ABA and Speech Therapy: How They Work Together

If your child is starting both ABA therapy and speech therapy at the same time, you're not alone, and you're not overdoing it. Research on children with autism found that 80% receive either speech therapy or occupational therapy, and 52% receive both at the same time as ABA (PMC, 2019). These aren't competing programs. When they're coordinated well, each one makes the other work better.

This guide explains how ABA and speech therapy actually work together, what good coordination between your BCBA and speech-language pathologist (SLP) looks like, and what to ask providers to make sure your child's team is actually talking to each other.

If you're weighing which therapies your child needs in the first place, see our complete guide to types of autism therapy. For a side-by-side breakdown of what each therapy focuses on, see ABA vs. speech therapy vs. occupational therapy.

Key Takeaways

• Most children with autism who receive speech therapy also receive ABA at the same time. They're designed to reinforce each other, not compete.

• ABA builds communication skills across every part of a child's day. Speech therapy goes deeper on the mechanics of language, sound production, and social conversation.

• The biggest factor in how well combined therapy works isn't which one your child gets more of. It's whether the BCBA and SLP are actually coordinating goals.

• A good provider can explain, in plain terms, how they share information with the other specialists on your child's team.

Why Many Children Need Both

ABA therapy is built to teach skills across every setting a child spends time in: home, school, and the community. Communication is almost always part of an ABA plan, because a child who can't yet ask for what they want will often express that frustration through behavior instead.

Speech therapy goes further into the specific mechanics of communication than a general ABA plan typically covers. A speech-language pathologist works on things like:

• Building first words and sentences

• Teaching a child to use a communication device or picture system (AAC)

• Understanding what other people say (receptive language)

• The back-and-forth of real conversation, like taking turns and staying on topic

• Feeding and swallowing difficulties, which are common in children with sensory sensitivities

A 2021 meta-analysis of nearly 3,000 children with autism found real improvements in both understanding and using language from speech therapy, with the strongest results when a trained clinician delivered it directly (PMC7842122, 2021). That's exactly the kind of specialized, hands-on work an ABA program benefits from having alongside it, not instead of it.

What Good Coordination Actually Looks Like

The American Speech-Language-Hearing Association (ASHA) specifically calls for speech-language pathologists to partner with BCBAs when ABA techniques are part of a child's care, and to work as part of one coordinated team rather than running separate, disconnected programs (ASHA Practice Portal).

In practice, that coordination usually includes a few concrete things:

Shared goals. If your child's SLP is working on requesting snacks by name, your child's ABA team should be reinforcing that same goal during snack time at their sessions, not teaching a different way to ask.

Consistent language. If the SLP uses a specific picture board or set of signs, the ABA team should be using the exact same system. Mixed signals between providers slow a child down.

Regular communication. This doesn't need to be a weekly meeting. Even a shared notes document or a monthly check-in call between the BCBA and SLP keeps both providers working toward the same target.

One point of contact for you. You shouldn't have to be the one relaying every update between two separate teams. Ask who takes the lead on communicating changes, so it doesn't fall entirely on you.

What a Combined Week Might Look Like

Every child's schedule is different, but a common setup looks something like this:

• ABA sessions several days a week, either at a center or at home, working on communication alongside daily routines, play, and behavior goals

• Speech therapy sessions once or twice a week, either at a clinic or during a scheduled block at the ABA center, focused specifically on language mechanics

• A shared home practice plan from both providers, so what your child learns in speech sessions gets reinforced during ABA time and at home

If your child is using a communication device or picture system from speech therapy, tell your ABA team right away. A well-run program will build that system into every session, not treat it as a separate speech-only tool.

Questions to Ask When Comparing Providers

When you're choosing an ABA provider and your child already has (or will need) speech therapy, it's worth asking directly:

• How do you communicate with outside speech therapists working with the same child?

• Can our SLP share their current goals with your BCBA, and will your team actually use them?

• If we bring in a communication device from speech therapy, will your team be trained to use it?

A provider who has a clear, specific answer to these questions is a good sign. Vague answers, or a sense that the two therapies happen in separate silos, are worth taking seriously. For a fuller list of questions worth asking any provider, see our guide to choosing an ABA provider.

Insurance and Scheduling Both

Most major insurance plans cover both ABA and speech therapy separately, each requiring its own authorization and diagnosis documentation. Getting a diagnosis in place is the first step for authorizing either one. See our full guide to ABA therapy costs and insurance for how authorization generally works.

Scheduling two providers can be more logistically complex than one, especially if they're at different locations. Ask any ABA provider you're considering whether they can host speech therapy sessions on-site or coordinate scheduling, since fewer separate trips usually means better consistency for your child.

Frequently Asked Questions

Do I have to choose between ABA and speech therapy? No. Most children with autism who need speech support receive it alongside ABA, not instead of it. They're designed to work together.

Will my child's ABA team and speech therapist actually talk to each other? Not automatically; it depends on the providers. Ask directly at intake how the two will coordinate, and don't assume it's happening in the background.

Can ABA replace speech therapy? No. ABA can build early communication skills and reinforce speech goals throughout the day, but a speech-language pathologist brings specialized training in language development, feeding, and communication devices that ABA doesn't replace.

What if my child's providers give conflicting instructions? Bring it up with both right away. A shared communication system is a basic coordination step, and conflicting instructions usually mean that step is missing.

Do I need a referral to start speech therapy alongside ABA? It depends on your insurance plan. Many plans allow direct access to a speech-language pathologist, while others require a referral. Check with your specific plan.

Should speech therapy happen before or after ABA starts? There's no fixed order. Many families start both around the same time once a diagnosis is in place, especially if communication delays are a primary concern.

How do I bring a communication device from speech therapy into ABA sessions? Tell your ABA provider about it during intake, and bring the device (or a description of the system) to the first session so the team can build it into your child's plan from day one.