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  • Melissa Druskis, MS, BCBA

Speech Therapy vs ABA Therapy



You don't need to choose between speech therapy and ABA therapy (including verbal behavior), but it's important to understand the differences between the two approaches.


Speech Therapy

Speech therapy is provided by speech language pathologists (SLP) which requires a masters degree in communication disorders, 400 hours of supervised clinical experience, a 36 week clinical fellowship, and passing a national exam (though there may be some variation in this state to state). SLP's provide interventions and assessments with adults and children with problems with speech, language, cognition, and swallowing (ASHA).


Speech therapists use a structural approach to language. The focus is on what language looks like and what is being said. They may teach these skills through play in the natural environment or in a more structured setting of sitting at a table looking at flashcards, or a combination of both. An example of a language goal might be "Client will identify colors by pointing to pictures or objects" (Bilinguistics).


When treating picky eating (separate from swallowing disorders) SLP's utilize SOS, Sequential Oral Sensory, approach which focuses on a child-led sensory processing and textures of food. While this method is widely used across speech and occupational therapists, research shows it is an ineffective approach (Peterson et al, 2016)


Applied Behavior Analysis (ABA)

ABA is overseen and provided by Board Certified Behavior Analysts (BCBA), though much of the direct therapy is provided by a trained therapist. BCBA's require a masters degree in ABA, psychology, or education and if it is not in ABA they are required to take about 1 year of leveling courses in ABA. They are also required to have 1500 field work hours and pass a worldwide exam. While many BCBA's work in the field of ABA therapy with individuals with autism focused on increasing skills in communication, socialization, and daily living activities and decreasing challenging behaviors, they are able to work with any behaviors of any living organisms. This includes employee performance for companies, animal behavior, pediatric behavioral therapy for typically developing children (toilet training, picky eating, sibling issues, etc.), and more. Regardless of the population or behaviors that we are trying to increase or decrease, BCBA's work by manipulating the environment (the things that come before and after the behaviors) to increase behaviors we want to see by providing reinforcement and decrease the behaviors we don't want to see by determining why they are occurring and withholding reinforcement (BACB).


BCBA's work on communication and language through the use of verbal behavior. Instead of looking at language using a structural approach, BCBA's use a functional approach. If a child can say "cookie" when we show them a picture of a cookie, it is not assumed that they can also say "cookie" when they want a cookie, say "cookie" when asked "what's a round food that has chocolate chips?", or that they can point to a cookie when asked "where's the cookie?". Each of these uses of the word "cookie" has a different function; request, label, answering a question, and receptive identification. These skills can be taught discretely at a table with flashcards or other materials, but it would always be moved to the natural environment where the language would occur. An example of a language goal would be "Client will label and identify 8 color targets with 80% accuracy over 3 consecutive therapy sessions". Progress through targets and goals is solely based on data, therefore accurate data collection and graphing data is very important in ABA.


Picky eating issues can also be addressed effectively through the use of ABA therapy for those that have additional training in this area. BCBA's use systematic desensitization to increase tolerance and acceptance of non-preferred or novel foods and ultimately increase these other foods into the child's regular diet. This is effective for mild cases if picky eating or serious issues that lead to malnutrition, GI tubes, hospitalization, or more. While ABA therapy will not allow escape from the instruction to touch, taste, or consume the food provided, forced feeding should never occur.


Comparison

Both speech therapy and ABA therapy can collaborate together to work towards the same goals, but keep in mind the different approaches when determining if one or the other is best for your needs. However there are some areas where they do not overlap. Speech therapists will not work on activities of daily living to the extent of BCBA's and do not work on decreasing challenging behaviors. BCBA's can work with language and feeding concerns, but do not work with swallowing issues or speech/language problems related to anatomical or physiological issues.

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