ABA Therapy vs Occupational Therapy: Key Differences Explained
Understand how ABA therapy and occupational therapy differ and how they can work together. Learn which therapy addresses which needs for your child with autism.
Shamay Selim, M.Ed., BCBA
Clinical Director at Foundations Autism
ABA Therapy vs Occupational Therapy: What's the Difference?
ABA therapy and occupational therapy (OT) are both commonly recommended for children with autism, but they serve different purposes and use different approaches. Understanding these differences helps parents make informed decisions and coordinate care effectively.
Side-by-Side Comparison
| Aspect | ABA Therapy | Occupational Therapy |
|---|---|---|
| Provider | BCBA and RBT | OTR (Occupational Therapist Registered) and COTA |
| Focus | Behavior change, learning, communication, social skills | Sensory processing, motor skills, daily living activities |
| Hours | 10-40 hours/week typically | 1-3 hours/week typically |
| Approach | Behavioral principles, systematic teaching, data-driven | Sensory integration, developmental, activity-based |
| Setting | Home, center, school, community | Clinic (sensory gym), school, occasionally home |
What ABA Therapy Addresses
Core Focus Areas
- Behavior change and skill acquisition
- Communication and language
- Social skills and peer interaction
- Following directions and compliance
- Reducing challenging behaviors
- Daily living skills (behavioral approach)
- Academic readiness
How ABA Approaches Daily Living Skills
ABA breaks skills into teachable steps, uses reinforcement, and focuses on independence. For example, teaching tooth brushing through task analysis and systematic prompting.
What Occupational Therapy Addresses
Core Focus Areas
- Sensory Processing: How the brain interprets sensory input
- Fine Motor: Hand skills, writing, cutting, buttoning
- Gross Motor: Coordination, balance, body awareness
- Self-Regulation: Managing arousal and attention
- Activities of Daily Living: Dressing, eating, grooming
- Visual Motor: Eye-hand coordination
- Executive Function: Planning, organization, problem-solving
Sensory Processing in Autism
Many children with autism have sensory processing differences:
- Over-sensitivity to sounds, lights, textures
- Under-sensitivity requiring more sensory input
- Difficulty with motor planning
- Challenges with body awareness
- Trouble regulating arousal levels
Where They Overlap
Daily Living Skills
- Both address dressing, eating, grooming
- ABA focuses on behavioral learning and motivation
- OT addresses motor skills and sensory factors
- Coordination between therapies is valuable
Self-Regulation
- Both work on emotional regulation
- ABA teaches behavioral coping strategies
- OT addresses sensory-based regulation
- Combined approaches often work best
Play and Social Skills
- Both use play as a teaching tool
- ABA targets social interaction directly
- OT may address motor aspects of play
- Both can work on peer interaction
How They Work Together
Complementary Approaches
- OT identifies sensory needs that affect behavior
- ABA implements sensory strategies throughout the day
- OT addresses motor skills needed for tasks
- ABA practices tasks in behavioral framework
- Both communicate about child's progress
Example: Writing Skills
- OT role: Develops hand strength, grip, posture, visual-motor skills
- ABA role: Increases writing motivation, teaches letter formation behaviorally, practices generalization
Example: Tolerating New Foods
- OT role: Addresses oral motor, sensory sensitivity, texture tolerance
- ABA role: Uses gradual exposure, reinforcement, behavior momentum
When to Prioritize Each
Prioritize ABA When:
- Communication is significantly delayed
- Challenging behaviors are the main barrier
- Social skills need intensive focus
- Overall learning needs comprehensive intervention
- More intensive hours are needed
Prioritize OT When:
- Sensory issues significantly interfere with function
- Fine motor delays affect daily activities
- Handwriting is a major challenge
- Self-regulation is driven by sensory needs
- Feeding issues have sensory/motor components
Coordinating ABA and OT
For children receiving both therapies:
- Request that providers communicate
- Share assessments between teams
- Coordinate on overlapping goals
- Ask OT for sensory strategies ABA can use
- Have ABA reinforce OT skills throughout the day
- Include both in IEP meetings if applicable
Questions to Discuss with Your Team
- What are my child's primary needs right now?
- How do sensory issues affect behavior and learning?
- What motor skills need development?
- How will the therapies coordinate?
- What can each therapy uniquely offer?
- How will we avoid conflicting approaches?
Insurance Considerations
- ABA: Typically covered under autism/behavioral health benefits
- OT: Typically covered under medical/rehabilitation benefits
- Both may require prior authorization
- Hour limits may differ between therapies
- School-based OT may be available through IEP
Got questions?
Frequently Asked Questions
Common questions about this topic.
ABA therapy focuses on behavior and learning using behavioral principles, while occupational therapy addresses sensory processing, motor skills, and activities of daily living. ABA uses systematic behavior change strategies; OT uses sensory integration and developmental approaches.
Many children with autism benefit from both. ABA addresses behavioral learning and communication, while OT addresses sensory processing issues, fine motor skills, and helps children regulate their bodies. They complement each other well when coordinated.
ABA therapists can address behavioral responses to sensory input (like tolerance for different textures) but aren't trained in sensory integration therapy. An occupational therapist evaluates and treats underlying sensory processing differences.
This depends on your child's most pressing needs. If behavior and communication are the biggest barriers, start with ABA. If sensory issues significantly interfere with function, start with OT. Many families start both simultaneously, especially after an autism diagnosis.
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