Maximizing Outcomes: How Speech and ABA Therapy Work Together
Autism spectrum disorder (ASD) is a neurodevelopmental condition that affects how people perceive the world, process information, and engage with others. Language and communication are one of the primary areas affected. Many children with ASD struggle to understand and use language, which can lead to frustration, difficulty forming relationships, and challenging behaviors that stem from unmet needs. Because autism exists on a spectrum, communication impairments can vary widely. However, developing strong communication skills is key to improving a child’s quality of life and overall well-being.
Two evidence-based therapies that are effective for children with autism are speech therapy and applied behavior analysis (ABA). Each offers a unique perspective and set of tools to support communication development. When combined through a collaborative, multidisciplinary model of care, these therapies complement one another and lead to significantly improved outcomes.
A Shared Goal: Supporting Communication
ABA therapists and speech language pathologists (SLPs) share a common goal—to support their learners in learning communication skills. While their expertise, areas of focus, and intervention approaches vary, both work toward empowering children to communicate in meaningful ways.
What is ABA Therapy?
Applied behavior analysis (ABA) is a therapy model based on the science of behavior and learning. In ABA, board certified behavior analysts (BCBAs) assess children and create individualized treatment plans that address their unique needs and goals. These plans are then implemented by behavior technicians—trained paraprofessionals who work directly with children in engaging, often play-based, sessions to teach skills and reinforce positive behaviors.
The ultimate goal of ABA is to improve quality of life by teaching essential skills and reducing behaviors that interfere with a child’s ability to learn and grow.
Depending on one’s unique needs, ABA therapists may work on many different skills across various domains such as:
- Receptive communication
- Expressive communication
- Social skills
- Joint attention
- Academic readiness
- Motor skills
- Play and leisure
- Adaptive living
- Emotional regulation
- Behavior reduction
- Safety awareness
- Community skills
- Vocational skills
What are the Benefits of ABA?
It’s a common misconception that ABA therapy is only for modifying challenging behaviors, like spitting, aggression, or property destruction. The truth is, ABA therapy offers numerous benefits, including:
- Reducing harmful behaviors, like aggression and self-injury
- Reducing disruptive behaviors or those that interfere with learning, such as screaming, throwing objects, and eloping
- Improving communication skills, such as requesting items, labeling, and following instructions
- Enhancing social skills, such as the ability to ask questions, hold conversations, and engage with peers
- Promoting independence in daily routines
- Building pre-academic skills, like attending and task completion
- Empowering children to self-advocate for their needs and desires
- Strengthening problem-solving skills
What is Speech and Language Therapy?
Speech and language therapy, commonly known as speech therapy, is a therapeutic approach to improving communication abilities. Speech language pathologists work with individuals to assess, develop, and strengthen their speech and language skills, tailoring support to each learner’s unique needs.
Following an individualized assessment, speech therapists may help with areas such as:
- Articulation and speech clarity
- Receptive language
- Expressive language
- Understanding spoken and written language in context
- Social pragmatic skills
- Stuttering and other fluency challenges
- Oral-motor weaknesses
- Feeding and eating
Speech therapists are often experts in alternative and augmentative communication (AAC). Around 25-30% of people with autism are non-speaking or have minimal spoken communication abilities. In these cases, alternative methods of communication—such as American Sign Language (ASL), Picture Exchange Communication System (PECS), or speech-generating devices—can be life-changing. Speech therapists help children find their voice by selecting the most appropriate AAC method and building a plan to teach and support its use in daily life.
What are the Benefits of Speech Therapy?
For children with autism, speech therapy offers a wide range of benefits that go beyond language development.
