nothing they want from the people around them has no reason to communicate with them. So before we teach a single word, we find out what this child loves, and we make sure the adults are the doorway to it.

In ABA this is called pairing and contriving motivation. In plain language it looks like this:

  • The therapist becomes the person who brings the bubbles, the spinning top, the silly voice, rather than the person who asks for things.
  • Favorite items are within sight but a little out of reach, so there is a natural reason to ask.
  • Preferences are checked often, because what a child loved on Monday may be boring by Thursday.

This is where the SLP’s input matters immediately. Once a child wants something, they need a way to ask for it that works today. That might be a word, a sign, a picture, or a button on a device. Our job is to respect every form of communication a child already uses and choose a system that lets them succeed quickly. Waiting for perfect speech before a child can request anything teaches frustration, not language.

Motivation plus a working communication system is what makes a child ready to learn. Everything else is built on top of it.

The principles of learning that do the heavy lifting

ABA is the science of how learning happens. A handful of its principles show up in almost every good communication session, whether or not anyone calls them by name.

Reinforcement. When communicating works, children communicate more. If a child reaches for the device and taps “bubbles”, the most powerful thing we can do is blow bubbles, right away. The natural result of the request is the reinforcer.

Prompting and fading. We help a child succeed, then step back on purpose. An SLP might model the word; a behavior analyst plans how that model is faded so the child is not waiting for it forever. Speech therapists call a close relative of this scaffolding. Same goal, different vocabulary.

Structured teaching and natural-environment teaching. Some skills are learned fastest in short, focused practice (in ABA, intensive teaching). But a word that only exists at the table is not really learned. Natural-environment teaching, and the SLP’s play-based routines, carry that word into snack time, the playground, and bath time at home.

Child-led motivation. Approaches such as Pivotal Response Training let the child choose the activity and build teaching into it. This is where ABA and play-based speech therapy look almost identical from the outside, and where joint attention and turn-taking grow.

Function before form

Here is the idea that most changes how parents see progress.

Behavior analysts, drawing on the verbal behavior framework, look first at the function of language: what the child is using it to do. The core early functions are:

  • Requesting — asking for what you want (“juice”)
  • Labeling — naming what you see (“dog!”)
  • Listener responding — following what someone else says (“find your shoes”)
  • Conversation — answering and exchanging (“What do you want?” “Juice.”)

The SLP then builds the form: more words, longer sentences, clearer sounds, correct grammar. So a child might move from “juice” to “want juice” to “more apple juice, please”. Each step is the same function with a richer form.

Teams that skip function and go straight to form often end up with a child who can label forty flashcards and still cannot ask for help. Teams that build function first, then form, give a child language that actually works in their life. That is also the language that later carries into school and early academics.

What it looks like at snack time

A four-year-old, just starting to use a few words and some pictures, at snack.

The behavior analyst has checked that crackers and apple slices are highly preferred today, set them in a clear container the child cannot open, and written a prompting plan: wait three seconds for the child to ask, then offer a model, then fade the model across sessions.

The SLP has chosen the targets: “open”, “more”, and the names of the two foods. She has matched them to sounds the child can already produce, and put the same words on the child’s picture board so either form counts.

In the moment, the adult waits. The child taps “more”. The adult says “more crackers!” and hands one over immediately. Nobody asked the child to say it properly first. Next session, the waiting and modeling are adjusted based on the data.

To an observer it is just snack. Underneath, motivation, reinforcement, prompt fading, target selection and generalization are all running at once, because two professionals planned it together.

Collaborating, not just coordinating

Many children technically receive both therapies but never experience them as one plan. The difference is easy to spot.

When teams only coordinate:

  • Each therapist writes separate goals and shares results afterward
  • They use different words, so the child gets mixed messages
  • There is no joint assessment or shared decision-making
  • Parents end up translating between professionals

When teams truly collaborate:

  • They assess together and agree on which goals come first
  • They use the same instructions and the same words for the same skill
  • They meet regularly and adjust the plan using shared data
  • Each understands the other’s tools well enough to support them
  • The child experiences one consistent plan

If you are a parent, you are allowed to ask your child’s team which of these lists describes them.

Three things families can do at home

  1. Let your child ask. Before handing over a favorite thing, pause for a few seconds. Give your child the chance to communicate in whatever way they can.
  2. Honor every attempt. A point, a picture, a sound, a word: respond to the message first. Model a slightly longer version afterward (“ball… big ball!”).
  3. Use the team’s words. Ask your SLP and BCBA for the two or three target words and the phrase they use for prompts. Consistency at home is the fastest route to generalization.

Frequently asked questions

Can a child do speech therapy and ABA therapy at the same time?

Yes, and for many autistic children it is the recommended approach. The benefit is greatest when the SLP and the behavior analyst share goals, words and data rather than running parallel programs.

Is ABA a type of speech therapy?

No. Speech-language pathology is a discipline focused on communication, language, speech and swallowing. ABA is the science of learning and behavior. ABA principles can make speech and language goals easier to learn, but they do not replace an SLP’s expertise in language.

My child is not speaking yet. Where do we start?

With motivation and a communication system that works now. That may be pictures, signs or a speech-generating device alongside ongoing speech goals. Using AAC does not stop a child from learning to talk; it gives them a way to be understood while they do.

How do I know whether my child’s team is really collaborating?

Ask whether goals are written together, whether everyone uses the same words, and when the team last met to review data. If the answers are “no”, “not really” and “never”, there is room to grow.

If your team is working out how to bring speech and ABA therapy together, the free Interprofessional Collaboration Checklist is a good first meeting agenda. For support with a specific child or program, see consultation services.

This article offers general information and is not a substitute for individual assessment or treatment.

Selected references

  • Slim, L., & Reuter-Yuill, L. (2021). A behavior-analytic perspective on interprofessional collaboration. Behavior Analysis in Practice, 14, 1238–1248.
  • Brodhead, M. T. (2015). Maintaining professional relationships in an interdisciplinary setting. Behavior Analysis in Practice, 8, 70–78.
  • Frost, L., & Bondy, A. (2002). The Picture Exchange Communication System training manual (2nd ed.). Pyramid Educational Consultants.
  • Partington, J. W. (2010). Assessment of Basic Language and Learning Skills – Revised (ABLLS-R). Behavior Analysts, Inc.
  • Miltenberger, R. G. (2023). Behavior modification: Principles and procedures (7th ed.). Cengage Learning.