What Is Speech Therapy vs. Behavioral Therapy?
Speech Therapy
Speech therapy focuses on helping children communicate more effectively. Speech therapists work on a child’s language, speech sounds, and social skills, helping them express their needs, thoughts, and feelings. Moreover, we can also help with feeding challenges, such as picky eating or texture sensitivities. A key part of speech therapy is building on each child’s strengths, meeting them where they are, and fostering natural communication skills that help them thrive in their daily lives.
Goals of speech therapy may include:
- Enhancing language skills so children can understand and use words
- Helping children pronounce words clearly for better understanding
- Developing social skills like turn-taking, and expressing emotions
- Supporting feeding and eating habits by addressing oral motor skills and sensory issues, which can help with picky eating, food textures, and other mealtime challenges
- Empowering children to feel confident in their unique ways of communicating
Behavioural Therapy or ABA therapy
Behavioural therapy, on the other hand, often focuses on changing specific behaviours to help children adapt to social norms or routines. It might involve setting goals to reduce behaviours like fidgeting, stimming, or avoiding eye contact, with a focus on teaching new behaviours to replace these. While some behavioural therapy methods help children build life skills, others can focus heavily on behaviour correction rather than natural self-expression.
Goals of behavioural therapy include:
- Reducing or modifying behaviours to meet social expectations
- Teaching alternative actions for behaviours seen as “disruptive” or “undesirable”
- Encouraging children to meet milestones based on typical developmental norms.
What Does Speech Therapy vs. Behavioral Therapy Look Like in Practice?
Speech Therapy
Speech therapy takes a child-led approach, where the therapist tailors the session to the child’s individual needs and interests. The focus is on building communication skills in a natural and supportive environment, guided by evidence-based practices that have been researched and proven to help children develop speech, language, and social skills. Speech therapists use a variety of strategies that are flexible and adaptive to each child’s pace and style of learning.
Example of a Child-Led Approach in Speech Therapy:
For instance, during a session, the therapist might observe the child’s favourite toy, and use it as an opportunity to model language. If the child is playing with a toy truck, the therapist might say, “The truck is going fast!” or “The truck is going up the hill!” The therapist will encourage the child to use words or phrases related to the activity, without forcing or pressuring them to respond.
If the child says “truck,” the therapist may expand on it by saying, “Yes, it’s a red truck!” or prompt them to say, “I see the truck” or “The truck is big.” The child is allowed to lead the direction of the play, while the therapist gently encourages language development through natural conversation and interaction.
Behavioral Therapy (ABA)
Behavioural therapy, or more commonly referred to as ABA (Applied Behavior Analysis) therapy, follows structured, principle-based approaches to modify behaviour. ABA relies on well-established principles of behaviour, such as reinforcement, prompting, and repetition, to help children learn specific skills. It focuses on breaking down complex tasks into small, manageable steps and reinforcing positive behaviour.
Example of ABA training where the therapist might be teaching the child about colours:
In ABA, teaching vocabulary often involves a highly structured method like Discrete Trial Training (DTT) (Lerman et al., 2016). In this approach, the therapist might present a red card and ask, “What color is this?” If the child responds correctly, they are reinforced with praise or a reward. If the child answers incorrectly, the therapist provides a prompt, such as, “This is red, can you say red?” and repeats the task. Typically, children are given a reward chart, and they receive rewards each time they correctly respond, such as stickers or tokens. This continues until the child consistently provides the correct answer, reinforcing the behaviour with each successful attempt.
While both therapies aim to teach important skills like vocabulary, speech therapy emphasises communication in context and builds on the child’s strengths, whereas ABA focuses on systematic teaching and behaviour modification based on principles.
Finding the Right Fit: Which Approach Aligns with Your Child's Needs?
It’s important to understand what each approach entails and how they align with your child’s unique needs. Research shows that parents can significantly improve their child’s outcomes by actively participating in therapy sessions (Leaf et al., 2024) By learning the goals, strategies, and techniques used in therapy, parents can help reinforce progress at home.
Speech therapists and ABA therapists approach communication differently. While ABA often focuses on behaviour modification and relies on external reinforcement, speech therapy centers around developing natural communication skills. The American Speech-Language-Hearing Association recommends that children with communication delays receive care from a licensed speech-language pathologist, even if they are also participating in ABA therapy. While ABA may provide structure and repetition in language learning, its focus on compliance can sometimes overlook a child’s individuality and emotional needs. In contrast, speech therapy emphasises child-led, play-based methods that support self-expression and provide tools for meaningful communication, rooted in research and tailored to each child’s developmental needs.
ABA therapy has been widely used but has faced criticism, particularly for its focus on behaviour modification rather than fostering authentic communication. Techniques like Discrete Trial Training (DTT) use rigid steps and external rewards, which can inadvertently prioritise conformity over a child’s unique communication style. Speech therapy, however, fosters an environment where children can naturally express their wants and needs without relying on external rewards or negative reinforcement.
While both therapies aim to improve communication, speech therapy, provided by professionals with specialised training in language development, is often the more appropriate choice for developing true communicative skills, especially for neurodivergent children. Speech therapists are trained to support children in expressing themselves and developing language in meaningful, natural contexts. For families choosing ABA, the most effective model is one that includes family involvement, individualised strategies, and collaboration with a team of professionals who respect the child’s autonomy and neurodiversity.
Ultimately, finding a therapy that supports your child’s communication development in a way that aligns with their unique needs and strengths is essential. Choosing a neurodiversity-affirming therapist—whether in speech therapy or ABA—can make all the difference in helping your child thrive.
References
Communication about autism: Considerations for Asha members. (n.d.).
https://www.asha.org/practice-portal/clinical-topics/autism/communication-about-autism/
Leafe, N., Pagnamenta, E., Taggart, L., Donnelly, M., Hassiotis, A., & Titterington, J. (2024). What works, how and in which contexts when supporting parents to implement intensive speech and language therapy at home for children with speech sound disorder? A protocol for a realist review. BMJ Open, 14(1).
https://doi.org/10.1136/bmjopen-2023-074272
Lerman, D. C., Valentino, A. L., & LeBlanc, L. A. (2016). Discrete trial training. Early intervention for young children with autism spectrum disorder, 47-83.
