Can ABA and speech therapy be done at the same time?

Yes, many children receive both therapies simultaneously. It is often the most effective approach when providers collaborate on shared goals. For example, an ABA therapist may reinforce the same words or communication strategies introduced by the speech-language pathologist. This ensures skills are practiced across different settings.

Does insurance cover both ABA and speech therapy?

Most private insurance plans cover ABA therapy for autism, often under behavioral health benefits. Speech therapy is also typically covered under medical or habilitative benefits. Medicaid covers both therapies in all states, though specific requirements vary. It's important to verify with your plan and choose in-network providers to minimize costs.

How do I know if my child needs ABA or speech first?

The decision should be based on a comprehensive assessment by a BCBA and an SLP. If your child has significant challenging behaviors (aggression, noncompliance) that interfere with learning, ABA usually comes first to build foundational skills. If your child is well-regulated but has severe communication delays, speech therapy may start first. Collaborate with your team to create a phased plan.

What if my child is nonverbal? Should we start with speech or ABA?

A nonverbal child can benefit from both therapies. Often, ABA begins first to establish joint attention, imitation, and motivation to communicate. Once the child is ready, the SLP can introduce AAC systems like picture cards or speech-generating devices. Many BCBAs and SLPs work together to bridge behavior and communication seamlessly.

How can Local ABA Therapy help me find a provider?

Local ABA Therapy is a free matching service. We listen to your child's needs, location, and insurance details. Then we connect you with vetted, BCBA-led ABA therapy providers who are experienced in collaboration with speech therapists. Our goal is to help you start an integrated care plan that addresses both behavioral and communication goals.

Is speech therapy effective without ABA?

Speech therapy can be effective on its own for children who do not have significant behavioral challenges blocking learning. However, for many children with autism, ABA helps build the attention, imitation, and compliance needed to benefit fully from speech therapy. Combining both usually produces the strongest outcomes.

ABA vs Speech Therapy: Which Comes First For Autism?

In short: There is no one-size-fits-all answer to whether ABA or speech therapy should come first. The decision depends on your child's behavioral readiness, communication needs, and the recommendations of assessing professionals. Many children benefit from both therapies working together, and a free service like Local ABA Therapy can connect you with BCBA-led ABA providers who often collaborate with speech-language pathologists.

Understanding ABA Therapy and Speech Therapy

When a child receives an autism diagnosis, families often hear about two main therapies: Applied Behavior Analysis (ABA) and speech-language therapy. Both are evidence-based and can dramatically improve a child's quality of life. But they target different core areas. ABA therapy focuses on understanding and changing behavior, teaching new skills like communication, social interaction, and daily living through positive reinforcement. It is typically led by a Board Certified Behavior Analyst (BCBA). Speech therapy, delivered by a licensed speech-language pathologist (SLP), addresses communication disorders including expressive and receptive language, articulation, social pragmatics, and alternative augmentative communication (AAC).

What is Applied Behavior Analysis (ABA)?

ABA is widely recognized as a gold-standard intervention for autism. It uses data-driven strategies to increase helpful behaviors (like requesting a toy) and decrease harmful ones (like aggression). A BCBA designs a personalized plan that breaks down skills into small, teachable steps. Sessions are often one-on-one, and progress is tracked daily. Most major insurance plans, including Medicaid, cover ABA therapy when deemed medically necessary for autism.

What is Speech-Language Therapy?

Speech therapy targets all aspects of communication. An SLP assesses a child's ability to understand language, use words and sentences, pronounce sounds correctly, and engage in conversation. For nonverbal children, the SLP may introduce AAC tools such as picture boards or speech-generating devices. Speech therapy also addresses social communication-like taking turns in conversation or understanding nonverbal cues. Many SLPs work in clinics, schools, or private practice, and therapy is often covered by insurance.

A young child and an encouraging adult working on a large floor puzzle together near a sunny window

🔗 Related reading: California Early Intervention Programs: A Complete Guide · Find ABA Near Me

The Core Question: Does ABA or Speech Come First?

There is no universal rule that ABA must always start before speech therapy, or vice versa. The best sequence depends entirely on the child's individual profile. A thoughtful assessment by both a BCBA and an SLP is the first step. Below we break down scenarios where one therapy might take an early lead.

When ABA Might Come First

If a child exhibits severe challenging behaviors-such as frequent meltdowns, aggression, or self-injury-those behaviors can block any learning, including communication. ABA therapy excels at reducing these barriers. A BCBA can teach the child to sit at a table, make eye contact, and imitate sounds or actions. These foundational skills are prerequisites for speech therapy to be effective. Once the child is more regulated and responsive, the SLP can step in to build language. In many cases, starting with a few months of ABA (even just 10-15 hours per week) makes speech therapy far more productive.

When Speech Therapy Might Come First

For children who are already calm, attend well, and have few interfering behaviors, speech therapy can begin immediately. For example, a preschooler who is highly motivated by toys but speaks only a few words may benefit from an SLP who introduces visual supports or AAC. The SLP can also address feeding or oral-motor issues that affect speech. If the child's main challenge is communication, early speech therapy can provide a voice-literally. Once the child begins to communicate, the BCBA can then layer in social skills, such as requesting from a peer or following multi-step instructions.

The Collaborative Approach: Simultaneous or Integrated

Increasingly, experts recommend a team-based model. ABA and speech therapy can run concurrently, with therapists sharing goals. For instance, the BCBA might work on requesting a snack using a single word, and the SLP targets the same word's correct articulation. Or the SLP teaches a child to use a picture exchange system, and the ABA therapist reinforces that exchange throughout the day. Many ABA providers, including those matched through Local ABA Therapy, routinely communicate with SLPs to ensure consistency. This collaboration often accelerates progress because skills are practiced across settings and people.

