The Big Question Parents Ask
You’ve just walked out of an evaluation. The doctor mentioned speech therapy, occupational therapy, maybe ABA therapy — and now you’re left wondering:
“Okay, but which one comes first? Do I start with speech therapy or ABA therapy? What if my child needs occupational therapy instead?”
This confusion is common. Parents often ask, “Which therapy comes first for autism?” or “Do kids need all three therapies (speech, OT, ABA)?” The truth? There’s no one-size-fits-all. What matters is early intervention.
Why Early Matters
Think of your child’s brain like play-dough. In the toddler years, it’s soft and moldable. Skills are easier to build. Wait too long, and things get harder to shape.
That’s why specialists emphasize early intervention autism therapies. Research shows that starting therapy early — whether it’s speech therapy, occupational therapy, or ABA therapy — leads to the best outcomes.
It’s not about panicking. It’s about giving your child the best shot at growth while their brain is most ready to learn.
Speech Therapy: Finding a Voice
For many families, speech is the first worry: “Why isn’t my child talking yet?” or “Why do they only repeat lines from shows?”
Speech therapy vs ABA therapy is a common parent debate, but the goals are different. Speech therapy focuses on communication itself, while ABA therapy for communication uses behavioral strategies to reinforce speech and language skills in everyday life.
What speech therapy works on:
- Understanding language (“Get your shoes”).
- Expressing needs (“more,” “help”).
- Social skills like turn-taking.
- Tools like picture cards or AAC devices.
Start with speech therapy if:
- Your toddler has very few words.
- They’ve lost words they once used.
- They echo phrases without using language functionally.
Parents sometimes ask, “Does speech therapy fall under occupational therapy?” The answer is no — they are separate but often work together.
Occupational Therapy: Everyday Life Skills
Occupational therapy vs ABA therapy is another common question. OT is not about behavior alone. It focuses on sensory processing difficulties, daily living skills, and fine motor development.
What OT helps with:
- Fine motor skills (grasping crayons, using utensils).
- Sensory needs (tolerating sounds, textures, lights).
- Self-care (dressing, brushing teeth).
- Play and participation in routines.
Start here if:
- Your child melts down due to sensory overload.
- They struggle with fine motor tasks.
- Everyday routines feel like battles.
OT is especially useful for children with developmental delays who need support in daily independence.
ABA Therapy: Structure and Behavior
When parents compare ABA therapy vs speech therapy vs occupational therapy, ABA often seems the most structured. It’s not about “fixing” kids. Done right, ABA is about using reinforcement to teach skills step by step.
What ABA therapy covers:
- Communication (verbal or AAC).
- Social interaction.
- Daily living skills.
- Safety and reducing harmful behaviors.
- Building flexibility (handling transitions).
ABA is often recommended when behaviors block progress in other therapies.
Parents also ask, “Is ABA part of occupational therapy?” No — ABA is its own discipline, provided by behavior analysts. But it complements OT and speech beautifully.
How They Work Together
Instead of “either/or,” think of these therapies as teammates:
- Speech therapy + ABA therapy: Speech teaches words. ABA reinforces them daily.
- Occupational therapy + ABA therapy: OT calms sensory systems so ABA teaching is more effective.
- Speech + OT: OT supports oral-motor control that helps speech clarity.
This multidisciplinary autism care ensures children don’t just learn skills in therapy — they use them at home, school, and play.
FAQs Parents Ask
1. Is OT or ABA better for autism?
Neither. OT focuses on sensory and motor independence. ABA builds behavior and learning. Most children benefit from both of them.
2. Which is better, ABA therapy or speech therapy?
If language is the biggest barrier, start with speech. If behavior blocks learning, ABA may need to begin alongside.
3. Does speech therapy fall under occupational therapy?
No. They’re different specialties, though they often collaborate.
4. Is ABA part of OT?
No. ABA is separate, led by behavior analysts. OT is led by occupational therapists. Together, they cover more ground.
Final Takeaway
Parents often search “Which therapy comes first for autism?” The real answer: it depends.
- Start with speech therapy if communication is the biggest challenge.
- Choosing occupational therapy if sensory needs or daily living skills are overwhelming.
- Begin ABA therapy if behavior is the barrier blocking everything else.
But the most important thing? Don’t wait. Early action — even if it’s not perfect — changes everything.
And you don’t have to figure it out alone. UniEliCare connects families with therapists across disciplines, coordinates care plans, and supports parents every step of the way.
Because your child deserves more than therapy. They deserve a team.