ABA Therapy vs Occupational Therapy: What Parents Should Know

TABLE OF CONTENT

Key Takeaways:

ABA therapy aims to build communication, social, and behavioral skills though structured sessions
OT helps builds independence in daily routines with play and activity-based sessions
ABA tends to be more structured and goal-based, while OT is more creative and flexible
Many families use a combination of both ABA and OT to provide well-rounded support for their child

With so many therapy options available, choosing the right one for your child can be overwhelming. You’re not alone in that, as many families feel the same way when beginning. Two of the most popular and effective evidence-based therapies are Applied Behavior Analysis (ABA) and Occupational Therapy (OT). Each of them can support your child in different ways.

This guide will help go over what ABA and OT are, how they differ, and how they can work together to help support your child’s growth and development. Although this guide focuses on how ABA and OT can help your child with autism, these therapies can also help support children with other developmental challenges.

What Is ABA Therapy?

ABA helps children improve their communication, social, and life skills through structured, evidence-based techniques like positive reinforcement and repetition.

Positive reinforcement rewards and encourages good behaviors like following directions or saying please or thank you. Repetition is when skills are done over and over so that they become second nature for your child.

For example, your child can be taught to ask for help and communicate how they feel instead of crying or throwing a tantrum. Over time, your child can build confidence and learn skills to make daily life feel more manageable.

ABA programs are supervised by highly-qualified Board Certified Behavior Analysts (BCBAs), who work hard to ensure that your child’s sessions are structured and goal-oriented.

What Is a Typical ABA Session Like?

With Alpaca Health, ABA is flexible and can fit into your lifestyle, as services can be offered at school, in-clinic, online, or in the comfort of your own home. Sessions are specifically designed to meet the needs of your family. No two sessions are exactly alike.

A typical session is guided by a BCBA and includes a variety of structured activities that build rapport, develop skills, and reinforce concepts that were already introduced. Some of these activities keep your child engaged through games or social interaction. These sessions are usually very structured and can have a time commitment of around 10 to 40 hours per week.

What Is Occupational Therapy?

In contrast to ABA, OT helps children with autism build confidence and independence in their activities of daily living. These tools can include fine-motor, self-care, and sensory processing skills. For example, children can improve their fine motor skills and coordination by making shapes with playdough.

The word “occupational” may make it sound like the therapy’s focus is on the workplace. However in this case, “occupational” refers to daily life activities such as playing, learning, and getting dressed.

What is a Typical OT Session Like?

Just like with ABA therapy, each OT session is unique and tailored specifically to the needs of your child. A licensed occupational therapist will make sure that each session is goal-oriented by focusing on activities to help your child develop independence with daily life skills. These sessions are usually creative and “play-based.” For example, they may be taught fine motor skills by doing activities like writing or drawing.

Key Differences Between ABA and OT

Now that we’ve learned the basics of what ABA and OT are, we can highlight their key differences. Both of them help children thrive, but they each differ in focus, structure, and goals. The table below summarizes some of these differences:

Aspect	Applied Behavior Analysis	Occupational Therapy
Core Focus	Shapes behavior, communication, and social responses through structured learning.	Builds sensory, motor, and self-care skills for independence in daily routines.
Philosophy	Behavior change happens through reinforcement and repetition.	Growth happens through meaningful activities and sensory experiences.
Approach	Highly structured and data-driven; progress measured step by step.	Flexible and play-based; progress is built through exploration and engagement.
Assessment	Analyzes behavior patterns to understand triggers and outcomes (Functional Behavior Assessment).	Evaluates how sensory, motor, and cognitive factors affect everyday function.
Session Format	Intensive, 10–40 hrs/week; guided by a BCBA with structured protocols.	Moderate, 1–3 hrs/week; guided by an OT using creative, activity-based plans.
Techniques Used	Reinforcement, prompting, modeling, and repetition.	Sensory integration, fine/gross motor exercises, and environmental adaptations.
Goals	Reduce challenging behaviors and teach new, functional behaviors.	Improve sensory regulation, coordination, and everyday independence.
Progress Tracking	Quantitative; tracked with data, charts, and measurable goals.	Qualitative; observed through functional success and confidence in tasks.
Parent Involvement	Parents learn behavioral strategies to reinforce progress at home.	Parents practice sensory and motor activities to generalize skills at home.
Best For	Children who need help with communication, routines, or behavior regulation.	Children who need support managing sensory input or fine-motor challenges.