How to Decide? A Practical Framework

Free matching services like Local ABA Therapy exist to help you navigate these decisions, but you still need input from professionals. Here's a step-by-step approach.

Assessment by Professionals

Schedule evaluations with both a BCBA and an SLP who have experience in autism. They will administer standardized tests, observe your child, and interview you. The BCBA will identify skill deficits and behavior excesses. The SLP will measure language comprehension, expression, and pragmatics. After assessments, ask each provider: "What do you see as the primary barrier to my child's learning?" If the answer is behavior, ABA likely comes first. If it's communication, speech may take the lead.

Consider the "Readiness" Factors

Think about your child's current ability to attend to an adult, follow simple instructions (like "sit down"), and tolerate transitions. If your child cannot sit for even two minutes without a tantrum, speech therapy will struggle. ABA can build that readiness. On the other hand, if your child is cooperative but silent, speech therapy can jumpstart communication. Also consider age: very young children (under 3) often enter early intervention programs that blend both disciplines.

Parent and Caregiver Insights

You know your child best. Write down the top three challenges you face daily. If your child's aggressive outbursts are the biggest concern, prioritize ABA. If you're mostly worried that your child can't tell you what they want or need, speech therapy may be the urgent need. Share your observations with the assessment team. Together you can create a phased plan.

An adult reading a storybook to two attentive young children sitting on a colorful rug

🔗 Related reading: Tennessee Autism Resources & Support Guide · Nearby ABA Therapy

The Role of Early Intervention and Insurance

Funding and availability often influence the order of therapies. Understanding your options can prevent delays.

Early Intervention Programs

In most states, Early Intervention (Part C of IDEA) serves children birth to 3 years old with developmental delays. These programs often provide speech therapy and may offer ABA or behavior support, though coverage varies. If your child is under 3, an EI evaluation is a great starting point. The EI team may recommend both therapies simultaneously. Local ABA Therapy can help you find BCBA-led providers that work with EI agencies.

Insurance Coverage for ABA and Speech

The vast majority of private insurance plans (including those purchased through the Marketplace) cover ABA therapy for autism, thanks to state mandates and the Affordable Care Act. Medicaid programs in all 50 states now cover ABA, though waitlists can apply. Speech therapy is also typically covered. To minimize out-of-pocket costs, choose in-network providers. Our free matching service helps you identify vetted ABA providers who accept your insurance. We can also connect you with providers who collaborate with SLPs.

Financial Considerations

The cost of both therapies can be significant, especially if you pay privately. ABA ranges from $120 to $200 per hour depending on location and provider type. Speech therapy is often $100-$150 per hour. Insurance drastically reduces these costs. If you have a high deductible, ask about payment plans or sliding-scale options. Early intervention programs may be free or low-cost. Never delay starting a therapy solely because of cost-most families find that insurance coverage is excellent once they work with a vetted provider.

Common Mistakes to Avoid

Parents navigating this decision sometimes fall into traps. Here are key ones to avoid:

Waiting too long to start any therapy. The earlier you begin, the better the outcomes. Even a few weeks of ABA can prepare a child for speech work.
Choosing one therapy over the other solely based on availability. Avoid starting speech just because the SLP has an opening immediately. Instead, get on waitlists for both and prioritize based on need.
Failing to ensure collaboration between therapists. If your ABA provider and SLP never speak, goals may conflict. Insist on regular communication or shared notes. Many good providers schedule joint meetings.
Ignoring your child's stress. If your child is overwhelmed by too many therapy hours, it can backfire. Quality matters more than quantity. A balanced schedule with breaks is essential.
Assuming one therapy is "enough." A child with autism often benefits from both ABA and speech. They address different aspects of development. Relying on one alone may leave gaps.

An adult and a young child pointing together at colorful picture-learning cards on a table

How Local ABA Therapy Can Help

Local ABA Therapy is a free nationwide service that connects families with vetted, BCBA-led ABA therapy providers. We understand that finding the right provider can be overwhelming, especially when you're also juggling speech therapy decisions. When you contact us, we listen to your child's needs and your insurance situation. We then match you with providers who are experienced in collaboration-many have SLPs on staff or strong referral relationships. Our service is completely free; we are compensated by the providers we recommend. This allows you to focus on what matters: getting your child the right combination of therapies.

We also provide guidance on how to talk to insurance companies and early intervention coordinators. While we are not a therapy provider ourselves, we are a trusted bridge. As you decide between ABA or speech first, we can help you find an ABA provider who will conduct a thorough assessment and coordinate with your child's SLP. That integrated approach often leads to the best outcomes.

Moving Forward: A Personalized Plan

Ultimately, the question "ABA vs speech therapy which comes first" has no one-size-fits-all answer. The best path is a dynamic, child-centered plan that evolves as your child grows. Start with professional assessments, consider your child's behavioral readiness, leverage insurance coverage, and ensure your providers communicate. Whether ABA takes the lead or speech does, remember that both therapies are powerful tools. With a supportive team and the right start, your child can make meaningful progress in communication and daily living.

If you're ready to explore ABA options, reach out to Local ABA Therapy today. Our team can match you with experienced BCBAs who understand how to sequence therapies for maximum benefit. It's free, and it could be the first step toward a more coordinated care plan for your child.

ABA vs Speech Therapy: Which Comes First for Your Child?

Key takeaways