Most children with autism have difficulty with speech and language. Speech and language issues are addressed by Speech/Language Pathologists (SLPs or “speech therapists”), as well as Applied Behavior Analysis (ABA) therapists. So wouldn’t it be great if ABA and speech therapists worked together?
There are many similarities between ABA and speech therapy. Both SLPs and ABA therapists will conduct assessments to determine where a child is at in relation to his peers and look at factors such as vocabulary, length of sentences, articulation, grammar, tone, and functional communication. (Functional communication involves the recognition that challenging behaviors are a form of communication, and the focus is on replacing those behaviors with more appropriate communication, such as saying, “All done” instead of hitting. Functional communication also involves working on goals that are useful to the child in daily life).
However, in addition to evaluating what a child can and cannot say, SLPs also assess other issues related to speech and language such as the mechanics of speech production (e.g. tongue placement), executive functions (e.g. working memory, the planning and executing of cognitive functions, etc.) and whether or not the child has an auditory impairment. (SLPs also address feeding and swallowing issues.)
On the other hand, ABA professionals such as Board Certified Behavior Analysts are experts when it comes to analyzing behavior, and changing the environment (i.e. antecedents and consequences) to get appropriate behavior to occur- including language. In addition to speech and language, ABA therapists also target a range of other behaviors, including self-help skills, play skills, independent living skills, social skills, and academics. In contrast, SLPs keep the focus on speech and language and are experts in the diagnosis and treatment of communication disorders. Thus, SLPs usually have a broader understanding of language development and speech production, and ABA therapists have a broader knowledge of environmental factors- including teaching strategies and issues of motivation- that affect whether or not a behavior will occur.
The assessment tools, teaching styles, philosophical orientation, and terminology may differ, but the end result is the same: to determine what kind of speech and language deficits exist, to create goals for the child, and to help the child reach those goals.
Here are some ways ABA professionals and speech therapists can work together:
Communication between therapists is essential. I recommend discussing goals, progress, and teaching methods. Goals that are coordinated so that ABA and speech are working on at least some of the same goals at the same time is important to a successful, comprehensive treatment.
To take it a step further, the SLP and ABA therapist should actually observe each other’s therapy sessions with the client. Observations can help clarify any questions as to what or how the other professional works with the client. Observations can also help a professional assess whether or not the skills learned in one setting have generalized to the other setting.
For example, sometimes children with autism engage in challenging behaviors (e.g. “stimming,” hitting, screaming, etc.) that get in the way of their learning a particular skill. Understanding and using the principles of ABA (e.g. functional analysis of problem behavior, extinction, reinforcement, etc.) can lead to a reduction of behavior issues and improve the effectiveness of treatment.
Likewise, an SLP can educate the ABA therapist regarding which goals are developmentally appropriate. In addition, SLPs often address things which ABA therapists overlook, such as whether or not the child has mechanical issues interfering with speech production, such as misplacement of the tongue when speaking.
Furthermore, each professional can share what works for them, and what doesn’t work for them when interacting with the child during therapy.
There is no harm in compromising, or trying different strategies, especially if what you are doing is not working.
Respecting The Other Professional’s Knowledge and Expertise
SLPs and BCBAs have a history of not fully appreciating what each brings to the clinical setting. But the good news is that there is a growing trend toward collaboration between the two fields, especially when it comes to treating children with autism. As an SLP, you may not agree with everything the ABA person does. As an ABA therapist, you may not agree with everything the speech therapist does. However, both are experts in their own right, and both are effective with the populations they serve. Keep in mind that no one domain has all the answers. No single teaching method is sufficient to create a comprehensive treatment program. When it comes to speech and language, our children with autism and related disorders are in need of the best of both worlds.