Key benefits include:
- Improving articulation
- Strengthening the muscles used for speech
- Teaching the expression of wants, needs, thoughts, and ideas
- Reducing frustration that often results from an inability to communicate effectively
- Improving the ability to eat and drink
- Increasing a learner’s vocabulary, grammar, sentence structure, and comprehension of language
- Improving the ability to engage with and relate to others
- Increasing confidence
How ABA and Speech Therapy Work Together
While ABA and speech therapy are separate disciplines, they are highly complementary—this is especially true when delivered through a coordinated, collaborative approach like the one offered at multidisciplinary clinics such as CompleatKidz. Many children experience incredible gains when receiving both therapies to support communication and behavioral needs from multiple angles.
A collaborative model of care is critical to maximizing the benefits of both ABA and speech. In a multidisciplinary clinic, therapists work together to ensure consistency and generalization of skills across environments and providers.
Here are a few examples of how ABA and speech can complement each other:
- Speech language therapists support speech production and language development.While ABA therapists target verbal behavior skills, they’re typically not trained on specifics related to speech production, such as articulation and oral-motor planning. Speech therapists can address these speech mechanics, ensuring the learner can physically produce sounds and words.
- ABA therapists target functional communication, reducing behaviors that interfere with developing communication skills.
Some children struggle to acquire skills in speech therapy due to behaviors that interfere with learning. Behavior analysts are experts in this area. They assess behaviors and implement interventions that target functional communication to replace challenging behaviors. Behavior analysts can also train speech therapists on the child’s behavior intervention plan (BIP), making speech therapy more productive.
- Speech and ABA therapists collaborate on AAC systems. Speech therapists often have more training and experience in assessing and individualizing AAC systems, so they frequently play a key role in determining the type of AAC to use and creating a plan. ABA therapists then teach and reinforce continuous use of the system in daily activities. This is important because speech therapists usually only work with learners for 30-60 minutes weekly. Conversely, children typically receive 15-40 hours/week of ABA therapy, offering significantly more teaching opportunities.
- ABA therapists create structured, yet naturalistic opportunities for practicing communication skills.ABA providers often work within a learner’s natural environments and can target communication skills as opportunities arise throughout the day. For example, a child learning to request preferred items would have many opportunities to ask for things within an ABA session, like when they want a specific toy or snack.
Why Multidisciplinary Care is Important
Individuals with autism experience a vast range of needs. For those with challenges across many areas of living, no single therapy may effectively manage all of their needs. In these cases, the child often experiences gaps in care. Instead, when multiple providers across specialties work together, the child can experience more holistic development.
Multidisciplinary care with speech and ABA therapy promotes:
- Holistic development across communication, social, and behavioral needs
- Enhanced outcomes
- Improved client and caregiver satisfaction
When to Consider Both Therapies
Every child’s therapeutic journey is unique. Some children thrive with only speech therapy or only ABA. There isn’t a one-size-fits-all approach to care. However, you may want to consider both therapies if your child:
- Has limited functional communication abilities
- Struggles to express their wants, needs, or feelings
- Engages in challenging behaviors as a result of an inability to effectively communicate
- Has difficulty following directions and understanding language
- Can’t speak or communicate effectively via other means
- Doesn’t understand nonverbal communication
If you have concerns about your child’s development, we encourage you to discuss with your pediatrician first. They can help guide you through the following steps and provide a referral for speech and/or ABA. A speech language pathologist will conduct an evaluation to determine whether your child is a good candidate for speech therapy. Similarly, a BCBA will assess to determine if your child is a good candidate for ABA therapy.
Better Together: A Whole-Child Approach to Autism Care
At CompleatKidz, we believe in taking a whole-child approach to therapy for children with autism. Because of this, our clinics across North Carolina offer four pediatric therapies under one roof—speech, ABA, physical, and occupational. Our multidisciplinary approach allows for meaningful collaboration among providers, driving the best possible outcomes for our learners.
References
Brignell, A., Chenausky, K. V., Song, H., Zhu, J., Suo, C., & Morgan, A. T. (2018). Communication interventions for autism spectrum disorder in minimally verbal children. Cochrane Database of Systematic Reviews, 2018(11), Article CD012324. https://doi.org/10.1002/14651858.CD012324.pub2