A few of the biggest key differences between ABA and OT are:

ABA focuses on behavioral and communication skills, while OT focuses on daily routines and activities
OT is more “hands-on” and play-based, while ABA is more structured and focused on measurable goals
ABA helps modify behaviors by encouraging positive ones and discouraging challenging ones, while OT is focused on building confidence in daily tasks

With all this being said, each therapy has a unique role in helping your child with autism develop important skills. The right choice will ultimately depend on what your child’s individual needs are. In many cases, both ABA and OT are used to complement each other and provide a comprehensive approach to building your child’s developmental and behavioral skills.

Just like with beginning any form of therapy, your qualified health professional can help you see what program or combination makes the most sense for your family.

How ABA and OT Work Together

Because ABA and OT work on different skillsets, a combination of both can help ensure that your child receives well-rounded care.

The skills learned in each therapy reinforce each other. Improving communication abilities through ABA can help your child gain more independence when doing daily activities such as brushing their teeth, getting dressed, or cleaning their room. For example, ABA can help your child follow and maintain a bedtime routine, while OT can help them manage their sensory processing when putting on their pajamas.

Working with both occupational therapists and BCBAs helps you and your child approach care from different perspectives. Providers often communicate with each other though shared progress notes or coordination meetings. Your role as parent involves helping your child carry over the strategies and routines they’ve learned to a home setting.

If all of this sounds very complicated, it’s reassuring to know that children typically do best when each therapy reinforces the same goals in different ways. Teamwork is essential!

Do you need help coordinating care? Alpaca Health takes the stress out of scheduling, insurance, and referrals so you can focus on what’s important. See how we support families with ABA therapy in your area.

How to Decide if ABA or OT Therapy is a Better Fit for Your Child

Every child is unique, so there’s no “one-size-fits-all” approach when it comes to choosing therapies for autism that best fit your child’s needs. It helps to know that this uncertainty in choosing is completely normal! To help guide you, here are a few questions to ask yourself:

Does my child get frustrated when trying to communicate or follow directions?
Does my child avoid or seek certain sensations (touch, sound)?
Does my child find daily routines, like dressing, brushing teeth, or mealtime, difficult?
Does my child struggle with focus, balance, or hand-eye coordination?
Does my child have frequent meltdowns or trouble with transitions?

If you answered “yes” to any questions about behavioral or communication challenges (following directions, meltdowns, trouble with transitions, etc.), then ABA might be a good fit for your child’s needs.

If questions about difficulties with daily life activities caught your attention (sensory sensitivities, routines, coordination, etc.), then OT might be helpful for your child.

If you’ve noticed challenges with both behavioral and motor skills, then a combination of ABA and OT may provide the most comprehensive support for your child. In fact, many families have successfully used both kinds of therapies to provide well-rounded care.

These questions can help you get a better idea of what therapies may be effective. In the end, the best way to determine the right fit for your child’s needs is to speak with a licensed BCBA or OT for guidance.

ABA vs OT FAQs

Can ABA and OT sessions happen on the same day?

It’s possible, but will depend on several factors such as insurance coverage, scheduling availability, and your child’s needs. Your BCBA or OT can help you figure out if same-day ABA and OT make sense for your family.

Which therapy should come first, ABA or OT?

This depends on your child’s specific needs. Your BCBA or OT can help determine if starting a particular therapy first or even beginning with a combination would be most helpful for your child.

How do I coordinate communication between ABA and OT providers?

When your child begins either therapy or a combination of the two, it’s important to be actively involved as a parent. Your ABA and OT providers will work with you to coordinate care and make sure that everything runs smoothly.

How do I know when my child is ready to start both therapies at once?

As every child is unique and has different goals, your BCBA or OT can help you figure out if starting both therapies at once is a good choice.

How Alpaca Supports Families From the Start

Whether your child needs ABA, is already in OT, or could benefit from a combination, we’re here to help you. You can rest easy knowing that all the hard work is done for you, so you can focus on what really matters.

Ready to explore ABA therapy services for your child? Alpaca Health connects families with local, independent providers in just a few days. No need to worry about waitlists or loads of paperwork.