The frustration of watching your child struggle to communicate can feel overwhelming. You hear them wanting to express themselves, but the words just don’t come out, or they come out jumbled and confusing. You want to help, but with so many therapy options available, it’s hard to know where to begin.
Applied Behavior Analysis (ABA) and speech therapy offer valuable tools to improve communication skills but have distinct approaches. Understanding these differences can empower you to choose the therapy that best suits your child’s needs.
What’s the Difference Between ABA Therapy and Speech Therapy?
ABA therapy uses positive reinforcement to teach social and communication skills in small steps, focusing on behavior, and is highly structured. Speech therapy targets specific language skills through practice and play, focusing on improving speaking and understanding language.
What is ABA Therapy?
ABA (Applied Behavior Analysis) therapy uses positive reinforcement to break down skills, like communication, into small steps. Therapists reward desired behaviors (saying “hello”) to gradually build towards complex communication. ABA is more structured and intensive, with frequent sessions focusing on broader social and communication development.
How Does ABA Help with Communication?
ABA therapy helps with communication by:
- Breaking Down Skills: Complex communication skills are divided into manageable steps. For example, starting with simple greetings like “hello.”
- Positive Reinforcement: Desired behaviors are rewarded to encourage repetition. For example, a child receives a sticker for making eye contact when greeted.
- Gradual Progression: As the child masters each step, more complex behaviors are introduced, such as combining words and phrases.
- Customization: Tailored programs focus on the child’s unique needs, adjusting strategies based on their progress.
Take the story of Ethan, a non-verbal 7-year-old with autism. Saying hello was a big challenge for Ethan. He would often avoid eye contact or withdraw when greeted.
During ABA therapy sessions, his therapist used the following steps to help him say “hello”:
- Pairing a picture of a smiling face with the word “hello.”
- Rewarding Ethan with a preferred item, such as a sticker, for looking at the picture.
- Gradually introducing the verbal cue “hello” alongside the picture.
- Using positive reinforcement for each attempt to say “hello.”
- Ethan eventually started greeting familiar people independently.
Some ABA programs might incorporate speech therapy techniques but primarily focus on the underlying behaviors that affect communication. A Board Certified Behavior Analyst (BCBA) typically leads ABA therapy sessions.
Pros and Cons of ABA Therapy
ABA therapy can be a helpful approach for children with autism. However, it may have some disadvantages. Here are some pros and cons of ABA therapy:
| Pros | Cons |
| Evidence-based: ABA therapy is a well-researched approach with proven effectiveness for improving communication in children with ASD. | Intensity: ABA therapy can be very intensive, requiring multiple hours of therapy per week. |
| Individualized: ABA programs are tailored to each child’s needs and goals. | Cost: Depending on the provider and the program’s intensity, ABA therapy can be expensive. |
| Structured: ABA therapy utilizes a structured approach with measurable goals, which can be helpful for some children. | Can feel “robotic”: Some critics view ABA therapy as overly focused on repetition and lacking in spontaneity. |
Who Benefits from ABA Therapy?
Children with autism who struggle with communication, social interaction, and challenging behaviors can often benefit from ABA therapy. This therapy can also be helpful for children with other developmental delays or learning difficulties.
What is Speech Therapy?
Speech therapy, or speech-language pathology, focuses on improving a child’s communication skills. A speech-language pathologist (SLP) assesses a child’s communication strengths and weaknesses and then develops a treatment plan to address those areas.
Speech therapy can target a variety of skills, including:
- Spoken language (articulation, pronunciation)
- Understanding language (receptive language)
- Using gestures and nonverbal communication
- Social communication skills (turn-taking, conversation skills)
How Does Speech Therapy Help with Communication?
Speech therapy helps with communication by:
- Practicing Sounds: SLPs help children improve articulation and pronunciation by practicing specific sounds and using tools like mirrors for visual feedback.
- Building Vocabulary: Expanding a child’s vocabulary through engaging activities and repetition.
- Using Visuals: Incorporating visual aids like pictures and gestures to support language comprehension and expression.
- Role-Playing: Using role-playing activities to practice social interactions and conversational skills.
- Oral Motor Exercises: Strengthening the muscles involved in speech through exercises like blowing bubbles or using straws.
Take Lily, a nine-year-old girl with Down Syndrome, as an example. Before speech therapy, it was difficult for people outside her family to understand her, leading to frustration for Lily. Her SLP used the following techniques to help improve her communication:
- Articulation Therapy: Focused on improving the pronunciation of specific sounds, such as “s” and “r,” using a mirror to show Lily how to position her tongue and lips.
- Vocabulary Building: Engaging activities to practice words like “sun,” “sand,” and “rabbit,” expanding her vocabulary.
- Oral Motor Exercises: Strengthening speech muscles with activities like blowing bubbles to improve lip muscles and breath control, and using straws to blow cotton balls across a table to enhance oral muscle strength and coordination.
- Exaggerated Facial Movements: Practicing exaggerated facial movements, such as smiling widely and puckering lips, to enhance muscle tone and control.
Over time, Lily improved her pronunciation, expanded her vocabulary, and strengthened her speech muscles. She became more confident in expressing herself, reducing frustration and enhancing her social interactions.
Pros and Cons of Speech Therapy
Speech therapy has strengths and weaknesses. Here are a few to consider.
| Pros | Cons |
| Targeted: Speech therapy directly addresses communication skills, making it a good choice for children with specific language delays. | Frequency: Speech therapy sessions can occur less frequently (weekly or bi-weekly) than ABA therapy. |
| Play-based: Speech therapy often incorporates play and fun activities to keep children engaged and motivated. | Limited focus on behavior: Speech therapy may not directly address behavioral challenges hindering communication. |
| Focuses on active learning: Speech therapists view children as active participants in their therapy, encouraging exploration and creativity. |
Who Benefits from Speech Therapy?
Children with a variety of communication difficulties can benefit from speech therapy, including children with:
- Speech delays
- Language delays
- Autism spectrum disorder (ASD)
- Articulation difficulties
- Social communication challenges
Integrating ABA and Speech Therapy
While ABA and speech therapy have distinct approaches, they can complement each other. For instance, a child can benefit from the structured, behavior-focused strategies of ABA while also working on specific language skills through speech therapy. This integrated approach can provide a more comprehensive developmental plan tailored to the child’s unique needs.
For Ethan, ABA therapy helped him progress from avoiding eye contact to confidently saying “hello.” For Lily, speech therapy provided her with the tools to improve her pronunciation. She gained the confidence to express herself clearly and connect with a broader circle of people.
By understanding the strengths of both ABA therapy and speech therapy, you can make an informed decision about the best starting point for your child. These therapies can often complement each other.
Consulting with a pediatrician or therapist can help you create a comprehensive communication development plan for your child.
